“[The birthers] evidence is non-existent” — not true. Maybe not convincing, but there is evidence.

Like Sam, I did pre-med through my sophomore year in college. I wanted to do medicine, and I’d gotten through organic chemistry, but I didn’t want it enough to go through medical school and internship. My roommate did. He makes 4 times what I make, hasn’t been unemployed, and lives in a much more expensive house than I do. He’s a pathologist now (no live patients, just slides) but he’s under a lot more pressure every day than I am, and still works more hours. If I had it to do again I wouldn’t go into medicine. (If I’d had time to think about it I’d have gone for law when I was still living like a student, not a single parent.) Most medical professionals are well aware that the internship hardships are barriers to entry to keep the salaries as high as they are. But on the front lines, there is a free market to an approximation — people rationally turn down the chance to be doctors.
I tell kids software is nice work if you can get it, but with outsourcing and non-immigrant visas don’t count on getting it. Plenty of doctors I know tell kids it’s not worth it, and likely to be less worth it in coming years.

That was the “usual and customary” for a rural surgeon, in the 90′s! OR what medicare said you were allowed to charge. I was told, by the “good old boys” on the state medical board, that at $70,000 a year, I had a really good income! I was in a rural area in one of the southern states!

I, too was charged $5,000 for an outpatient hernia surgery during that time! Fact was, with a large opiate dose on board, I was given IV anti-inflammatory (Toradol) that killed my pain completely! Then, I was not breathing because I was over-medicated on the opiates! I had an apnea monitor for six hours after the operation and paid out the butt for the “service”, when I could have died from the inability of the anesthesiologist to see what he had done! A little Narcan would have stopped it all and my pain would still have been relieved by the Toradol. Obviously, we, doctors, don’t know it all!

#23 – There may be a glut of doctors in West L.A., but it’s not true across the country. There are lots of places where there are a lot of places, especially in rural areas, where doctors are hard to find.

It’s clear that the medical system needs to be reformed. It’s a damn shame the only reform being considered will be to make it worse, not better.

Standards. ha!

I dated a girl who took her med school in the bahamas. She spent most of her time working on her alsoholism and addiction to pills. When she returned to the US and became an intern (pre-resident, i’m not sure, she was wasted and could never explain it fully), her med student friends were all fucked up all the time. And they were all becoming doctors.

I don’t have a free-market vs. single payer system argument to make here. I’m just saying – don’t put your doctor on a pedestal… most intelligent people with a degree in English are one standardized test and trip to the loan office from med school, no matter how crazy and messed up they are.

Oh, and many of those pre-med students start out with a chemistry or biology degree. Lots of schools don’t have an official premed course, which is how I ended up in chemistry, which is how I ended up in chemical engineering, which is how I know a gal that went to med school with a chemistry degree that couldn’t do basic math with scientific notation. She really really wanted to be a doctor and I’m really really glad she didn’t make it through her second year in med school…but she sure was accepted.
A doctor makes damned decent money, it’s not worth it, it’s obviously not worth it, we have a shortage of docs and have for a long time, and there’s your free market. Too bad the gov’t helps keep it that way.

As I understand it, the worst of the hell medical students go through is unnecessary and counter-productive. Other countries don’t demand massive sleep deprivation from interns, and get doctors that are about as good.

Exhausted people are a danger to themselves (car accidents) and others.

http://www.google.com/hostednews/ap/article/ALeqM5gtME6rwpVYyyaIuEi2CtxhMj9B7wD9AAOMA80

Considering your interests, I’d assume there was a reason for this decision?

I heard of heart surgeons now becoming millionaires, but those are very specialized practices. General surgeons are actually being phased out. Their payment of $350 for appendectomies and hernias, do not provide the $400,000 income, stated in the article. Why should a person spend years on an education, then be denied fair compensation?! The people that think doctors make too much will get the care they paid for, in the end! I think I am witnessing that in the number of foreign names I see on shingles and in the yellow pages, now-a-days!

I am no supporter of organized medicine and the AMA because they had been of any help to me! More of a hindrance. What I do recollect is the interference that all of these political groups had on a practice and the little assistance ever provided! Medical politics are just as much a cause of the problem, as anything else, so the AMA likely deserves some calling out! I just wonder how many competent doctors are not practicing in our country now, because of the heavy handed politics practiced in medicine and condoned by the AMA?

The cost in many cases are just pure greed. I remember while working for an ER company that I was asked not to be re-scheduled for work at a particular hospital because I had a difference of opinion in their tactics to collect more for each ER visit. Just fill in the check boxes for the ROS (review of systems) and a few other things and the charge could be increased by $135 to each patient! It did not matter if the review was performed, only that the check marks were filled in! It did not matter that the kid only had a 3 stitch laceration! Charge them for a complete H&P, as well! But, his could be covered up by claiming it was “standard of care”? The crooks are everywhere! And, if you speak too loudly, you find yourself unemployed!

The problems in the cost of medicine are very complex, partly because the hospitals want it that way! Nothing like my grandfather getting a hospital bill for my grandmother’s hospitalization, dated for when she was already laying in her grave! Fraud, I guess it was just an honest mistake! But, medicare paid it!

Ask yourself, should a CEO for a medical company make millions of dollars a year? Should oil company CEO’s?

PS the comments were very informative in the article, as well.

As an aside, I agree that physician salaries would fall on an unencumbered market. However, they could enjoy an exponential increase in their productivity. A great deal of time is wasted working within and around bureaucratic restrictions. The best examples are documentation requirements and controlled substance restrictions. With these hurdles removed docs could see more patients in less time compensating for the fall to market billing levels. This income would be justly earned, and the most efficient/effective producers would still be well compensated. Sadly, this point is often overlooked by my colleagues, especially those in bed with the AMA.

BTW, the fact that there even is a Pennsylvania “Bureau of Dog Law Enforcement” should be enough to give people pause. Specialized “law enforcement” divisions like this will have a tendency to over-enforce laws to justify their existences. Does anyone think that department would willingly go away even if all Pennsylvanians were responsible pet owners? Or, would they start finding violations where none existed? Exactly.

I learned one lesson quickly when carriers started charging fees for checked in luggage. Don’t check in your luggage and when you get to the plane and there is no space – you luggage gets checked. Free.

Or do a little thing called planning. You don’t need to carry your wardrobe with you. Hell my last four day trip to vegas I walked on with the clothes I had on and a credit card. Spent the first four hours shopping and than FedEx’d the clothes back at the end (actually I had the hotel do it – they even provided the box).

I’d love to have access to a midwife without having to drive an hour each way. As it is, I just had to spend a lot of time in Chicago traffic to get to a place that wasn’t a c-section factory.

What we mind and don’t mind as salary’s doesn’t really matter, what matters is what the market determines the appropriate salary to be. While I’ll disagree with a lot of folks on here by saying that the government does need to get involved when things get ridiculously out of whack, the AMA’s stranglehold on washington is a major cause for a lot that’s wrong with health care.

High salaries aren’t the problem, the way they’re generated is the problem. If a doctor ears his 400k a year by administering 40mln in services when 4mln are needed and 10 more on the margins of responsibility, there’s a big problem.

Rigid standards do indeed keep people out of the profession. Especially when one sees the potential earnings doctors make. They simply don’t make enough to attract many potential candidates.

Shortages of doctors also seems to be regional. Here in West L.A., if you throw a rock, you’ll hit a doctor. If anything, there’s a bit of a strange dynamic going on with health care. The more that’s available, the more people want. Which seems to be the real reason health care costs are so high. More doctors leads to more research, more treatments, more subspecialization, and ultimately more costs. Even if your family practice doc never gets a raise at all, he can now treat your weak boner, thinning hair and refer you to a wider variety of specialists for more serious afflictions that you simply had to live with 30 years ago.

But sure, doctors make too much damn money. And chiropractors are a viable alternative. Let class warfare and flaky science lead the way.

Meant to strike “years.”