B Dupon

we are not dealing with a socialist system… that would perhaps manifest itself as doctors being apart of local fire dept, ie working through govt

we are not dealing with a capitalist system… that would allow for market efficiency, options to peoples needs, innovation, supply to match demand, etc.

what we are dealing with is feudal oligarchy… cartel style manipulation of supply.

cutting edge? those who code out the signal from noise of gene expression, those who study nanoparticle drug delivery… are cutting edge.

people who order tests, do procedures r glorified wait staff.

currently my dad needs another cataract surgery and has a bad ticker, well thats what overseas hospitals with better recovery rates and transparent stats than US counterparts come in. My kid gets ear infections… thankyou Walmart nurse!

in 30 yrs when my ticker goes bust, ill turn to gene expression for the diagnosis and a tech for the therapy…. um so yeah, u and more importantly ur attitudes are very much old hat.

heres to seeing u go out of business one day

Dinosaurs? We are the tip of the sword. Yes, We are arrogant and yes we are elite for good reason.

As far as going overseas, someone is going to die and the family is going to sue the employer. Its going to happen. Having surgery by some hack that didn’t have the intelligence or social skills to stay stateside, then taking a 12 hour plane ride afterwards is setting someone up for a fatal PE no way around it. Which doesn’t look good when you are trying to save a few bucks.

yeah, its sad when the cartel (racist, and greedy) curtly stifles the free market, exists solely through artifical scarcity, and is bemused by the plight of others seeking equitable distribution.

by the way, those pts in need that u reject, do u refund the office co-pays?

fundamentally, docs are outdated dinosaurs, desperately clinging to their turf. in the face of real science, personalized medicine will make this sort of inequity merely a bitter memory.

in the mean time, middle america struggles to take care of our parents and rear our young… but there is hope, the free markets, democracy will ultimately prevail regardless of corruption, elitism, and rent collection.

real scientist r working while glorified waiter/resses now have tools such as google to contend with…

quite frankly, faced with this kind of arrogance, ill gladly go overseas for care

(by the way, how does one pronounce dr. pho’s last name?)

Show me ANY other professional who needs the same amount of education and training before he or she can BEGIN working in his or her chosen profession and then we can talk about what doctors deserve to make….”

uhh, thats kind of my pt. these things are set in place as hurdles to limit supply, ie artificial scarcity

by the way, to become world class in anything takes about 10yrs of work… things are set up in medicine that require those ~10yrs to fall under cartel contrl.

no comparisons were made to becoming athletes, celebrities because those cases require extreme talent/competition.

Becoming a surgeon requires the opportunity to train- any average person can do it. In fact in Europe surgeons are technicians with cerebral docs being the behind the scenes directors. What does take talent/competition is getting the cartel to grant u the opportunity to train.

Whats funny is how hard it is to find out what a surgeon’s stats r for a given procedure… then everything goes opaque.

whats sad is noone has called out the racist defense that was posted as being a reason for artificial scarcity.

to recap, what ive heard in defense of artificial scarcity is

1) elitism: we’re smarter, faster, stronger, + we paid more $ to train ?

2) racism: we dont like when u docs have funny last names ?

3) safety, save the children- yeah right, thats why there exist a culture of silence, hierarchy, and hospital error in top 10 way to die

give me a break

again me and my $ go:
overseas because i appreciate diversity, transparency, dignity, walmart-$40-rn, specialty hospitals

It takes four years of college, four years of medical school and five years of residency to become a surgeon, not to mention hundeds of thousands of dollars in tuition.

Show me ANY other professional who needs the same amount of education and training before he or she can BEGIN working in his or her chosen profession and then we can talk about what doctors deserve to make….

Funny how no comparisons are being made between what doctors, who save LIVES, make and what people who bounce basketballs or scream into a microphone or show off lots of skin make…

So racism is a defense for the artificial scarcity that stifles real market value?

lets extend this, r u saying that the O’Malleys, Polskis, Steins, Kumars, Phoe, Wang, Ramirez, Kawamuras, Obis cannot practice medicine in the US?
(ill just assume at this point that u mispoke and drop it)

elitism:
“It’s easy for those with no medical education to think it’s easy and that anyone can do it.”
I agree! Ill add plumbing, TV/VCR repair, firefighting, policing, golf… just about every human activiity under the sun is difficult and requires discipline, dedication, and sarifice to achieve proficiency. Ask someone trained to change an appendix to remove your engine’s head gasket (vice versa)… ull run into problems. By the way, go ahead and try to fix ur VCR/TV, its actually pretty darn complicated/dangerous even if u understand basic electronics etc, unless uve been trained specifically for that task. Someone mentioned Devry. Well as an engineer trained at one of the nations top five engineering schools, one of my first internships was under an eclectic guy that came out of Devry- a person who was in every way a consumate professional. Since then i have worked with several proficient coders from Devry. Ive also known bad apples, but we’ve all seen the ive leaguer with zero skills as well. The key factor to note, was that these people r not jockeying for academic laurels… they r simply working a job with a certain skill set, for $, to take care of their families, and live their lives… (very much like everyone else).

“No one will go into 100,000+ in debt and give up the best years of their lives stuck on call and in the hospital to fight for 80K a year when they are done.”
If $1-2K test cost credentialing were implemented, the real threat to the academic-industrial complex would be how the market reacts to the flux of providers. Ill assume that the ‘neuve riche’ insurance rates and salaries would initially be higher/lower respectively. But over time, the market embraces those proficient in their craft.

Now the real threat… If those harvard etc eligible level candidates saw no economic benefit (other then academic credentialing), a vast majority of people would have great enticement to circumvent the current regime (which enforces artificial scarcity through limited residency slots, etc.). Ur right its not fair to go 100K+ into debt just to be allowed to take tests- which i understand that schools like harvard yale do not even provide anylonger. So basically ur paying for the right to take a state exam. (Quite frankly, i think the situtation would transform into the highly motivated students studying with their own resources, and less motivated studying through testing agencies such as Kaplan etc, and the totally party animals deciding to shell out $Ks to med schools to credential/find jobs for them.)

The real questions r not P4P vs HMO (the market of doc services is overvalued, imho).
The real question is how many docs would the market need to bring average salaries to 100K? Would market competition improve safety (by removing the current culture of silence, hierarchy)? What about save the children arguements- how can security legitemetely be addressed?

Ultimately, as a doc if u think ur better than a fireman, policemen, programmers, waiters, plumbers, line cooks… get overself, because the market everyday is trying her best to.

so for my money- boutique, elitism, oligarcy, scarcity NO!
overseas, walmart-$40-RN, transparency, free-market, YES!