Yes, entitlement is a problem: entitlement to have someone else pay for the medical services and then also to have someone else pay for the insurance policy that pays (sort of but not really) for the medical services.

So is the failure of the insurance industry to actually become a market. It behaves like a cartel.

The medical profession behaves as a collection of varied interest groups with sometimes common and sometimes opposing interests. Pitting specialists against generalists by suggesting one has to take from the other, opposite; supporting a government option or even single-payer insurance reform bill, common (surprisingly, 80% regardless of practice type.)

Tony Montana, Scarface

Excellent post. Political representation may be the only way to get a toe hold into preserving our interests. I agree that growing divisions within the House of Medicine will make it harder. The fact remains that it must be done.

Of course, when you are talking about the folks I’ve been fighting – or the ones in government, regulation & law enforcement who’ve been pretending I don’t exist – big monkey tactics (as in business) sounds good too;)

Senator Bill Frist. Now there’s an interesting subject. Probably shouldn’t be talking about cats around him. And from Wikipedia (the short version because links on my long-ago posts are dead): “Frist has a fortune in the millions of dollars, most of it the result of his ownership of stock in Hospital Corporation of America, the for-profit hospital chain founded by his brother and father. HCA paid over $1.7-billion in criminal penalties for Medicare fraud.”

In point of fact, Christophil, to a large degree, blogging openly and signing my name has gotten me out of my cage. Eleven years of college/training, followed some time later by a good solid three years of legal pummeling (and about 9 awful years of eeking by) had beaten the ME out of me. I lived in absolute fear.

Blogging at least changed that. I do have a much better sense of what my time & expertise is worth (especially in certain situations), and I don’t put up with garbage anymore. Moreover those who contract and work with me know it.

And those who wronged me are now the ones living in fear . . . i.e. when will the other shoe drop?

Otherwise, good points.

My case (as I’ve found out, actually not so “rare”) SCREAMS for intervention on a state/Federal and JOURNALISTIC level. Again, where are all of our so-called advocacy organizations – the ones that are supposed to be there to protect us? Where are the news organization that boo-hoo when Conan bumps his head?

The people that are in power now have ZERO RESPECT for physicians – and very little comprehension of what most of us do and endure on a day-to-day basis. Some of it is our own fault (or rather a previous generation of MD’s fault) because we let them devalue what we do . . . and gradually herd us – like reluctant cats – to our respective cages. Now we are only here to do their biding . . . so they can satisfy the masses who now feel entitled to a whole lot of expensive something for nothing.

Someone somewhere else in another comment thread on this blog NAILED it. ENTITLEMENT IS THE PROBLEM!!! It is the elephant in the room. Is our President addressing that in his grand plan for “reform”? No. He is FEEDING it.

You might recall that, just a few posts ago here on Kevin’s, we talked about medical schools clamping down on what medical students say and do outside of their professional lives. In JCAHO’s eyes (and apparently the AMA’s – please don’t get me started on “which doctors” have been in control), anything a doctor might say or do to fight back against arrogance, ignorance, ineptitude and greed on the part of a hospital or its administration is “disruptive”.

I’ve been fighting the equivalent of a lone gorilla war for eleven years. I’m heartened to see some of my colleagues finally waking up. But it’s probably way too late.

How? Well, not by continuing to do what hasn’t worked! Throw the “rules” out. Desperate times call for desperate measure- gorilla tactics are needed. Work slow downs are a legitimate and ethical form of protest. According to AMA code of ethics- “In rare circumstances, individual or grassroots actions, such as brief limitations of personal availability, may be appropriate as a means of calling attention to needed changes in patient care”.

It’s not a question of HOW?, rather WHO?, who has the courage to take off the gloves and do what is necessary!