by RedStateGreen » Mon 19 May 2008, 19:26:48
$this->bbcode_second_pass_quote('Prince', '')$this->bbcode_second_pass_quote('RedStateGreen', 'T')hat's after a bachelor's degree, four years of medical school, and another three of residency (where you're paid less than minimum wage -- we figured it out in internship and it was $1.70/hour
).
You come out on average with $100,000 of debt, and that's your salary. For sixty-hour workweeks minimum, BEFORE call.
I'm engaged to a doctor, so I'd like to point out some of the blatant lies and misconceptions in your post.
Way to flame, dude.
$this->bbcode_second_pass_quote('', 'F')irst off, I'm not sure when you did residency, but now they work 80 hrs/week tops, and that's usually only in Year 1. In years 2-4, they usually work an average of 60 hours or less. They are paid roughly $38,000 in Y1 and it goes up steadily to $50,000 by Y3-4. So given the worst case (Y1):
$38,000/(80hrs * 50wks) = $9.50/hr in the WORST CASE. Obviously, this is much higher than minimal wage. Adjusted for inflation, I'm sure your $1.70/hr is well above today's minimum wage, so either retake Math 101 or quit bullshitting us.
You're very rude.
I graduated from med school well before 'residency lite', and I did my residency at a county hospital. We worked well over 90 hours a week (my top was 110, while pregnant with my first, during internship).
But if you would have actually read what I wrote you would see that I was speaking of being an attending physician, which you have yet to learn the joys of. I worked 60 hour weeks before call, which in my group was every night during the week with rotating weekends.
$this->bbcode_second_pass_quote('', 'A')s for the bachelor's degree + medical school + residency argument, this is weak for a few reasons. First, everyone who goes to college gets a BS/BA degree, so now we're down to medical school + residency. [s]Residency, we just learned, is paid well enough to survive comfortably[/s]
FIXED, so now we're down to just the 4 years of medical school. A fair number of college graduates (non-medicine) today seek MS/MA degrees, so now the only real difference is 2 years of additional school for the medical student vs traditional college student. Couple that with the fact that the average college graduate still has debt, has far less job security than medicine, and might end up with a $45k/yr job if he's lucky, and that resident salary isn't looking so bad now, is it.
$this->bbcode_second_pass_quote('efarmer', '&')quot;Taste the sizzling fury of fajita skillet death you marauding zombie goon!"
by Pretorian » Mon 19 May 2008, 21:56:06
$this->bbcode_second_pass_quote('AgentR', '')$this->bbcode_second_pass_quote('Pretorian', 'w')ait a minute. There is no malpractice policy or insurance. When a doctor fuckes you up, due to negligence or ignorance, he goes to prison directly, to get a break ( vacation? ) and reread some books. What made you think you are entitled to get any money? You can apply for a state assistance as anybody else with disability.
And exactly how does the malpractice attorney get his payout if the doctor goes to jail and there is no insurance.
If you can't find a way for the attorney to get his cut; and the doc to stay in a quasi "self employed businessman" environment.. It ain't happening.
Doesn't matter whether your idea is good, bad, or indifferent. Those two facets are non-negotiable in our political system.
It is not my idea, its how it works in a number, if not all , of countries with socialized healthcare. The idea that a doctor can kill someone and make other patients pay off his dues is a bit weird to me.
by AgentR » Tue 20 May 2008, 09:13:47
$this->bbcode_second_pass_quote('Pretorian', '')$this->bbcode_second_pass_quote('AgentR', ' ')If you can't find a way for the attorney to get his cut; and the doc to stay in a quasi "self employed businessman" environment.. It ain't happening.
Doesn't matter whether your idea is good, bad, or indifferent. Those two facets are non-negotiable in our political system.
It is not my idea, its how it works in a number, if not all , of countries with socialized healthcare. The idea that a doctor can kill someone and make other patients pay off his dues is a bit weird to me.
Ok fine. Doesn't matter whether THE idea is good, bad, fair, unfair, or indifferent, if THE IDEA doesn't provide for the attorney to get his cut; and the doc to stay in a quasi "self employed businessman" environment, it ain't happening.
Jail or no jail..... couldn't care less. Though, I don't think there'd be many docs willing to take interesting or complicated patients, if jail was the potential result for failure. The money just isn't that good.
Yes, we are. As we are.
And so shall we remain; Until the end.
by smallpoxgirl » Tue 20 May 2008, 12:49:24
$this->bbcode_second_pass_quote('AgentR', 'J')ail or no jail..... couldn't care less. Though, I don't think there'd be many docs willing to take interesting or complicated patients, if jail was the potential result for failure. The money just isn't that good.
I would actually disagree with that. I think it would be a fabulous thing if malpractice moved from the civil to the criminal courts. The reality is that very few doctors would ever be prosecuted in criminal court, and the few that were, should be. With the civil system, most doctors face litigation at some point in their career. For the average OB, it happens every few years. The standards are so much different for civil court that doctors frequently face ruinous litigation for things that would never get anywhere in criminal court. It also creates the malpractice lottery. If you can convince a jury that your doctor messed up, congratulations, you just won the powerball. The few doctors that do practice in a criminally negligent way, should go to jail. I'd much rather take my chances with criminal charges than to pay $30,000 a year to funding a lottery for any patient that decides to get rich by accusing me of malpractice.
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by vision-master » Tue 20 May 2008, 13:21:59
$this->bbcode_second_pass_quote('smallpoxgirl', '')$this->bbcode_second_pass_quote('AgentR', 'J')ail or no jail..... couldn't care less. Though, I don't think there'd be many docs willing to take interesting or complicated patients, if jail was the potential result for failure. The money just isn't that good.
I would actually disagree with that. I think it would be a fabulous thing if malpractice moved from the civil to the criminal courts. The reality is that very few doctors would ever be prosecuted in criminal court, and the few that were, should be. With the civil system, most doctors face litigation at some point in their career. For the average OB, it happens every few years. The standards are so much different for civil court that doctors frequently face ruinous litigation for things that would never get anywhere in criminal court. It also creates the malpractice lottery. If you can convince a jury that your doctor messed up, congratulations, you just won the powerball. The few doctors that do practice in a criminally negligent way, should go to jail. I'd much rather take my chances with criminal charges than to pay $30,000 a year to funding a lottery for any patient that decides to get rich by accusing me of malpractice.
I know a former "whisle-blower" Doctor. They paid her off, she went to Law school and now teaches Medical Law. You Doctor peeps are as bad as Cops. Protect your own at any cost.
by AgentR » Tue 20 May 2008, 13:56:09
$this->bbcode_second_pass_quote('smallpoxgirl', 'I')'d much rather take my chances with criminal charges than to pay $30,000 a year to funding a lottery for any patient that decides to get rich by accusing me of malpractice.
You do have a point about the standards for conviction in criminal court... Still think you'd have a heck of a time convincing the avg doc that risking criminal prosecution in lieu of current civil actions would be worth it.
Either way its a mess; and can't happen in this country as long as the Dems are locked up by the trial lawyers, and Reps are bound to the AMA business folks. A stronger guarantee of no-action you couldn't design on purpose.
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by smallpoxgirl » Tue 20 May 2008, 14:23:56
$this->bbcode_second_pass_quote('AgentR', 'Y')ou do have a point about the standards for conviction in criminal court... Still think you'd have a heck of a time convincing the avg doc that risking criminal prosecution in lieu of current civil actions would be worth it.
I don't think so. If someone can show beyond a reasonable doubt that you committed criminal negligence, then they SHOULD go to jail. I don't think any doctor would have a problem with that. The problem with the current system is that most claims arise from situations where the patient had a bad outcome that was only minimally related to anything the doctor did. The patients then are sick and are often struggling economically. We've created this giant pot of gold through malpractice insurance. The sick patients look at their situation, look at the pot of gold, and it is incredibly tempting to go for it. Add in the lawyers salivating over the same pot of gold, and you've got a very bad situation. I am much less concerned about the local DA deciding to maliciously prosecute me, than I am about some low life plaintiff's attorney deciding to buy a scratch ticket and go for the grand prize. I don't think most doctors have a problem with being held accountable for their actions in a reasonable way. Many malpractice claims involve doctors who were practicing medicine appropriately and still got sued. The US has criminal negligence statutes. I bet there's not more than one doctor a year prosecuted under them, because it's a very high standard to show. That's a way different situation from civil court where the prosecution pays an "expert" witness big bucks to lie under oath and the jury who knows nothing about medicine applies the "more likely than not" standard in assigning blame. For the lawyers, civil court is a giant slot machine. Keep at it and eventually you'll get lucky and get the big payout.
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The way things were before
I lost my way" - OCMS
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by Ferretlover » Tue 20 May 2008, 18:08:09
$this->bbcode_second_pass_quote('Prince', '')$this->bbcode_second_pass_quote('SteinarN', 'A')s to the sentence in bold, in Norway, the hospitals get a fixed sum every year to make do with. This restricts in a way what treatment is available. Some of the most expensive threatments is limited to some degree, at least if the outcome for the patient is dubious. Thereby the total cost for health care is not alowed to skyrocket, but at the same time the health care given is at a reasonably level for every citizen.
I'm not saying this is the best system, but I would like to see a bit more open discussion.
We're not talking about Norway, so your points are irrelevant.
Prince, I disagree. Since the US does not have national health, people in nations that do have this program can expand the discussion based on the good and bad that have developed in those programs.
It also wouldn't hurt if you were a bit more polite.
Last edited by
Ferretlover on Tue 20 May 2008, 22:03:23, edited 2 times in total.
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by smallpoxgirl » Tue 20 May 2008, 18:51:26
$this->bbcode_second_pass_quote('Byron100', 'T')o tell you the truth, the kind of universal health system I would propose for the US is a basic, no-frills system based on modest, let's say, 1960's standards. To treat a patient with 1960's tech would be quite economical, and really not that much drastically different than today's medical tech, with the exception of the very few. I'd be thrilled to death if I could get on a basic 1960-level plan for free, and have 95% of all medical mishaps taken care of at low cost, then be stuck with the horrid, bewildering array of modern-day treatments. I plan on dying at home, not at a hospital. If we can get the entire US to start thinking this way, then maybe we have a chance.
Thank would be absolutely wonderful! The problem is that there is no way in the world that Americans would tolerate it. The Oregon Health System is a perfect example. A few years ago, Oregon spent a ton of effort revamping it's medicaid system. They made a list of all the medical treatments they could think of. Then they spent a long time interviewing medicaid enrollees finding out what services they wanted and interviewing public health authorities figuring out what medical treatments provided the most benefit for the least cost. They ended up with a list of procedures from most important to least important. When they got their budget from the legislature they drew a line on the list. Everything above the line was covered. Everything below the line wasn't. It was a great system. Everybody had unfettered access to primary care. They could get their teeth fixed. Life was great. Then a little girl got renal failure. Medicaid said "Look. We're very sorry. Kidney transplants are below the line. They don't provide enough health benefit for the money, we can't afford them, and they're not covered." All the bleeding hearts went into conniptions. They wrote their senators who went into conniptions, and the whole system was scrapped. Americans don't want and will not tolerate affordable healthcare. The want wasteful, excessive, ineffective healthcare, and they want someone else to pay for it.
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by jlw61 » Tue 20 May 2008, 20:28:07
$this->bbcode_second_pass_quote('Byron100', 'T')o tell you the truth, the kind of universal health system I would propose for the US is a basic, no-frills system based on modest, let's say, 1960's standards.
I'm sorry but I have a problem with this. No transplants? Only older antibiotics? No EMS? No stents? External Pacemakers? Amputated limbs are thrown away? No MRIs? No modern diagnostic tools? No plastic bag IVs? No flexible IV needles?
Do you really mean this?
The 1960's were like the stone age compared to today's medicine and a lot of people are alive today because of those advancements.
When somebody makes a statement you don't understand, don't tell him he's crazy. Ask him what he means. -- Otto Harkaman, Space Viking
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by Milret2 » Tue 20 May 2008, 20:55:50
$this->bbcode_second_pass_quote('jlw61', '')$this->bbcode_second_pass_quote('Byron100', 'T')o tell you the truth, the kind of universal health system I would propose for the US is a basic, no-frills system based on modest, let's say, 1960's standards.
I'm sorry but I have a problem with this. No transplants? Only older antibiotics? No EMS? No stents? External Pacemakers? Amputated limbs are thrown away? No MRIs? No modern diagnostic tools? No plastic bag IVs? No flexible IV needles?
Do you really mean this?
The 1960's were like the stone age compared to today's medicine and a lot of people are alive today because of those advancements.
"No transplants, only older antibiotics, no stents, external pacemakers, no plastic IV bags" .... how much of that level of care will be available at pretty much any price after our civilization realizes that peak oil has happened? Petroleum has an integral part to play in all modern health care. I sort of suspect that most of the tools/techniques you list as an example of what is not stone age medicine will disappear very quickly as petroleum gets more and more expensive.
I was, back in the late 60's, a licensed nurse and remember having to calculate flow rates using the drip chamber stuck in a glass IV bottle. I also remember, in Viet Nam, getting my foot cut on some IV glass from a bottle that was broken while trying to help someone hurt in a mortar attack at night on our firebase ... I was barefoot as I had been sound asleep before the incident. A few years later I became a physician's assistant and watched such things as advanced life support, metered infusion of both fluids and meds, pulse oximetry, pocket telemetry, and the like become a standard part of care. I happily retired from medicine in 1994 ... only a couple of years after the ER I was working in got it's first computer .. which was dedicated pretty much only to poison control stuff.
Anesthesiology ain't primary care. Some of us have to work for a living.
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