Primary care will soon be taken over by foreign-trained physicians

Yes, it’s because of the money:

As more U.S. doctors opt for better-paying specialties such as cardiology and orthopedics, residency programs for family physicians here are increasingly drawing doctors from abroad.
This year, 28 of the 78 first-year residents in family practice programs in Minnesota came from foreign medical schools. At Hennepin County Medical Center, eight of 10 places were filled by foreign graduates. At the University of Minnesota’s Smiley’s Clinic in the Seward neighborhood in Minneapolis, five of six places were filled by foreign doctors.

Comments

Okulus
Not news at all. This kind of overseas graduate recruiting has gone on for decades. All that is new is that some programs accustomed to more residents coming out of U.S. schools are not getting as many now. That probably includes their D.O. applicants.
And it hasn’t solved any of the problems of primary care, either.
The Polish or Indian or Nigerian-educated residents still face the same challenges as American-schooled practitioners face. If they are lucky, someone else has paid their medical school bills-their families or their governments. Sure, practicing here is probably better-paying than in Lucknow or Gdansk, but living costs are higher and practice operating costs are much higher too. Bringing in overseas-trained doctors will fill residency training slots, but it won’t compel these doctors to take and, more importantly, keep jobs in underserved areas. The visa system has attempted to do this, but the results, over a generation of practice incentives, have at best shown only mixed results. Low-income, poorly-insured populations in rural areas still have difficulty supporting viable private medical practices, and the practice life for many of those doctors isn’t always so good.
CJD
It’s always about the money with a physician. Whenever they pontificate about patient access, underserved rural areas, etc., it’s about the money.
The only difference between them and everyone else is that they think the public will believe that it’s not about the money.
ismd
Really CJD? Please don’t tell me you believe the legal profession actually has the good of mankind in their thoughts! They really don’t think of all the money they can get when they file all their class action suits, malpractice suits and the like? Geez – something about calling the kettle black….
CJD
You should have read closer, particularly the last paragraph.
No one in the medical or legal profession is going to be confused with Mother Theresa.
Criminallopath
Truer words have not been uttered. If only the sheeple would wake up from their idolatry and push for a system that actually serves the citizenry first instead of serving the enrichment purposes of the providers first.
Okulus
“. . . sheeple. . . push for a system… ‘
Please. What makes you think people are so crippled they can’t vote with their feet or their wallets whthout your wisdom? The “system” you speak of is bought and paid for by, you guessed it, the same people who use it. Flawed as it is, it still provides care to millions who would not receive care at all from anyone for lack of ability to pay. Sorry to say, but there aren’t too many contenders for the replacement job.
No, no one should confuse either the medical profession or the legal profession with Mother Teresa. Neither are charities at heart, but both at their best do perform charity labor, to the very great benefit of those labors recipients. That is life, when your profession has to support itself and provide an acceptable livelihood.
Drinkysr
CJD,
Sorry to disappoint but I have met plenty of doc whom I would consider Mother Teresa equivalents including just about all of the docs woking for Unity in Washington DC. This is a charity for the homeless that provides shelter and nursing facility to the sick and injured homeless in the area.
Some of the docs there:
1) A fellowhip- trained breast cancer surgeon and researcher-turned nun- turned family practioner.
2) A ENT-plastic surgeon-turned internest.
These remarkable folks work in the basement of 2nd and D shelter in DC, one of the largest homeless shelters in the country (1200 beds).
Oh, and just an aside, which one of these organization recently won the Nobel Peace Prize:
1) Doctors without boders
2) The ATLA
Criminallopath
Hmm. Wasn’t Stanley “Tookie” Williams nominated for a NPP?
Criminallopath
One also wonders how many “Mother Teresa” equivalent allopaths would be doing their “good deeds” if not for the paltry low six figure salaries commanded by even the lowliest of FPs and internists.
lawyersux
Didn’t the ATLA win the Nobel Prize? They had their lobbyists take the Nobel voters on a “pleasure boat” full of Hookers, cocaine and Alcohol and suddenly they were given the Prize. Oh, wait, that’s how they act to prevent Tort reform.
Drinkysr
Sorry, criminalpath, the MDs I worked wtih at Unity made nowhere near 6 figures. Under $50k was the starting figure.
They were there becuase of a dedication to the service of the less fortunate.
Just becuase your shriveled heart cannot imagine it does not make it impossible.
Anirban
crminallopath would never understand that nobody has invited him to seek allopathy .lots of ‘pathies’ reign now-a days and he/she is free to avail those. When you avail a service it should not be a problem for you to pay from your own Six-figures or what ever. Don’t begrudge some ones hard-earned money, even when you couldn’t make it. The idea is quite absurd that people primarily get into medicine / law to help others. No profession can be noble, individual people can. Any service would pay if there is a demand and you have got the skill. It is that simple, rest is glib talk
Criminallopath
“Sorry, criminalpath, the MDs I worked wtih at Unity made nowhere near 6 figures. Under $50k was the starting figure.”
Taking your word for it… when it becomes the norm instead of the exception is the day that I will consider the practice of the art of medicine as one akin with gallant egalitarianism.
Criminallopath
“crminallopath would never understand that nobody has invited him to seek allopathy .lots of ‘pathies’ reign now-a days and he/she is free to avail those.”
Absolutely. The problem is that the majority of the other “pathies” (excluding osteopathy) are based on foundations as shaky as “clinical causation analysis” – pure junk.
“When you avail a service it should not be a problem for you to pay from your own Six-figures or what ever.”
Great. Just don’t ask me to pay into the system so that illegal aliens can receive free healthcare at the ER and scared old people who are suckers for AMA extortion can continue to enrich the providers.
“Don’t begrudge some ones hard-earned money, even when you couldn’t make it. The idea is quite absurd that people primarily get into medicine / law to help others. No profession can be noble, individual people can. Any service would pay if there is a demand and you have got the skill. It is that simple, rest is glib talk”
You can do better than this. Medical malpractice lawyers work hard to get their money. Many on this board do not like their methods. However, according to you, one should not begrudge the attorneys of the money that they earn? What is “glib” is your attempt to justify the coattailing of the current crop of money first providers onto the construct of gallant egalitariansim – the tenets of which are used to beguile the sheeple into supporting the current healthcare system. I have no problems with a capitalist system in which the purveyors of service can earn their worth based on their skill. On the other hand, a system that is set up like the current healthcare system, with its supply side restrictions such that the most bottom of barrel provider can easily earn six figures and commit malpractice with nary a worry of loss of licensure is not even close to the type of system described in the prior sentence.
lawyersux
“Medical malpractice lawyers work hard to get their money”
Are you kidding me? By going to Law School for 4 years? WIth what we go through? Half the time they don’t even have to bring their shit to court, they just settle. The major Asshole in my town just won 5 million bucks by settling before trial on a cerebral palsy lottery win. Just cause they only win like 30% of the time because of all the frivolous puke they bring to court, doesn’t mean they work hard. Then you put down illegal aliens, half of who work twice as hard for minimum rage?
CJD
“Sorry, criminalpath, the MDs I worked wtih at Unity made nowhere near 6 figures. Under $50k was the starting figure. “
I know public defenders and prosecutors who make much less as well. Yippee!! The average US physician is still the best paid physician in the world by nearly 50% over the next best paid. So apparently some of you are making it alright.
CJD
“Are you kidding me? By going to Law School for 4 years? WIth what we go through?”
According to you, you get paid for ordering tests to cover your ass. What’s so difficult about that?
Criminallopath
“Are you kidding me? By going to Law School for 4 years? WIth what we go through?”
Look. Both of us know that the “X” years of school arguement, whether used to justify a puffed up clinical salary or, with what you are attempting to use it for in your arguement with an equating to post-education work product doesn’t cut it.
“Half the time they don’t even have to bring their shit to court, they just settle. The major Asshole in my town just won 5 million bucks by settling before trial on a cerebral palsy lottery win.”
It is called strategic evaluation of the case at hand. Some cases have a certain value for settlement purposes while others require taking the matter to trial. An apt analogy would be the use of conservative treatment on a litigant/dirtbag/patient with history of MVA instead of sending them “all the way” to the local chop shop artist for the invariable discectomy and fusion.
“Just cause they only win like 30% of the time because of all the frivolous puke they bring to court, doesn’t mean they work hard.”
Frivolous lawsuits? You didn’t respond to my post regarding clinician involvement in junk science PI lawsuits where the clinician is more than happy to parrot the patient’s provided history regarding an MVA or slip and fall (without the ability or capability for actually evaluating the events in question) to determine “causation to a reasonable degree of clinical certainty.” It doesn’t take much observation to realize that clinicians who complain mightily when they are defendants in litigated actions are the very same that open wide to lie, speculate and prostitute themsevles for the same scummy breed of PI litigants when the litigants approach as patients.
“Then you put down illegal aliens, half of who work twice as hard for minimum rage?”
Making a statement of fact regarding who is utiilzing ER services in major cities such as LA and driving them out of business? You must live a very privileged existence or have your head buried deep in the sand. In either event, if the “do no harmers” wish to provide healthcare to illegals, then let them do it on their own dime.
lawyersux
You’re the first one on this blogsite discussing the bullshit artist doctors who throw up shingles staing “free Back injury evaluations” then go to court to make a dime. This form of scum is much different then the scumbag lawyers who have turned medicine into a giant “rule out” fishing expedition, where patients get 2 colonoscopies a year “just in case”. These physician crooks are no better then the plaintiff attorneys who pray every night a baby is born with CF so they can make a million. Both are simply scum of the earth. Most of us are here to complain that we can no longer practice medicine because of the Lawyer Nazis chasing us. I have enough problems because of them, I want to leave medicine because of it, I don’t really care about these docs who do insurance fraud, it’s another topic.
lawyersux
“You must live a very privileged existence or have your head buried deep in the sand. In either event, if the “do no harmers” wish to provide healthcare to illegals, then let them do it on their own dime.”
Again, If I didn’t have to cover my fucking Ass on every patient that walked into the ED, these illegal aliens could be swiftly kicked out of my ER, along with all the other “worried well” who each currently get a million dollar workup so I can avoid getting sued.
Anirban
” On the other hand, a system that is set up like the current healthcare system, with its supply side restrictions such that the most bottom of barrel provider can easily earn six figures and commit malpractice with nary a worry of loss of licensure “
In a bell curve among doctors few will be excellent and few wil be rubbish most of them will be just average .That applies to each and every aspect of life .I can say that ,even a bottom of the barrel banker of merryl lynch is earning Six/Seven figures .let them be → in a free market that is the relative value added to that service . if people could find someone else ,their pay wil go down . there will always will be restrictions on the supply side as very few in the near future will invest 10/12 yrs of their life and student loans , if the pay-off is not good. If government would decide to open more medical schools and train more doctors , the average salary wil go down but that is hard to come by as leading Economists has shown in their studies that lawyers / doctors or any other professional can create their own demand. See Even with so many lawyers the price of an attorney has not gone down.
Nobody commits malpractice by sweet will and there are professional reasons for not doing so ,because people will get some one else and the doctor will be out priced. I never heard of ABA going after any lawyers license either . Professional organizations never do
“The average US physician is still the best paid physician in the world by nearly 50% over the next best paid”
CJD . Do you have statistics about rest of the professions all round the world. I hope it applies to them also including lawyers. So public defenders and the prosecutors in that context are also ‘making it right’,so long they are in that position (they don’t stick there for long → reason is obvious ,what started this thread)
“lie, speculate and prostitute themsevles for the same scummy breed of PI litigants when the litigants approach as patients”
This is what attorneys do all the time . Who is bringing these cases in the first place ,those publicity whore attorneys , and you parrot that they earn their money by hard work . I didn’t know your justice association ever investigated these.
“if the “do no harmers” wish to provide healthcare to illegals, then let them do it on their own dime “
Could’nt agree more with you ,but this is also the punch-line of the political party, the”justice seekers” are known to endorse and run to sue if they get a chance ,over this issue. Lots of “hard work ” you know.
CJD
“Most of us are here to complain that we can no longer practice medicine because of the Lawyer Nazis chasing us. I have enough problems because of them, I want to leave medicine because of it, I don’t really care about these docs who do insurance fraud, it’s another topic.”
So what’s keeping you from quitting medicine?
CJD
“I can say that ,even a bottom of the barrel banker of merryl lynch is earning Six/Seven figures”
No, they aren’t. Although how does one judge which banker is “bottom of the barrel”? If it’s based on income brought to the firm, and you’re talking about Wall Street, which you have to be because Merrill Lynch doesn’t have retail banks, the bottom of the barrel will not last long there.
” I never heard of ABA going after any lawyers license either . Professional organizations never do”
Of course you don’t. The ABA is a lobbying organization,like the AMA – they don’t have that power. The state bars do that, and if you pick up any state bar magazine any month, you’ll see a list of the people sanctioned, reprimanded, suspended, and revoked.
“CJD . Do you have statistics about rest of the professions all round the world. I hope it applies to them also including lawyers.”
I did, but all I can find now are the US ones. I’ll look.
As for your analysis of how hard attorneys work, particularly med mal attorneys, it’s pretty clear that you’ve never even been in a courtroom, so you probably aren’t the best source of knowledge on that front.
Anirban
“As for your analysis of how hard attorneys work, particularly med mal attorneys, it’s pretty clear that you’ve never even been in a courtroom, so you probably aren’t the best source of knowledge on that front”
CJD There are not many cases in the court-room , they are settled ,and if it is only there ‘hard-working’ attorneys are found then 80% of the time they must have been lazy. Now it should be ‘pretty clear’ for → you.
CJD
Anirban, how many cases have you settled? You do know that cases settle at all phases right? Some settle pre-suit, some settle after filing, some settle after discovery, some settle the day before trial, some settled mid-trial, and some even settle after the case has been submitted to the jury.
You probably didn’t know that, which would be in keeping with the fact that you really know next to nothing about what you’re talking about here. But at least you’re consistent.
Criminallopath
“You’re the first one on this blogsite discussing the bullshit artist doctors who throw up shingles staing “free Back injury evaluations” then go to court to make a dime.”
It is no surprise that nobody really wants to touch this one. The Med Mal attornies are really no different than the run of the mill PI attorneys. The clinicians don’t want to touch this because they are happy to whore themsevles out to these attornies on the PI cases. When both the clinicians and the PI attornies can screw over some innocent third party (e.g. defendant on a low-speed rear-end impact soft fraud case) there doesn’t exist a reason for either party to complain. The problem, however, is even deeper and deals with the junk science method for “clinical cause assessment.” As a hypothetical example, let us consider the dirtbag litigant that shows up in an ER with complaints of neck and back pain and claims that it was due to a rear-end auto accident. You run your battery of orthopaedic/ neurological tests – all of which are subjective and depend entirely on either the compliance (ROM testing for example) or veracity of the litigant. Plain film radiographs with “positive findings” such as loss of cervical/lumbar lordosis can be due just as easily to malpositioning error as they can be secondary to muscle spasm. There are no tests for MVA caused strain/sprain injuries (i.e. no hallmark diagnostic indicator). Yet, how often do ER (and other) clinicians happily go along with the biased litigant’s “history” of MVA and determine that the diagnostic impression was one of post-traumatic or MVA caused strain/sprain injury? Even forgoeing the whole subjective nature of the diangosis, the preceding “MVA” or “post-traumatic” is purely parrotting the patient. This is the type of junk science, however, that gets passed off as “causation” testimony on a daily basis to orders of magnitude greater extent than the junk science (following the same paradigm) medical malpractice “causation” testimony.
“This form of scum is much different then the scumbag lawyers who have turned medicine into a giant “rule out” fishing expedition, where patients get 2 colonoscopies a year “just in case”.”
Actually it is the same. The whore that sleeps with the john is really no better off in this scenario.
“These physician crooks are no better then the plaintiff attorneys who pray every night a baby is born with CF so they can make a million. Both are simply scum of the earth.”
Think about that the next time you diagnose “post-traumatic” or MVA caused injury when some dirtbag litigant shows up in the ER whining about their subjective “MVA caused” injury. By parrotting their history as the “cause” you are only helping to feed the litigation beast. It is about time that clinicians finally admit that unless there exists a hallmark diagnostic indicator or until the history itself is actually evaluated in an unbiased manner, that a substantive amount of “clinical causation” is purely speculative. It shouldn’t be a surprise that litigants will fabricate, exxagerate or psychosocially claim all sorts of BS injuries to scam money from third parties that aren’t clinicians.
“Most of us are here to complain that we can no longer practice medicine because of the Lawyer Nazis chasing us. I have enough problems because of them, I want to leave medicine because of it, I don’t really care about these docs who do insurance fraud, it’s another topic.”
I would about as much expect a clinician to complain about junk science PI insurance fraud as I would a plaintiff’s med mal attorney to complain about junk science med mal cases. Why complain about the part of the legal system that is providing handsome profit to each respective party? The underlying paradigm for both types of cases is the same. If the rules of evidence, particularly those based on Daubert, were applied in an unbiased manner for clinical testimony – both types of cases would be thrown out.
Criminallopath
“This is what attorneys do all the time . Who is bringing these cases in the first place ,those publicity whore attorneys , and you parrot that they earn their money by hard work . I didn’t know your justice association ever investigated these.”
The attornies are advocates for their clients. The clinicians, perhaps are as well for their litigant/dirtbag PI/patients. Attornies, however, are not the ones parrotting their clients’ claims in the guise of “expert testimony.” The clinician as a lie detector that always finds the litigant to be truthful as long as someone else is getting sued (god forbid the same truthful litigant sue the clinician for malpractice) is purely in the court of junk science clinical causaton testimony.
Anirban
CJD
not a single one ,fortunately no lawyer could put his grubby hands on me till now. Wish this remains so , but with 30 yrs of practice ahead who knows ? But if half of your work is never reaching the court room , the only hard work it seems perfecting your howls in front of TV camera.
Criminallopath
As a “client advocate” in a CP case John Edwards interviwed 41 obstetricians and was refused and found the 42nd scum to testify in a bogus causation theory ,which has been refuted a no. of times .I bet if you interviewed 42 scientists, you could find one willing to testify he had been probed by aliens as long as it brought him $600 an hour.The worst part of the story is that most CP cases are not even caused by oxygen deprivation during delivery . If a person Is that morally wretched ( if morality means any thing to lawyers) to win millions at any cost , whatever you try ,they will get someone , . Edwards and his cabal do all these ‘hard work’
All the time . your contention that being just advocates expunge them off all truth and responsibility ,doesn’t hold water. After all the lawyer chooses to be the advocate/pimp of some Dirtbag/PI litigant and there should be no reason he can’t be sued.
CJD
“not a single one ,fortunately no lawyer could put his grubby hands on me till now.”
So then I am correct, you have no idea what you’re talking about. So stop pontificating about how hard or not hard it is.
Care to back up your John Edwards claim? Or did you just hear it from a friend somewhere?
No wonder you don’t like courts – your “evidence” for your opinions wouldn’t take you very far.
gad
if you’re all working so hard, how are you able to waste so much time whining on this site.
anonymous
I agree. It is obvious all none of you are working hard enough and with all this repressed sexuality manifested as rage, you could all use a good lay.

Previous post: Tips to catch drug diverters

Next post: Congrats to Diabetes Mine

Primary care will soon be taken over by foreign-trained physicians

Related Stories

More in Uncategorized

Comments

Site

Channels

Subscribe

Related Stories

More in Uncategorized

Comments

Site

Channels