<p>The ceo of the univ of pitt medical school makes 6 million a year. </p>
<p>That is a non profit.</p>
<p>"She claims that most of the doctors wealth is earned from being partners in the firms that do the various tests. She says their salaries averaging $100-200k are pocket change. "</p>
<p>I’ll have to store that info for future use.</p>
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<p>We’ve been at that point at least since EMTALA was passed back in 1986. The problem is that it is an unfunded mandate (which is two words, not one big word :D) - so basically we’ve said that it is a societal good/mandate/whatever that emergency care be provided to everyone regardless of ability to pay, but we (as a whole) don’t want to pay for it, so it shall be the responsibility of individual providers and hospitals to absorb that cost. I forget the actual stats, but IIRC each emergency physician provides >$100k annually of unreimbursed care - care that he/she is legally required to provide and is still on the hook for professional liabilities like malpractice, etc. </p>
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<p>The problem is that medical journal articles are typically very difficult, if not impossible, for a person without medical training to interpret and sort through all the bad research and biases out there. Hell, it’s not exactly easy for doctors, either - I’ve had entire courses devoted to critically evaluating medical journal articles, and there is a not inconsequential amount of time during residency devoted to this as well. As for getting medical advice and information from internet forums, it should be clear why this is a bad idea.
This is clear from all the bad information out there - case in point…</p>
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<p>This is patently false. I know of multiple surgeons who routinely do whipples in just my tiny corner of the country, and I imagine they are even more numerous at larger academic centers than mine, of which there are many :).</p>
<p>Actually, i agree with Bay. I’m constantly jumping on my kids who are young, and strong and healthy right now to eat properly, watch the hygiene, risky behavior, sleep, discipline, etc, etc. The way I figure it is that we are all born with a bag full of conditions and ailments and there isn’t anything we can do about them. Part of the DNA, part of us. Doesn’t mean any of them will be drawn from the bag, but they are there and some of us get a better lot than others. And then we have events that happen that add more stuff to the bag, a lot that we cannot do anything about. You get hit by a car, you get struck by lightening, some outside intervention outside of the bag that loads it up with more risk factor. </p>
<p>But you can add to the bag too. Doesn’t mean you won’t get lung cancer if you don’t smoke or work in high risk environment. You can have that in the bag already and it can get drawn even in it’s only one in a million. But you can add more chances to the bag with every cigarette you smoke and other things that are under your control. Yes, some jerk can hit you when you are driving, or you make a mistake and you have a car accident, and it can kill you though you are the safest driver around and work at being careful and paying attention. It CAN happen. But if you are reckless , speed and don’t pay attehtion, you up the odds. That’s the control you have are over the odds, not the necessarily what is drawn but you can stuff that bag with bad things or with better ones. Gain a lot of weight and not exercise, you are adding some nasty consequences in that bag. Never mind that Anne Jones and your grandpa lived to age 103 and were 300 lbs most of their lives. The chances that weight related problems are going to come when you are overweight or under weight are higher than if you are within a healthy range. </p>
<p>Unlike the state pot, you don’t have to “play” to “win” because you’ve been entered with a set pot at birth with some unsolicited additions along the way, but what YOU can control is what you add to the pot and and it doesn’t take a probability and statistics course to understand that increasing the odds for bad things makes them more likely to happen. </p>
<p>When my brother was told about his pancreas, there was not one good thing he read about his prognosis. And he was furious. Excellent shape, diet, exercise, but as far as he was concerned, bad luck and bad genetics gave him a bad draw. I knew exactly how he felt as I felt the same way when my then little guy was dxed. I had to fight the bile coming up my throat for a long, long time. The only way I could shut down my brother’s rant on how unlucky he was and how he had the worst cancer there was, was to tell him he did not. I had it, because it was in my kid and I would have traded places in a heart beat to have what my brother was given the day I got that dx. That shut him up. He then was on a rant about how Steven Jobs had the dx but with the connection and money he would beat it whereas he, with Tricare and no money, no connections was a dead man walking.</p>
<p>Well, Randy Pausch was a better man than my brother in terms of the grace with which he took his dx, and Steve Jobs had the money and the contacts, but both are dead and 7 years later, my brother is alive and well though missing a significant piece of his pancreas. THough the reason is not due to anything we were able to do, that he was strong and healthy made a big difference in what he had to endure in terms of surgery and recuperation. So we put in the box what we can, in terms of upping the odds and then there is chance.</p>
<p>" I forget the actual stats, but IIRC each emergency physician provides >$100k annually of unreimbursed care - care that he/she is legally required to provide and is still on the hook for professional liabilities like malpractice, etc."</p>
<p>That’s only at the booked rate - which is simply propaganda. What they would actually get paid for it, is at most, less than a third of that, and, if the patient was on Medicaid or Medicare (already more than 50% of the population), it’s about 1/9th of that. And at that rate, they’d still make a profit.</p>
<p>The docs I know are happy to earn their $100K-$200K/year. I don’t believe they are making millions, but I could be wrong. Most have wives that work because they HAVE to. One doc I know says he spent ALL his retirement money on building an Electronic Medical Record System for his office and has NO retirement for himself or his wife. Yes, he has a more lavish lifestyle than we do and has a nicer, more expensive house, but in my late 50s, I would not be comfortable having NO retirement savings.</p>
<p>I’ve just read the first paragraph and all I can say is that a person does NOT need MD Anderson for NHL.
Just sayin’.
Will keep reading.</p>
<p>Free medical school with some kind of public health commitment. And include a BMW in the deal so they won’t feel inferior to previous generations.</p>
<p>Do u think if doctors were told they are only going to make 100000 to 400000 tops, would we end up with a shortage of doctors?</p>
<p>I am just using doctors as an example… Everybody takes a cut… From the top down. </p>
<p>Would we end up with a shortage of health care workers? >>>>></p>
<p>Maybe. Naturally, there are many people who would still by the nature want to be healers and caregivers. By the same token, medicine is not exactly something someone goes into just for the hell of it to make money. LOL. It’s a hell of a journey one has to make to succeed, long and tough and hellish.</p>
<p>This isn’t news. Ten years ago I needed a specialized surgery. Nobody in my town did the procedure who took my insurance, so I went to Big Med Center in another city. Surgeon on Med School staff did surgery, everything went fine. First bill I got from hospital was $48000 . Insurance paid $12000. I paid nothing above my usual co-pey.
Big Med Center has beautiful Multi-story lobby /atrium with a grand piano player. Very soothing. Since we had “good” insurance, we never saw a bill until we were back home. </p>
<p>Example #2
My father had heart valve replacement at the local major U hospital by a world renowned surgeon. All paid by his basic Medicare. My parents say that they never paid anything</p>
<p>When we went to #1 respiratory hospital in the world for my treatment and my kids’ weeklong evaluation, we just paid our 20% until we reached the annual maximum out-of-pocket maximums for those years (it was $2500/person and $7500/family), and insurer paid all of the balance. We didn’t need to get a referral or justify when we went there.</p>
<p>One of the people who worked on our S for a test was not participating and not preferred by our insurer. After a brief disagreement, insurer agreed to pay him and we didn’t have to pay any more than if he had been participating & preferred; insurer paid the rest. It takes a lot of stamina to argue with insurer about correct amounts of charges and is not for the faint of heart. I thought it was a long time when it took two years to finally get all the bills settled from our 1st visit–the medical center thought it was rather prompt payment.</p>
<p>When we were patients there, they ALWAYS had us have testing before we saw ANY doc, even if we saw mulitiple docs in the same day, we were tested before EACH visit. We also got imaging tests each year we were seen. They do have a LOT of testing that is performed in-house.</p>
<p>Our local major hospital is purchasing docs and their practices, used to mostly have a lot of solo docs. Our BCBS insurer has a lot of negotiating power, since it insures about 75% or more of our state, so it reimburses close to Medicare rates and claims to only spend 7% on administration. It still pays its CEO and many of its top execs very well. The HMO that covers about 20% of the remaining insured in our state also makes 7 figures; several of her execs are also well reimbursed.</p>
<p>“Do u think if doctors were told they are only going to make 100000 to 400000 tops, would we end up with a shortage of doctors?”</p>
<p>Do you think we have an overabundance of young people going into medicine at today’s salaries?</p>
<p>So, we mostly agree that the system is messd up .?</p>
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<p>That seems to be a trap that some people have complained about, where one may go into a facility that is generally within the preferred list of your insurance, but where some providers may not be, and you may not find out until you see the bill (one of the horror stories is about going into surgery and getting assigned a non-preferred anesthesiologist).</p>
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<p>How much of that testing is medically necessary? I have noticed that some doctors are pretty aggressive about ordering tests, even when their value is dubious according to the USPSTF and published research studies. Excessive radiological imaging can also slightly increase the risk of cancer due to the radiation exposure.</p>
<p>“How much of that testing is medically necessary? I have noticed that some doctors are pretty aggressive about ordering tests, even when their value is dubious according to the USPSTF and published research studies. Excessive radiological imaging can also slightly increase the risk of cancer due to the radiation exposure.”</p>
<p>The issue isn’t only how much testing is medically necessary, how much is it legally necessary.</p>
<p>Well…since only about 40 percent+ of applicants get into medical school, I don’t see a shortage of people that want to become doctors.</p>
<p>Yes, actually, S had a non-participating, non-preferred anesthesiologist, even tho the facility and the main doc who was performing the procedure WAS participating & preferred. It took a considerable argument from me to get insurer to not force US to pay the difference.</p>
<p>I could never see why we needed to get a breathing test multiple times/day. It’s like getting a blood pressure test multiple times a day or even a temperature, except they were allowed to be reimbursed EACH time they tested us! I asked insurer why they never grumbled about having to reimburse for those multiple tests/day when they were thinking that our local docs would OVER-TEST. They said, “Well, that place you went to is #1 in the US, so of course what they did was OK.” </p>
<p>Insurer even refused to allow my allergist locally to give me allergy shots until the allergist at the out-of-state medical center agreed it was appropriate! I was furious and said it was highly insulting as my allergist has been treating me for many years and is on the faculty at our local med school, while the other allergist only saw me on one visit, but they still insisted and I had to get a letter from the out-of-state allergist! I was very fortunate that my out-of-state specialist leaned on his colleague to write the letter or I would have been out of luck. I was not charged for having the letter written, but can see how I could have been.</p>
<p>I have lately taken to refusing to get annual xray exams unless and until my internist can tell me WHY I should have them, as it makes no sense to me and he can’t say what he’s even looking for. (He does not have his own xray lab.) He also does annual EKGs in his office with his staff, which I have not objected to, as I figure there is no radiation danger. The rest of my extended family continues to get their annual xrays.</p>
<p>Well, I suppose many will say I am crazy, but H and I are retiring in 2014 and moving to Spain. He is a citizen and I as his wife will have the same care he gets. Universal health care.
Son has lived there for 10 years and thinks it’s (the healthcare) great. When D was there studying, she refilled her prescriptions for her diabetes-Type 1. She paid $25. Over here the cost is ~$1500. Not all covered by our insurance. As a senior I will have to pay I euro/mo per prescription.</p>
<p>Gloworm, I am sure you have thought things out and decided that Spain is the place for you. Why is that crazy?</p>
<p>dstark, </p>
<p>Those who think the US has the best healthcare in the world. I will also be living on the Mediterranean, in a place w/o winter, near my son, his wife, and our granddaughter.</p>