Where have all the ER specialists gone?

Driven away by the three ills of American medicine – too much work, too little pay, and the fear of malpractice lawsuits:

On-call surgeons worry there’s more chance of getting sued by a stranger whom they rush to treat in an ER than by an established patient having elective surgery. “Anything can happen in an ER,” says Jose Arrascue, a kidney specialist in Boynton Beach, Fla.”If you have no rapport with the family, they may conclude you did something wrong, and you are wide open for a suit. That really concerns me.” There have been calls for legislation exempting doctors on ER duty from lawsuits, but the idea of immunity from malpractice hasn’t appealed to federal or state lawmakers.

To minimize risk, many doctors stop taking ER calls. Or, Valadka says, surgeons may limit the types of operations they do in regular practice, which means they won’t be called in for emergencies that are beyond those limits. For example, some neurosurgeons””ironically””have stopped doing brain surgery and focus only on the spine.

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  • Anonymous

    I have a simple solution, increase the nightly stipend until you fill the spots. It is a novel idea called market pricing. Additionally, the hospitals could also entice doctors by paying for thier annual malprac insurance. There it is, problem solved.

  • Okulus

    Goodness, with ideas like that, a fella’s likely to stir up trouble!

    Funny how ideas that work anywhere else seemingly without a hitch get such stubborn resistance when it comes to medical care. “You mean I should have to pay you for getting out of bed to see me in the middle of the night? Don’t you make enough already?”

  • Anonymous

    INstead of paying docs more, what the govt will eventually do is let open the floodgates to FMGs (foreign medical grads).

    A FMG neurosurgeon would be happy to work for 80k in the USA. They could greatly undercut american specialists.

  • Anonymous

    “INstead of paying docs more, what the govt will eventually do is let open the floodgates to FMGs (foreign medical grads).”

    The floodgates are already open to FMGs that want to come here and practice. Curiously, your childlike dream of a river of fictitious surgeons flooding the country is not happening.

  • Anonymous

    “A FMG neurosurgeon would be happy to work for 80k in the USA. They could greatly undercut american specialists.”

    You are utterly clueless. That might be a fine way to hire a landscaper, but not a specialist surgeon.

    First of all, no one with training of an adequate quality to be a neurosurgeon would work here for that amount of money. Period. There are other places that would pay far more. Second, you don’t just get to train as a neurosurgeon somewhere else, even in countries where care and training standards are similar to those here and walk on for a job as a neurosurgeon. You have to train here if you want to get board certified here. Neurosurgery slots are hard to get and are very long residencies, usually 7-8 years, minimum, without a fellowship (following medical school, realize, as you seem not to understand the training requirements). So there is a natural scarcity, and absolutely no reason a qualified residency graduate would accept that kind of pay. That will never happen. Ever.

    Opening the floodgates to FMGs will not solve this problem. You cannot get foreigners to come here and work for nothing any more than you can get native-born physicians to do the same. FMG does not mean desperate or stupid or willing to work for peanuts.

  • Anonymous

    FMGs have to pass the english competency test as well. That is unless you want to abolish that and don’t want people to understand a single word their physicians says. That seems like a great way to take U.S. medicine.

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