But do not imply that they demand a higher level of intellectual ability. That is poppycock. Specialty choice is far more a matter of temperament and personality than IQ. Granted some are far more competetive, but that is a function not of what is required by the nature of the work, but the differing effectiveness or desire of the leaders in limiting the training opportunities.

I am, and have the right to be, resentful of the changes in the payment system that has put those who don’t benefit from or value my services, with snobby attitudes like jb, in charge of MY fees and my income. JB’s supercilious post is proof again that given the disdain that some specialists have for those who practice the core of medicine, letting committees composed of these arrogant snobs “determine” the value of our work is stupid, and those who play along are suckers.

I do not. The people who need my services value them more than those who don’t–which is logical.

The way for whining PCP’s to “put their money where their mouth is” is not to go do a radiology residency and do something no less valuable, no more challenging, and, for them, far less interesting–it is to declare their independence of collectivist fee setting and live in the free market where they will find patients value their care more than bureaucrats and their incomes will rise–when they have the guts to take the risk and endure the criticism.

It is the radiologist who read the film 2 days after the ER doc and the orthopod had read it and treated the fracture, but who charged more than both of them together who would find patients valuing his services far less than the central controllers in a real free market–especially since that digital image can be sent anywhere in the world, read by someone who earns a fraction of what he earns, and reported back soon enough to do some good. When the cartel breaks . . .

Primary care docs who, like most, persist in refusing to insist on being payed what they are worth, expecting instead that their ongoing self-sacrifice will be recongized without asking–who prefer heroism and martyrdom over asking for and collecting a fair fee–will be starved out of business.

Continuing to just take whatever value third parties who are not the beneficiary of the service choose to place on it is economically insane.

I do believe that the leaders will never have the guts to address the problem effectively. The only path to freedom and fairness is to opt out of socialized medicine and set their own fees at prices which the public are willing to pay.

It is a clear indication in regulated markets that the price is set too low when the service is not available.