Posted on 04/23/2013 8:01:21 PM PDT by neverdem
The result has been a flood of foreign trained doctors who qualify to practice here, over whose training the AMA has exercised '0' influence, except in after-the-fact testing.
In addition, medical schools practice the same perverse admission policies as colleges, universities, police departments, and corporate HR .... that is a normal white man has about the same chance as the old camel-through-the-eye-of-of-the-needle thing.
I don’t think AMA gets any money out of using ICD-9 or the forthcoming disaster of ICD-10, the diagnosis coding. They get it for CPT, the procedure coding, which isn’t changing, at least not yet. AMA was foolish to go along with ICD-10 initially, and came to its senses too soon to stop it.
bookmark
well just watch....the national outcry for drs will begin and the govt will graciously step in and give out free rides for the blacks, and other minorities, and decrease requirements....
The EMR (Electronic Medical Record) in Emergency Medicine reduces productivity - the number of patients who can be seen by an individual physician - by AT LEAST 30%. That is after a minimum of 3 months to become proficient with the system.
Instant Doctor shortage.
We spend 80% of our time with a mouse and keyboard, not a stethoscope, entering data into prescribed templates. Now the feds are complaining about “cookie cutter” records that they mandated.
Expect the majority of encounters to be with midlevels, because there are not enough physicians to do the mandated BS.
After 38 years in the ER, I can now see 1.3-1.5 patients per hour. 25 years ago it was 6-10. “Good enough for government work?” Oh yes, reimbursement is hovering around 25 cents on the dollar.
In 1985 or so I heard Leonard Peikoff give a keynote speech at the annual meeting for neurosurgeons. I was a young resident at the time. He pointed out that RBRV was the lawyer’s way of “divide and conquer” and it’s purpose was to pit the specialists against the primary care docs. It worked. At the time it seemed to me that if students wanted to get into the “higher pay” fields they should have to suffer the 100+ hour weeks for years as I was doing.
Phylis Schlafly did an excellent article on the AMA and ICD several years back. Her point was essentially that the AMA had “sold out” the doctors they claimed to represent as they realized that dwindling numbers of docs joining was going to make them extinct soon if they couldn’t find a revenue source. They found gummint’s teat and have been hanging on ever since.
Myself, I started my own business several years ago. There were a number of factors but now I don’t have to deal with any of the crap that irritates most docs. I don’t have any employees, I answer my own phone, and I had to learn coding to get paid but I have to say that since I don’t need much at this point I can “make a go of it” at just about any level. Even so I have been in the red for three years (marginally) but I see it as “Going Galt”. The area I am in is saturated so I am not very busy but I keep busy with my “projects”.
When I look down the road after 30 years what I see is not pretty. Young docs are indoctrinated into believing in socialized medicine. They have no regard for what our profession has suffered to get where we were decades ago (read Paul Star’s “The Social Transformation of American Medicine) how it took DECADES to recover from the “sawbones” era following the Civil War. Will they ever pull their head out of their butts in time to prevent total collapse of our profession? I see “gumint medicine” coming and what we now call “health maintenance” will be the ONLY free service. It will be run by SEIU cliics staffed by Union Drones given a 6 week course in how to use an algorithm similar to the Army’s FM 22-20. Maybe some “minor illness” type free service (URI Viral infections, perhaps. It is cheap to have a 25 y.o. high school dropout just tell folks yuo don’t need antibiotics, the manual says so!)
Of course The Mayo and Johns Hopkins will be there for “cash only” or the “politician’s insurance plan” which will be the ONLY one left.
Years ago I said (posted here), “We are approaching a day when abortion will be easily available on Main Street but Lipitor will only be available in alleys and handed through car windows.” We are almost there.
To become a doctor you have to spend so long in schoool that you are brainwashed by the commie professors completely before you can get anywhere near an exit.
The AMA hasn’t represented docs for decades. Read the Phylis Schlafly article I referenced above. When I was a resident it was down to 40 percent (that was decades ago), at the time she wrote the article IIRC it was down to 17%. They saw they had no future unless they did something. Selling out was what they did.
LOL. Really. If you want a good future in Medicne, get a BSRN. 4 years at the bedside and then presto, bureaucrat. With 6 figure salary, weekends and nights off and you spend all your time telling doctors what to do.
“Once upon a time” I used to moonlight in ERs. I could see 60 or more patients in a twelve hour shift. Back then the nurses helped a lot. Over time the nurses refused to do more and more and the doctor had to pick up the dropped ball. Documentation requirements became more important then time with the patient. Prgressively, things got worse and worse. The last time I left an ER I swore I would never go back.
Yup, and that has been going on for a LONG time. Back in the mid-1960's, my cousin and I started college together. I was then in engineering, and he pre-med. He did wonderfully on all his medical-related (comparative anatomy, microbiology, etc., etc.) courses, but due to a poor school background in math, did poorly on a couple of physics courses. Those low grades in physics kept him out of med school.
Nope, a surgeon cannot operate out of a clinic, except for some low-risk orthopedics and such like. He needs a hospital, with all that infrastructure of operating rooms, OR nurses and technicians, hosptial-owned equipment. Hundreds of millions of dollar, and it all must be maintained and administered for yet more millions.
Have spent many years on FR trying to persuade people that "doctor bills" are not their problem. "Hospital bills" are. Haven't made a dent yet. I still hear complaints about greedy doctors. Well, they won't be around to complain about much longer.
Nope, a surgeon cannot operate out of a clinic, except for some low-risk orthopedics and such like. He needs a hospital, with all that infrastructure of operating rooms, OR nurses and technicians, hosptial-owned equipment. Hundreds of millions of dollar, and it all must be maintained and administered for yet more millions.
Have spent many years on FR trying to persuade people that "doctor bills" are not their problem. "Hospital bills" are. Haven't made a dent yet. I still hear complaints about greedy doctors. Well, they won't be around to complain about much longer.
It's easy to get into law school. They are not as expensive to maintain as a teaching hospital. That's why we have so many lawyers rotting and stinking up the country. See my post above. It's all about the infrastructure. Doctors must have hospitals to treat the sick. It's more than clinical care.
Yeah, but just seeing one patient an hour (and that one some creep trying to lie his way into a narcotics prescription, and taking up your whole hour...my idea, call the cops. You ER docs need to start sending your patients to jail)...you have a much lower risk of a malpractice lawsuit than if you worked to your full potential. let that lawyer with the kidney stone sit out in the waiting room for TWO DAYs.
Typical “guild mentality caused the problem because I’m so smart but I couldn’t get into med school.”
***My turn to call nonsense. It’s the AMA which determines how many med schools there are. They could double the number of med schools and not reduce the quality of care. The number of slots are artificially kept low so that doctors are in high demand in this country.
We hire hundreds of foreign docs every year because we cannot *afford* to educate more doctors.
***Sure we can. Those foreign docs come from places that can barely afford to dig a well for water, yet they keep open reasonably good med schools.
I appeal to those who have some sense. Look at a law school. Classrooms, teachers, $40.k a year. Look at what it takes to educate a doctor, pharmacist, nurse or PA. A vast technological enterprise with a pool of interesting patients.
But what I meet are those who think they were smart enough for med school and the Guild kept them out.
Once again, we import doctors by the hundreds from other countries, and the "guild" didn't keep THEM out.
Other countries can afford it, then so can we. It’s the AMA stopping it.
It's true that other countries can educate doctors cheaply, but they execute lawyers. No, not really *execute* but they don't allow lawyers to run the country for *their* own interests the way the US and RINOs and Democrats do. Be thankful that they do educate these doctors, or our shortage would be worse than it is.
One thing they test for on the MedCat is linear reasoning. "We have a shortage of doctors because the AMA is a guild that limits the number of doctors" is a sign of very poor reasoning and likely poor intellect. Have you thought of applying to law school?
You assume that the AMA operates in the interest of doctors.
***I do not assume it. I have observed it.
They sell out doctors if its in their interest.
***You’ll need a lot more examples if you’re going to counteract 60 years of advocacy for Doctors above all others in medicine.
One thing they test for on the MedCat is linear reasoning. “We have a shortage of doctors because the AMA is a guild that limits the number of doctors” is a sign of very poor reasoning and likely poor intellect. Have you thought of applying to law school?
***Ever hear of Occham’s Razor? This is inductive reasoning, not deductive nor linear reasoning.
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