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	<title>Comments on: Primary care crisis in northern New York</title>
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		<title>By: Matt</title>
		<link>http://www.kevinmd.com/blog/2007/08/primary-care-crisis-in-northern-new.html/comment-page-1#comment-79765</link>
		<dc:creator>Matt</dc:creator>
		<pubDate>Sun, 02 Sep 2007 16:40:00 +0000</pubDate>
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		<description>&quot;Venom towards trial lawyers who pursue bogus and unjustified malpractice lawsuits, who then also make 40% of the verdict - that&#039;s who physicians venom is directed, not the legal profession in general.&quot;&lt;br/&gt;&lt;br/&gt;Yet you know as little about those cases as you accuse others of knowing about the practice of medicine.  Do you not see the irony of your complaints?</description>
		<content:encoded><![CDATA[<p>&#8220;Venom towards trial lawyers who pursue bogus and unjustified malpractice lawsuits, who then also make 40% of the verdict &#8211; that&#8217;s who physicians venom is directed, not the legal profession in general.&#8221;</p>
<p>Yet you know as little about those cases as you accuse others of knowing about the practice of medicine.  Do you not see the irony of your complaints?</p>
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		<title>By: ismd</title>
		<link>http://www.kevinmd.com/blog/2007/08/primary-care-crisis-in-northern-new.html/comment-page-1#comment-79754</link>
		<dc:creator>ismd</dc:creator>
		<pubDate>Fri, 31 Aug 2007 18:30:00 +0000</pubDate>
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		<description>Matt,&lt;br/&gt;&lt;br/&gt;Venom towards trial lawyers who pursue bogus and unjustified malpractice lawsuits, who then also make 40% of the verdict - that&#039;s who physicians venom is directed, not the legal profession in general.&lt;br/&gt;&lt;br/&gt;N14, &lt;br/&gt;&lt;br/&gt;your comment about NJ - &quot;Was it not in your state where the infamous boondoggle happened with providers extorting their patients by not performing certain procedures until their demands for special legal protections were met (it was and I have saved the e-mails)?&quot; If you are referring to the work slowdown of 2003, then your statement is completely false. While the state senate capped noneconomic damges at 1,000,000 dollars, the assembly shot it down along party lines. There is still no malpractice relief other than a tightening of expert witness requirements. If you refer to e-mails from a particular surgeon, that&#039;s his OPINION, not fact. I did participate in the work slowdown, but, understand - hospital patients were covered , ERs did not close, and emergencies were handled. Get your facts straight.&lt;br/&gt;&lt;br/&gt;There are no special privileges for doctors in NJ, probably the most anti-doctor state in the country. We&#039;re plagued by nonsense regulations that actually take us away from patient care, such as the new &quot;cultural competency training&quot; law that requires 6 hours of a course over and above the 100 hours we have to take every 2 years. And I wouldn&#039;t call price controls set by the government in the form of Medicare to be any special privileges. We can still be sued, and with recent court decisions in the state, even more easily than before.&lt;br/&gt;&lt;br/&gt;Get real and get your facts straight.</description>
		<content:encoded><![CDATA[<p>Matt,</p>
<p>Venom towards trial lawyers who pursue bogus and unjustified malpractice lawsuits, who then also make 40% of the verdict &#8211; that&#8217;s who physicians venom is directed, not the legal profession in general.</p>
<p>N14, </p>
<p>your comment about NJ &#8211; &#8220;Was it not in your state where the infamous boondoggle happened with providers extorting their patients by not performing certain procedures until their demands for special legal protections were met (it was and I have saved the e-mails)?&#8221; If you are referring to the work slowdown of 2003, then your statement is completely false. While the state senate capped noneconomic damges at 1,000,000 dollars, the assembly shot it down along party lines. There is still no malpractice relief other than a tightening of expert witness requirements. If you refer to e-mails from a particular surgeon, that&#8217;s his OPINION, not fact. I did participate in the work slowdown, but, understand &#8211; hospital patients were covered , ERs did not close, and emergencies were handled. Get your facts straight.</p>
<p>There are no special privileges for doctors in NJ, probably the most anti-doctor state in the country. We&#8217;re plagued by nonsense regulations that actually take us away from patient care, such as the new &#8220;cultural competency training&#8221; law that requires 6 hours of a course over and above the 100 hours we have to take every 2 years. And I wouldn&#8217;t call price controls set by the government in the form of Medicare to be any special privileges. We can still be sued, and with recent court decisions in the state, even more easily than before.</p>
<p>Get real and get your facts straight.</p>
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		<title>By: N14</title>
		<link>http://www.kevinmd.com/blog/2007/08/primary-care-crisis-in-northern-new.html/comment-page-1#comment-79749</link>
		<dc:creator>N14</dc:creator>
		<pubDate>Thu, 30 Aug 2007 20:32:00 +0000</pubDate>
		<guid isPermaLink="false">http://clients.emmense.com/kevinmd/2007/08/primary-care-crisis-in-northern-new-york.html#comment-79749</guid>
		<description>ismd:&lt;br/&gt;&lt;br/&gt;No venom at all.  You might disagree with my positions and that is fine.  As far as special dispensations go, they come from an enabling society coupled with the collision between provider groups and government.  There is no other single field of endeavor in which the practitioners of the field have created a supplier side benefit as with domestic allopathic healthcare.  This holds from the training side of the equation (via severe limitations on the number trained per anum), the disciplinary side of the equation and through collusive actions with the government via grossly restrictive scope of practice limitations to preclude the populace from obtaining access to healthcare when they are either abandoned or deemed unworthy of the few providers that are trained.  And let us dispense with the fallacy of training of lawyers (locally accredited non-ABA schools with full rights to practice within the State of California upon passage of the bar examination) preclude such a comparison.  Dentists, by virtue of being limited in their practice to one specific anatomical region of the body are also precluded.  In order for allopathic medicine to be compared one would have to have specific and different schools for each specialty with rigorously enforced scope of practice to limitations.  This special set of privileges also holds true for professional liability.  No other field of endeavor has the protections that already exist on the books as does allopathic medicine.  The disciplinary boards are a joke as is the ability of providers to border jump to set up their malpractice in neighboring states in the few cases in which licensure is revoked in any particular state. &lt;br/&gt;&lt;br/&gt;As far as patients being abandoned... I am correct.  You can do the research for yourself by simply looking at the states with purported &quot;malpractice crisis&quot; (of course this doesn&#039;t address the actual malpractice occurring).  How many states have we seen false cries of &quot;providers being killed&quot; by the costs of their premiums (only to learn that they are still making a good six figures after all expenses) coupled with fleeing (i.e. abandoning patients for purely fiscal reasons)?  Was it not in your state where the infamous boondoggle happened with providers extorting their patients by not performing certain procedures until their demands for special legal protections were met (it was and I have saved the e-mails)?&lt;br/&gt;&lt;br/&gt;It is time to decide if physicians are &quot;special&quot; or if they are just like everybody else.  If they are special then they need to be held to a standard of responsibility commensurate with being &quot;special&quot; (e.g. no abandoning of patients for purely fiscal reasons).  If they are just like everybody else then we can start with the dismantling of the special provider protections in the marketplace and truly have healthcare reform.</description>
		<content:encoded><![CDATA[<p>ismd:</p>
<p>No venom at all.  You might disagree with my positions and that is fine.  As far as special dispensations go, they come from an enabling society coupled with the collision between provider groups and government.  There is no other single field of endeavor in which the practitioners of the field have created a supplier side benefit as with domestic allopathic healthcare.  This holds from the training side of the equation (via severe limitations on the number trained per anum), the disciplinary side of the equation and through collusive actions with the government via grossly restrictive scope of practice limitations to preclude the populace from obtaining access to healthcare when they are either abandoned or deemed unworthy of the few providers that are trained.  And let us dispense with the fallacy of training of lawyers (locally accredited non-ABA schools with full rights to practice within the State of California upon passage of the bar examination) preclude such a comparison.  Dentists, by virtue of being limited in their practice to one specific anatomical region of the body are also precluded.  In order for allopathic medicine to be compared one would have to have specific and different schools for each specialty with rigorously enforced scope of practice to limitations.  This special set of privileges also holds true for professional liability.  No other field of endeavor has the protections that already exist on the books as does allopathic medicine.  The disciplinary boards are a joke as is the ability of providers to border jump to set up their malpractice in neighboring states in the few cases in which licensure is revoked in any particular state. </p>
<p>As far as patients being abandoned&#8230; I am correct.  You can do the research for yourself by simply looking at the states with purported &#8220;malpractice crisis&#8221; (of course this doesn&#8217;t address the actual malpractice occurring).  How many states have we seen false cries of &#8220;providers being killed&#8221; by the costs of their premiums (only to learn that they are still making a good six figures after all expenses) coupled with fleeing (i.e. abandoning patients for purely fiscal reasons)?  Was it not in your state where the infamous boondoggle happened with providers extorting their patients by not performing certain procedures until their demands for special legal protections were met (it was and I have saved the e-mails)?</p>
<p>It is time to decide if physicians are &#8220;special&#8221; or if they are just like everybody else.  If they are special then they need to be held to a standard of responsibility commensurate with being &#8220;special&#8221; (e.g. no abandoning of patients for purely fiscal reasons).  If they are just like everybody else then we can start with the dismantling of the special provider protections in the marketplace and truly have healthcare reform.</p>
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		<title>By: Matt</title>
		<link>http://www.kevinmd.com/blog/2007/08/primary-care-crisis-in-northern-new.html/comment-page-1#comment-79748</link>
		<dc:creator>Matt</dc:creator>
		<pubDate>Thu, 30 Aug 2007 19:56:00 +0000</pubDate>
		<guid isPermaLink="false">http://clients.emmense.com/kevinmd/2007/08/primary-care-crisis-in-northern-new-york.html#comment-79748</guid>
		<description>ismd,&lt;br/&gt;&lt;br/&gt;Is his venom any different from the venom that physicians direct toward lawyers?  Not really.  Similar assumptions are made by physicians as this anon as made toward physicians.&lt;br/&gt;&lt;br/&gt;Although he does have one valid point - that physicians are always asking for special protections on the premise that if they don&#039;t get it, &quot;patients lose&quot; (to borrow from Kevin).  Yet no matter how much special treatment you give them, their attitude toward patients and the patients&#039; access of physicians doesn&#039;t change much.  Can you blame people if you don&#039;t hold up your end of the bargain?  Sure, they should have known it was just lobbying nonsense, but still, some are going to be disappointed.</description>
		<content:encoded><![CDATA[<p>ismd,</p>
<p>Is his venom any different from the venom that physicians direct toward lawyers?  Not really.  Similar assumptions are made by physicians as this anon as made toward physicians.</p>
<p>Although he does have one valid point &#8211; that physicians are always asking for special protections on the premise that if they don&#8217;t get it, &#8220;patients lose&#8221; (to borrow from Kevin).  Yet no matter how much special treatment you give them, their attitude toward patients and the patients&#8217; access of physicians doesn&#8217;t change much.  Can you blame people if you don&#8217;t hold up your end of the bargain?  Sure, they should have known it was just lobbying nonsense, but still, some are going to be disappointed.</p>
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		<title>By: ismd</title>
		<link>http://www.kevinmd.com/blog/2007/08/primary-care-crisis-in-northern-new.html/comment-page-1#comment-79747</link>
		<dc:creator>ismd</dc:creator>
		<pubDate>Thu, 30 Aug 2007 19:06:00 +0000</pubDate>
		<guid isPermaLink="false">http://clients.emmense.com/kevinmd/2007/08/primary-care-crisis-in-northern-new-york.html#comment-79747</guid>
		<description>N14,&lt;br/&gt;&lt;br/&gt;Let&#039;s examine your suppositions, the first being that there is some sort of &quot;privilege side of the equation&quot;. Excuse me? What might you be talking about? You think we get special dispensation from God? Or society in general? Hardly. I don&#039;t know where you&#039;ve picked up this nonsensical idea from, but you are very far off the mark. &lt;br/&gt;&lt;br/&gt;As far as this prepostorous notion - &quot;Patients are routinely abandoned if they do not give up their rights and carve out special protections just for the physician class and patients are abandoned if they don&#039;t pay enough (do no harm, right)&quot; - you are so wrong. Where is your data to support this idea of yours? Ah - there isn&#039;t any. It&#039;s just your perception/bias based on your obvious hatred of the &quot;physician class&quot;, not hard data.&lt;br/&gt;&lt;br/&gt;I realize that I&#039;m not going to change your mind, nor do I care to, but your venom needs to be counteracted.</description>
		<content:encoded><![CDATA[<p>N14,</p>
<p>Let&#8217;s examine your suppositions, the first being that there is some sort of &#8220;privilege side of the equation&#8221;. Excuse me? What might you be talking about? You think we get special dispensation from God? Or society in general? Hardly. I don&#8217;t know where you&#8217;ve picked up this nonsensical idea from, but you are very far off the mark. </p>
<p>As far as this prepostorous notion &#8211; &#8220;Patients are routinely abandoned if they do not give up their rights and carve out special protections just for the physician class and patients are abandoned if they don&#8217;t pay enough (do no harm, right)&#8221; &#8211; you are so wrong. Where is your data to support this idea of yours? Ah &#8211; there isn&#8217;t any. It&#8217;s just your perception/bias based on your obvious hatred of the &#8220;physician class&#8221;, not hard data.</p>
<p>I realize that I&#8217;m not going to change your mind, nor do I care to, but your venom needs to be counteracted.</p>
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		<title>By: N14</title>
		<link>http://www.kevinmd.com/blog/2007/08/primary-care-crisis-in-northern-new.html/comment-page-1#comment-79744</link>
		<dc:creator>N14</dc:creator>
		<pubDate>Thu, 30 Aug 2007 18:19:00 +0000</pubDate>
		<guid isPermaLink="false">http://clients.emmense.com/kevinmd/2007/08/primary-care-crisis-in-northern-new-york.html#comment-79744</guid>
		<description>ismd:&lt;br/&gt;&lt;br/&gt;Whether or not you like my commentary is particularly of little relevance to me.  There is a dichotomy when it comes to the privilege side of the equation and the responsibility side of the equation when dealing with providers.  Providers are granted a degree of privilege that is far beyond that of workers in any other field of endeavor.  One need only look as far as the model that has been enacted to prevent competition in the field of allopathic medicine to ensure high after-expense compensation rates for the providers (no other field of endeavor has anything as restrictive as allopathic medicine when it comes to limiting the numbers of those that can be trained).  While it would seem odd that the American populace would support such a system... perhaps it is not given the skillful manipulation of the healthcare system by the allopaths over the last century.  It also doesn&#039;t hurt when the softheaded are willing to buy into the &quot;do no harm&quot; nonsense that often gets peddled around.  For this level of economic privilege we see little in return from the responsibility side of the equation.  Patients are routinely abandoned if they do not give up their rights and carve out special protections just for the physician class and patients are abandoned if they don&#039;t pay enough (do no harm, right).  You might disagree regarding the justification for patient abandonment but the simple fact in this case is that this provider abandoned his patients for fiscal reasons.  The American public, for as long as they support the current system, deserve every bit of maltreatment that is heaped upon them.</description>
		<content:encoded><![CDATA[<p>ismd:</p>
<p>Whether or not you like my commentary is particularly of little relevance to me.  There is a dichotomy when it comes to the privilege side of the equation and the responsibility side of the equation when dealing with providers.  Providers are granted a degree of privilege that is far beyond that of workers in any other field of endeavor.  One need only look as far as the model that has been enacted to prevent competition in the field of allopathic medicine to ensure high after-expense compensation rates for the providers (no other field of endeavor has anything as restrictive as allopathic medicine when it comes to limiting the numbers of those that can be trained).  While it would seem odd that the American populace would support such a system&#8230; perhaps it is not given the skillful manipulation of the healthcare system by the allopaths over the last century.  It also doesn&#8217;t hurt when the softheaded are willing to buy into the &#8220;do no harm&#8221; nonsense that often gets peddled around.  For this level of economic privilege we see little in return from the responsibility side of the equation.  Patients are routinely abandoned if they do not give up their rights and carve out special protections just for the physician class and patients are abandoned if they don&#8217;t pay enough (do no harm, right).  You might disagree regarding the justification for patient abandonment but the simple fact in this case is that this provider abandoned his patients for fiscal reasons.  The American public, for as long as they support the current system, deserve every bit of maltreatment that is heaped upon them.</p>
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		<title>By: ismd</title>
		<link>http://www.kevinmd.com/blog/2007/08/primary-care-crisis-in-northern-new.html/comment-page-1#comment-79736</link>
		<dc:creator>ismd</dc:creator>
		<pubDate>Thu, 30 Aug 2007 12:49:00 +0000</pubDate>
		<guid isPermaLink="false">http://clients.emmense.com/kevinmd/2007/08/primary-care-crisis-in-northern-new-york.html#comment-79736</guid>
		<description>N14,&lt;br/&gt;&lt;br/&gt;You have NO freakin&#039; clue what any of this is all about. Posting your comments may make you feel better, but contribute nothing to the discussion. If physicians choose to have a better lifestyle, and make more money in the process, then so be it. I was a solo doc for 3 1/2 years, with no one to cover me, on call 24/7. It wasn&#039;t pretty, and I missed alot of my kids growing up. Again - why is it OK for anyone else besides docs to &quot;go for the gold&quot;, but when docs change jobs for a better lifestyle, that&#039;s patient abandonment? Those rural docs have no social contract or obligation to stay in that area. I&#039;m not sure where your anti-doctor hatred comes from, but you need to get a life and get a clue.</description>
		<content:encoded><![CDATA[<p>N14,</p>
<p>You have NO freakin&#8217; clue what any of this is all about. Posting your comments may make you feel better, but contribute nothing to the discussion. If physicians choose to have a better lifestyle, and make more money in the process, then so be it. I was a solo doc for 3 1/2 years, with no one to cover me, on call 24/7. It wasn&#8217;t pretty, and I missed alot of my kids growing up. Again &#8211; why is it OK for anyone else besides docs to &#8220;go for the gold&#8221;, but when docs change jobs for a better lifestyle, that&#8217;s patient abandonment? Those rural docs have no social contract or obligation to stay in that area. I&#8217;m not sure where your anti-doctor hatred comes from, but you need to get a life and get a clue.</p>
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		<title>By: Throckmorton</title>
		<link>http://www.kevinmd.com/blog/2007/08/primary-care-crisis-in-northern-new.html/comment-page-1#comment-79735</link>
		<dc:creator>Throckmorton</dc:creator>
		<pubDate>Thu, 30 Aug 2007 12:37:00 +0000</pubDate>
		<guid isPermaLink="false">http://clients.emmense.com/kevinmd/2007/08/primary-care-crisis-in-northern-new-york.html#comment-79735</guid>
		<description>After 5 years of being on call every night, I looked down and saw that my children were growing up without me and my wife had become a single mother.  &lt;br/&gt;&lt;br/&gt;Like many, I chose to move.  My call is better, I actually see my children and I can help coach baseball.  I was able to do this so because I moved to a larger city where there are more of us to take the call.  In the small town there was no time off.&lt;br/&gt;&lt;br/&gt;This may sound trivial to those not in medicine, but after working 12 hours a day, then either going in to the hospital in the middle of the night or at least woken each night with no such thing as weekends off, a night without a beeper becomes a trip to paradise.</description>
		<content:encoded><![CDATA[<p>After 5 years of being on call every night, I looked down and saw that my children were growing up without me and my wife had become a single mother.  </p>
<p>Like many, I chose to move.  My call is better, I actually see my children and I can help coach baseball.  I was able to do this so because I moved to a larger city where there are more of us to take the call.  In the small town there was no time off.</p>
<p>This may sound trivial to those not in medicine, but after working 12 hours a day, then either going in to the hospital in the middle of the night or at least woken each night with no such thing as weekends off, a night without a beeper becomes a trip to paradise.</p>
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		<title>By: N14</title>
		<link>http://www.kevinmd.com/blog/2007/08/primary-care-crisis-in-northern-new.html/comment-page-1#comment-79731</link>
		<dc:creator>N14</dc:creator>
		<pubDate>Thu, 30 Aug 2007 03:40:00 +0000</pubDate>
		<guid isPermaLink="false">http://clients.emmense.com/kevinmd/2007/08/primary-care-crisis-in-northern-new-york.html#comment-79731</guid>
		<description>Anon 9:55&lt;br/&gt;&lt;br/&gt;The truth is difficult for some to take.  People generally do not respond well to being held to account for the purported claims of being &quot;special&quot; and deserving of benefits not provided for anyone else.</description>
		<content:encoded><![CDATA[<p>Anon 9:55</p>
<p>The truth is difficult for some to take.  People generally do not respond well to being held to account for the purported claims of being &#8220;special&#8221; and deserving of benefits not provided for anyone else.</p>
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		<title>By: MedFriendly</title>
		<link>http://www.kevinmd.com/blog/2007/08/primary-care-crisis-in-northern-new.html/comment-page-1#comment-79729</link>
		<dc:creator>MedFriendly</dc:creator>
		<pubDate>Thu, 30 Aug 2007 02:57:00 +0000</pubDate>
		<guid isPermaLink="false">http://clients.emmense.com/kevinmd/2007/08/primary-care-crisis-in-northern-new-york.html#comment-79729</guid>
		<description>When people here about the training it took for me to become a neuropsychologist they often shake their head and say that it is way too much school. I tell them it is nothing compared to what physicians have to go through. And it never seems to end for them, especially the part about being on call all the time. Not a life I could live due to the high stress.</description>
		<content:encoded><![CDATA[<p>When people here about the training it took for me to become a neuropsychologist they often shake their head and say that it is way too much school. I tell them it is nothing compared to what physicians have to go through. And it never seems to end for them, especially the part about being on call all the time. Not a life I could live due to the high stress.</p>
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