I'm sure he was also thinking our specific area of practice rather than medicine entirely.  I would not want to do anything else.  While I think dermatology is neat, it wouldn't be among even the top 5 specialties I would have picked.  Don't get me wrong, dermatologists perform a great service.  They basically prevent cancers or remove them when they haven't spread or need anything more than an office excision.  It's certainly fun to think about an easier lifestyle while still practicing medicine.

Do you guys think the future of medicine is with a single-payer system?  Or do you envision a permanently bifurcated system where the insurance companies still reimburse their half of the patients and doctors continue to be slightly reimbursed for treating medicare/medicaid patients, which is funded by Obamacare?





I realize there won't be enough funds to make up for the additional 40 million patient influx via medicare/medicaid, but do you think Congress will end up just borrowing more to pay the deficit, as opposed to dictating to insurance companies what they can and can't pay?





I've been watching a lot of videos on this lately, mostly with doctors doing the talking. It looks BAD. Some MDs in a congressional committee are quoting statistics like 45% of doctors will end up leaving the practice because, in many areas, the average age of doctors is 55 yo or older, and they would rather retire early than have to go through the massive costs of compliance with Obamacare when it is fully implemented. They also say 60% will end up becoming employees of hospitals or ACO's, since the costs of having a private practice will be so great.





These are scary times for medicine.
 

A small town doctor friend of mine has also decided it isn't worth it.
He got out of med school, worked in hospitals for several years and finally started his own practice in family medicine.
He's closing the office and going into research.
Bummer... Real nice guy, 45 years old, feeling forced to dump a couple hundred or so patients into the abyss.

Speaking of a government tier... I had no idea Congress asked Obama if they could be exempted from the new Obamacare requirements because it would be too costly for them and their staff. He supposedly signed off on it behind closed doors because it would look too bad for Congress to vote on (as they should have) whether or not they should exempt themselves from Obamacare while everyone else gets stuck with the short stick. Later, I read how 1300 organizations were petitioning and later granted exemptions from the requirements because they helped to support and vote Obama into office.





One cardiologist said 75% have ended up working for hospitals because
the costs of tests are too much for private practice and the
reimbursements were too small; his group had to make payroll out of
their own pockets because medicare/medicaid didn't reimburse them enough
to completely cover their costs. What a terrible thing it is to go through 7-13 years of training only to end up spending the rest of your career working for a hospital system because the costs were too great and the red tape too burdensome to work in a private practice.





What a shame
 
 

"Comrade?"  I own a few AK's but I have even more AR's.  Anyway, I do not support the concept you allude to but we have to admit that the doctor is either an individual and can do what he wants, in which case there is no right to doctor administered health care, or people have a right to doctor administered health care in which case the doctor's individuality is subservient to the right to care.  If we want our doctors to be the slaves to providing care, then you need to not pay them enough that they can get out of the profession.  The current direction of health care dictates that doctors who think do it my way or I quit will need to be removed from the system and replaced by doctors who are willing to work as employees for a salary.  The doctors who know the financial benefit of the past cannot be allowed to corrupt the future doctors who will not be permitted to make the same amount.  

And I guarantee you someone in government has already thinks that if you pay them less then can never retire and thus there will be more doctor administered health care to go around.  Personally, I believe the solution to health care is not found in more state control but in making health care nothing but a service like all others and making people pay for it.  In other words, get rid of the third party payer problem and accept the fact that some may not get the same care as others, and live with the consequences.  

I have to admit, I have been encouraging potential health care students to look elsewhere the last couple of years.  Going into that kind of debt just to take a big bite of the shit sandwich being served isn't in their best interest.

I am pretty sure the government will also issue breeding orders as well as forced sterilization orders to ensure a proper electorate.



 

I would not say I work in a "busy" Emergency Department, but today saw 39 patients. Lots of urgent care stuff which gets worse every day, and takes away from the time I have to care for the brain hemorrhage. Office visits filled up by 0930 with the pcp, so we pick up the slack.
I can't wait to get out.

I see a single payor HMO type of plan with docs required byaw to paticipate. Remember under HillaryKare there were fines and potential jail time for those docs who did not compy