Comments on: The war on terror leading to physician shortages? http://www.kevinmd.com/blog/2007/07/war-on-terror-leading-physician.html Tue, 14 Feb 2012 19:56:00 +0000 hourly 1 By: Anonymoushttp://www.kevinmd.com/blog/2007/07/war-on-terror-leading-physician.html#comment-78064 Anonymous Mon, 23 Jul 2007 12:10:00 +0000 http://clients.emmense.com/kevinmd/2007/07/the-war-on-terror-leading-to-physician-shortages.html#comment-78064 The last poster doesn't get the idea that practice in many rural areas is just not feasable on any terms that relies on the ability of the local market to pay.<br/>Even if you flooded the overall market so as to make city/suburban practice less profitable for the providers does not make the rural practice that could not support even a willing provider before suddenly able to afford that provider after. "No market" is in fact a prevailing market condition. That won't necesssarily change by flooding other markets to the point of minimum profitability. All it will do is drive providers into other lines of work. The last poster doesn’t get the idea that practice in many rural areas is just not feasable on any terms that relies on the ability of the local market to pay.
Even if you flooded the overall market so as to make city/suburban practice less profitable for the providers does not make the rural practice that could not support even a willing provider before suddenly able to afford that provider after. “No market” is in fact a prevailing market condition. That won’t necesssarily change by flooding other markets to the point of minimum profitability. All it will do is drive providers into other lines of work.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2007/07/war-on-terror-leading-physician.html#comment-78061 Anonymous Mon, 23 Jul 2007 05:25:00 +0000 http://clients.emmense.com/kevinmd/2007/07/the-war-on-terror-leading-to-physician-shortages.html#comment-78061 Thank you for reaffirming my hypothesis. There just are not enough providers in this country such that market forces dictate that providers must practice in rural and urban areas at the compensation levels offered in order to remain in practice. Perhaps one day the intellectual level of the populace will rise above that of cold fish and they will come to easily discerned realization that the current system serves, as primary beneficiaries, others besides themselves. Thank you for reaffirming my hypothesis. There just are not enough providers in this country such that market forces dictate that providers must practice in rural and urban areas at the compensation levels offered in order to remain in practice. Perhaps one day the intellectual level of the populace will rise above that of cold fish and they will come to easily discerned realization that the current system serves, as primary beneficiaries, others besides themselves.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2007/07/war-on-terror-leading-physician.html#comment-78059 Anonymous Mon, 23 Jul 2007 03:23:00 +0000 http://clients.emmense.com/kevinmd/2007/07/the-war-on-terror-leading-to-physician-shortages.html#comment-78059 "Extortionist rates"? "Fair market value"?<br/><br/>How about paying the same rate as the cities? Rural areas are paid LESS for the same medical service.<br/><br/>I moved from a rural area to a big city. For a mid-level office visit, established patient, Medicare pays about 20% more in my new practice, a nice suburb of a big city. The private insurers tend to follow Medicare in that payment pattern. “Extortionist rates”? “Fair market value”?

How about paying the same rate as the cities? Rural areas are paid LESS for the same medical service.

I moved from a rural area to a big city. For a mid-level office visit, established patient, Medicare pays about 20% more in my new practice, a nice suburb of a big city. The private insurers tend to follow Medicare in that payment pattern.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2007/07/war-on-terror-leading-physician.html#comment-78047 Anonymous Sun, 22 Jul 2007 20:25:00 +0000 http://clients.emmense.com/kevinmd/2007/07/the-war-on-terror-leading-to-physician-shortages.html#comment-78047 To 3:32:<br/><br/>Extortionist rates or fair market value? Importing doctors offloads the costs of education on the countries that they came from. That might sound good to you, until you get outsourced yourself.<br/><br/>The attraction won't be to come here and work for peanuts, not ever. There are other countries that doctors from eastern Europe, Africa and Asia willing to pay as well, and in many cases with fewer professional annoyances.<br/><br/>I don't see any barriers to going to rural areas except for the fact that those communities usually are relatively resource-poor, with fewer employment opportunities, poorer tax bases to fund public amenities, including schools and hospitals and generally lower incomes which also mean in many cases higher public assistance burdens and poorer reimbursement on average to private doctors. <br/><br/>Flooding the market won't be possible. That isn't the solution to this problem, or any problem where there isn't a strong market to begin with. To 3:32:

Extortionist rates or fair market value? Importing doctors offloads the costs of education on the countries that they came from. That might sound good to you, until you get outsourced yourself.

The attraction won’t be to come here and work for peanuts, not ever. There are other countries that doctors from eastern Europe, Africa and Asia willing to pay as well, and in many cases with fewer professional annoyances.

I don’t see any barriers to going to rural areas except for the fact that those communities usually are relatively resource-poor, with fewer employment opportunities, poorer tax bases to fund public amenities, including schools and hospitals and generally lower incomes which also mean in many cases higher public assistance burdens and poorer reimbursement on average to private doctors.

Flooding the market won’t be possible. That isn’t the solution to this problem, or any problem where there isn’t a strong market to begin with.

]]> By: Johnhttp://www.kevinmd.com/blog/2007/07/war-on-terror-leading-physician.html#comment-78043 John Sun, 22 Jul 2007 19:34:00 +0000 http://clients.emmense.com/kevinmd/2007/07/the-war-on-terror-leading-to-physician-shortages.html#comment-78043 --Anon 3:32<br/>"Extortionist Rates"???<br/><br/>How about fair market value. The supply of rural doctors is low, so cost should increase.<br/><br/>We could import foreigners for every job and pay them lower wages. What do you do for a living? Why don't we import more people of your profession to decrease costs? –Anon 3:32
“Extortionist Rates”???

How about fair market value. The supply of rural doctors is low, so cost should increase.

We could import foreigners for every job and pay them lower wages. What do you do for a living? Why don’t we import more people of your profession to decrease costs?

]]> By: Anonymoushttp://www.kevinmd.com/blog/2007/07/war-on-terror-leading-physician.html#comment-78039 Anonymous Sun, 22 Jul 2007 18:00:00 +0000 http://clients.emmense.com/kevinmd/2007/07/the-war-on-terror-leading-to-physician-shortages.html#comment-78039 In the article, mention was made of the one-way trade in docs. They come here, but we don't leave to go to the other countries.<br/><br/>Actually, most of those countries, it would be difficult for an American doctor to go there. Licensure is very difficult for foreigners. The USA is relatively easy. In the article, mention was made of the one-way trade in docs. They come here, but we don’t leave to go to the other countries.

Actually, most of those countries, it would be difficult for an American doctor to go there. Licensure is very difficult for foreigners. The USA is relatively easy.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2007/07/war-on-terror-leading-physician.html#comment-78038 Anonymous Sun, 22 Jul 2007 17:58:00 +0000 http://clients.emmense.com/kevinmd/2007/07/the-war-on-terror-leading-to-physician-shortages.html#comment-78038 I thought the war on terror had caused a crisis in Kansas after some tornadoes recently. I thought the war on terror had caused a crisis in Kansas after some tornadoes recently.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2007/07/war-on-terror-leading-physician.html#comment-78037 Anonymous Sun, 22 Jul 2007 17:38:00 +0000 http://clients.emmense.com/kevinmd/2007/07/the-war-on-terror-leading-to-physician-shortages.html#comment-78037 I thought when rural states like Mississippi got tort "reform", this was no longer going to be a problem?<br/><br/>You mean that we were lied to? Shocking! I thought when rural states like Mississippi got tort “reform”, this was no longer going to be a problem?

You mean that we were lied to? Shocking!

]]> By: DDx:dxhttp://www.kevinmd.com/blog/2007/07/war-on-terror-leading-physician.html#comment-78035 DDx:dx Sun, 22 Jul 2007 16:07:00 +0000 http://clients.emmense.com/kevinmd/2007/07/the-war-on-terror-leading-to-physician-shortages.html#comment-78035 I agree with Anon 7:53. The "shortage" of rural docs often is a lifesyle problem. Three docs in a town of 5000 want a fourth and fifth to take less call, but the actual demand isn't that great, so the grow their clinic then start dragging pt.s in, promoting practices...Marketing.Create demand.<br/>But the 3 docs might feel better about covering the ER every third night if they made more money.... I agree with Anon 7:53. The “shortage” of rural docs often is a lifesyle problem. Three docs in a town of 5000 want a fourth and fifth to take less call, but the actual demand isn’t that great, so the grow their clinic then start dragging pt.s in, promoting practices…Marketing.Create demand.
But the 3 docs might feel better about covering the ER every third night if they made more money….

]]> By: Anonymoushttp://www.kevinmd.com/blog/2007/07/war-on-terror-leading-physician.html#comment-78034 Anonymous Sun, 22 Jul 2007 15:12:00 +0000 http://clients.emmense.com/kevinmd/2007/07/the-war-on-terror-leading-to-physician-shortages.html#comment-78034 Anon:10:50 AM- <br/><br/>In X-Men 2 when Nightcrawler asks Mystique (the shape changing one) that if she could alter her shape to appear human - why didn't she? <br/><br/>Her answer?: Cuz she shouldn't have to!<br/><br/>We shouldn't be asking their people to change their last names/culture to adjust to America's culture...because like it or not they WILL be incorporated into America's culture in time. Anon:10:50 AM-

In X-Men 2 when Nightcrawler asks Mystique (the shape changing one) that if she could alter her shape to appear human – why didn’t she?

Her answer?: Cuz she shouldn’t have to!

We shouldn’t be asking their people to change their last names/culture to adjust to America’s culture…because like it or not they WILL be incorporated into America’s culture in time.

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