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Posted: 1/23/2021 6:20:19 PM EDT
[#1]
Quote HistoryQuoted: What is an FMG? Full Metal Gynecologist |
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Posted: 1/23/2021 6:23:04 PM EDT
[#2]
Quote HistoryQuoted: What is an FMG? Foreign medical graduate. |
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Posted: 1/23/2021 6:27:31 PM EDT
[#3]
Quote HistoryQuoted: Medical errors are the third leading cause of death. https://www.cnbc.com/2018/02/22/medical-errors-third-leading-cause-of-death-in-america.html If you believe that, you logically will never go to a doctor or a hospital. |
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Posted: 1/23/2021 6:30:20 PM EDT
[#4]
OST
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Posted: 1/23/2021 6:31:01 PM EDT
[#5]
Quote HistoryQuoted: Take insurance companies out of the equation. A year or so ago my daughter tore her ACL. We took her to the doctor the following morning and she was prescribed a neoprene soft brace with a couple hinges which she received at the office. This was a DonJoy that you can get off Amazon for less than $200, and you can pick up something similar at Dick's Sports for less than $100. DonJoy billed us nearly $500 for this device because of their contact with BCBS which allows them bill up to the deductible amount. So if our deductible had been $1500 they would have billed us $1500. Total scam! And let me reiterate, I could have purchased the same or similar brace for less than $200 from Amazon or a local retailer. I refused to pay the nearly $500, filed a complaint with the State Insurance Commissioner, the State Consumer Protection and have not heard from DJO since. In comparison when my daughter was prescribed a hard brace after surgery, a DJO (DonJoy) Renegade was prescribed, the price quoted $450-500 which was the going rate. As it turned out I found one used on Ebay for $150 and resold it for the same price. Quote HistoryQuoted: Quoted: You're not wrong, but people literally can't afford to go to the doctor. I have several family members that drastically need to see a doctor. They work 40 hours a week but still can't afford medical attention. Somethings got to give. I'll admit though, they could take better care of themselves. Take insurance companies out of the equation. A year or so ago my daughter tore her ACL. We took her to the doctor the following morning and she was prescribed a neoprene soft brace with a couple hinges which she received at the office. This was a DonJoy that you can get off Amazon for less than $200, and you can pick up something similar at Dick's Sports for less than $100. DonJoy billed us nearly $500 for this device because of their contact with BCBS which allows them bill up to the deductible amount. So if our deductible had been $1500 they would have billed us $1500. Total scam! And let me reiterate, I could have purchased the same or similar brace for less than $200 from Amazon or a local retailer. I refused to pay the nearly $500, filed a complaint with the State Insurance Commissioner, the State Consumer Protection and have not heard from DJO since. In comparison when my daughter was prescribed a hard brace after surgery, a DJO (DonJoy) Renegade was prescribed, the price quoted $450-500 which was the going rate. As it turned out I found one used on Ebay for $150 and resold it for the same price. I had a similar experience w/ a chiro. Threw my back out, went to my wife's chiro, she did some BS exam, used some BS thumping tool, couldn't really adjust me because of the pain, 'gave' me a back brace and billed BCBS (back when I could afford them) The brace was nice but when I saw the charge, which was about three times the average price, I said I'm bringing it back. She and I went back and forth, she said BCBS allows her to charge what she does, I said I don't care, it's being returned. She offered to discount it but the price was still crazy, I said nope. Gave it back and ordered the same one online for much much less. She tried saying because the brace is considered DME (durable medical equipment) she has the right to charge what she does. Not in my world. |
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Posted: 1/23/2021 6:34:58 PM EDT
[#6]
Quote HistoryQuoted: And further intentionally pushed by Zeke Emanuel with pay disparities between hospital owned practices and private practices. He's on record of staying this was his intent to force vertical intergration and get better control of doctors. Zeke Emanuel is a truly evil person. |
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Posted: 1/23/2021 6:35:45 PM EDT
[#7]
Quote HistoryQuoted: They also aren't training them in the proper use of a paragraph. Quote HistoryQuoted: Quoted: I graduated my emergency medicine program 9 years ago. I trained at a level 1 trauma center and had 3 years of extremely rigorous training as well as 4 previous years at a state medical school. 2 years ago a medical school opened in my little rural town that accepted applicants that barely made it out of college. I was tasked by one to write a letter of recommendation and I told her "think about other options". She was accepted....horrible grades and lackluster motivation. Fast forward to today when MULTIPLE small hospitals around me are opening up residencies. The goal is to pump out cheap labor and to have the prestige of being a training facility. My wife just graduated from a nurse practitioner program, and it was a joke....by her own admission it was a joke...and she passed her boards with ease and was the honor graduate in her class. In 10 years the US will be flooded with VERY poorly trained US medical grads that never went through any of the academic or professional rigor that prior physicians endured. That rigor is 100 percent necessary to train people to function. Our medical training system is being undermined. You may think that that PA or NP that you're seeing knows what they're doing, but MOST new grads don't. The knowledge is very superficial, and I guess MD/DO education will soon follow suit. They will work for less than I'm making now because they'll have huge loans to pay, but the care won't be equivalent. TLDR: new docs aren't getting trained appropriately. They also aren't training them in the proper use of a paragraph. |
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Posted: 1/23/2021 6:41:03 PM EDT
[#8]
Have you seen the quality of incoming residents, and even fellows, over the last few years? More entitled than ever, more dependent on Dr. Google than ever, and less grateful to be where they are. Not everyone, but many of them. To make things worse, the "pandemic" has changed medicine such that many attendings do not want to be present if at all possible; they prefer to teach and treat via telemedicine. This carries over and, just like elementary school children, the students (residents) get dealt a shit hand and are forced to learn as best they can without the teachers present.
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Posted: 1/23/2021 6:54:44 PM EDT
[#9]
Quote HistoryQuoted: If you track the financial returns on the heal care industry since Obama care was instituted, you will see the returns are astronomical, if you had invested in a health care ETF in 2010 you could have doubled your money about every 2-3 years. Gee I wonder who benefited from that? I’m currently paying about $4500/yr. for Medicare and the Doc only gives my 5 minutes of his time if I’m lucky. And then you need 2nd and 3rd opinions due to the low level of expertise even in a large metropolitan area. As has been previously mentioned health care is the 3rd leading cause of death. They kill thousands a day simply due to incompetence. Yep, work you ass off all your life, play by the rules, pay your taxes, eat right, take care of yourself, then aging deals you a bad hand and you get to deal with the medical system and hope you come out the other end in one piece and alive. I know there are some good Doc’s out there and I’m grateful for them, but they are few and far between. I’ve also talked with many in the last 3 years and each and everyone says the government and the health insurance bureaucracy has destroyed the medical profession and that they whish they hadn’t gotten into the business. New doctors coming into the system is at an all time low, due to government involvement destroying the profession. @Jitterbug The esprit de corps of medicine has been destroyed. When I started out in private practice 19 years ago, everyone worked very hard. Primary care docs would admit their own (or their partners’ s) patients, and the docs put their job first, everything else second. They did a good job with their patients in the hospital because they would have to face them later in the office. The latest generation of doctors see it more as a 9 to 5 job, with one day off a week. There is a sharp split between in-patient and out-patient. If you get admitted by a hospitalist, their only concern is to get to the end of their 12-hour shift, then pass the patient on to the next person. Care as a result is very fragmented. |
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Posted: 1/23/2021 6:56:54 PM EDT
[#10]
Quote HistoryQuoted: Have you seen the quality of incoming residents, and even fellows, over the last few years? More entitled than ever, more dependent on Dr. Google than ever, and less grateful to be where they are. Not everyone, but many of them. To make things worse, the "pandemic" has changed medicine such that many attendings do not want to be present if at all possible; they prefer to teach and treat via telemedicine. This carries over and, just like elementary school children, the students (residents) get dealt a shit hand and are forced to learn as best they can without the teachers present. This is one of the worst aspects of medical training from a nurse perspective. The residents are assigned to a treatment team and told to go manage their patients. They show up without access to the charting system (vital signs, vent settings, I&Os, etc.). When told by the nurses that they need to ask their senior resident or attending for computer access/orientation, they get a distressed look and ask if they can just follow along as you enter data/review the chart. |
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Posted: 1/23/2021 6:58:24 PM EDT
[#11]
Quote HistoryQuoted: My prediction -- you heard it here first -- Major insurers like BCBS and United will begin funding residency programs. Bank it. Quote HistoryQuoted: Quoted: Quoted: 4th year med student here who's applied EM for match...it definitely is interesting seeing all these new programs pop up *cough HCA*. There's a discussion on SDN and reddit that hits all the points you've mentioned. Am I concerned about the job market down the line? Most definitely. It's going to be harder and harder to find open positions in large cities. The HCA residencies are definitely not to the same level as some of the other residency programs I’ve been involved with. My prediction -- you heard it here first -- Major insurers like BCBS and United will begin funding residency programs. Bank it. If they don’t just abolish the health insurance industry with single payer healthcare, you’re probably spot on. |
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Posted: 1/23/2021 7:02:19 PM EDT
[#12]
Quote HistoryQuoted: I think an excellent coder is worth their weight. If smart they are at worst revenue neutral. Would you rather spend hours reviewing your chart, making sure the chart is complete, procedures appropriately documented and having the appropriate level? You can go ahead, I’ll hire a smart cider. I graduated emergency medicine residency in 99. No limited hours. Limited backup after hours on off services. You had to do it all. Some residents graduated today have not done many procedures as they are in the hospital less than half the time. You might think that they work fewer hours to improve patient care. Nope, it is for resident wellness and some residents falling asleep while driving home. I teach residents and med students at a level 1 trauma center I spend quite a bit of time trying to bring many up to snuff. While there are a few stellar ones, the quality of the resident student and training is nothing compared to what I experienced. The coders aren’t the administrative dead weight. In fact, many (? most) places don’t do enough to make sure they have good coders and large sums of money are left on the table. |
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Posted: 1/23/2021 7:05:33 PM EDT
[#13]
28 years ago I had a tooth ache (it was dying and hurt like a bitch) and my primary dentist had his son look at my tooth. Talk about stupid, this guy, USC grad, said nothing was wrong and sent me home.
Ache goes away and at 6 month cleaning, primary dentist (dad) looks at my tooth and said "it died" There are those who can pass the tests but cannot perform, nothing new |
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Posted: 1/23/2021 7:10:45 PM EDT
[#14]
OP just noticed this? As a patient I noticed it in the 90's.
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Posted: 1/23/2021 7:18:04 PM EDT
[#15]
Quote HistoryQuoted: I went to a prestigious expensive private medical school. I never practiced a day and I work in a career that doesn’t require an MD. I feel bad for taking that spot sometimes but I didn’t cause the decline of medical training quality. The applicant pool of today is not what it was in 2000, 1990, 1980, 1970, 1960.... There are too many career paths that offer better pay and quality of life for less work. Medicine caused its own demise. Get ready for CT scan and Lube Xpress. I'm not in medicine myself but a couple of relatives are. If I'm not mistaken, back in the 1970s medical school was very, very difficult to get in. |
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Posted: 1/23/2021 7:21:37 PM EDT
[#16]
The last few times I went to a doctors office, got checked out, payed to see a doctor, but never talked to an actual doctor. I find that odd. They sure charged me like I saw a doctor.
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Posted: 1/23/2021 7:22:09 PM EDT
[#17]
Quote HistoryQuoted: @Jitterbug The esprit de corps of medicine has been destroyed. When I started out in private practice 19 years ago, everyone worked very hard. Primary care docs would admit their own (or their partners’ s) patients, and the docs put their job first, everything else second. They did a good job with their patients in the hospital because they would have to face them later in the office. The latest generation of doctors see it more as a 9 to 5 job, with one day off a week. There is a sharp split between in-patient and out-patient. If you get admitted by a hospitalist, their only concern is to get to the end of their 12-hour shift, then pass the patient on to the next person. Care as a result is very fragmented. I absolutely concur on the fragmentation and discontinuity of the healthcare spectrum. Physicians not following their patients during inpatient hospital stays and hospitalists just pulling shift work on strangers they know nothing about has buggered a lot of things. Not to mention that the hospitalists end up treating numbers and lab values instead of the patient in front of them. |
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Posted: 1/23/2021 7:25:14 PM EDT
[#18]
Don't worry. In a few years doctors will be replaced with computer programs and robots.
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Posted: 1/23/2021 7:31:54 PM EDT
[#19]
Quote HistoryQuoted: Pretty bad, especially as lackluster as so many of the doctors I ran across during my time at work were. Some were just lazy, and didn't want to work, but they were a minor percentage of incompetent. They are test readers any more. Very few doctors in the bunch. @lostintejas One of the contributing factors for this is a lot of docs are salaried or fixed hourly wage. The local hospitalists get a fixed pay for each 12-hour shift, regardless of how many patients they admit/manage. They fight the ER constantly about admitting the patient because the case is too complex, they “don’t feel comfortable”, and that the patient should be transferred to a tertiary care hospital. My answer to that would be “GET FUCKING COMFORTABLE!” You won’t get good if you never take care of sick patients. Except for my very first year where it was a guaranteed salary, I’ve either worked for what was collected from insurance minus overhead, or for RVU’s (Relative Value Units). If I don’t bill for patients, I don’t get paid. It motivates you to work. |
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Posted: 1/23/2021 7:34:20 PM EDT
[#20]
Quote HistoryQuoted: Zeke Emanuel is a truly evil person. Quote HistoryQuoted: Quoted: And further intentionally pushed by Zeke Emanuel with pay disparities between hospital owned practices and private practices. He's on record of staying this was his intent to force vertical intergration and get better control of doctors. Zeke Emanuel is a truly evil person. I never heard of this person and just briefly looked him up. Among other things he's a "bioethicist". Is he really evil? |
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Posted: 1/23/2021 7:34:24 PM EDT
[#21]
Quote HistoryQuoted: As long as Form 27B/6 is filled out correctly, the wrong leg won’t be cut off. I'm a bit of a stickler for paperwork. |
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Posted: 1/23/2021 7:37:57 PM EDT
[#22]
Quote HistoryQuoted: All part of some plan. Robots to make people feel good about not living as long or why they need to die, NOT heal them or keep them healthy. Depopulation. |
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Posted: 1/23/2021 7:38:10 PM EDT
[#23]
Quote HistoryQuoted: The part that truly cracks me up about all this is that as MD/DO standards drop, PA standards drop, the programs for ARNP's are getting more difficult. I have found that new ARNP's (mostly in their 40's & 50's) know more than doctors out of residency and fellowships.  I am going to have to disagree with that. |
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Posted: 1/23/2021 7:38:12 PM EDT
[#24]
Quote HistoryQuoted: The coders aren’t the administrative dead weight. In fact, many (? most) places don’t do enough to make sure they have good coders and large sums of money are left on the table. Tell me about it. Years ago the hospital I worked with had shit for coders. The 6 ED docs had a contract that split any “profit” over costs 1/2 to the hospital 1/2 to the 6 docs. One year we had a slight surplus of about $40,000. We split $20,000 6 ways. They audited the shit for brains coders and found they left $2,500,000 on the table. I could have had 1/6 of $1,250,000. |
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Posted: 1/23/2021 7:39:54 PM EDT
[#25]
Quote HistoryQuoted: I never heard of this person and just briefly looked him up. Among other things he's a "bioethicist". Is he really evil? You have no idea....He is Rahm Emmanuel's brother. There is an article from a few years ago where he basically stated that no one should live past 70 years old. I think it was on the Atlantic? |
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Posted: 1/23/2021 7:41:19 PM EDT
[#26]
Quote HistoryQuoted: When a surgeon had to insert a chest tube in me last year, how well he writes his notes in the chart wasn't really one of my concerns. Quote HistoryQuoted: Quoted: Quoted: I graduated my emergency medicine program 9 years ago. I trained at a level 1 trauma center and had 3 years of extremely rigorous training as well as 4 previous years at a state medical school. 2 years ago a medical school opened in my little rural town that accepted applicants that barely made it out of college. I was tasked by one to write a letter of recommendation and I told her "think about other options". She was accepted....horrible grades and lackluster motivation. Fast forward to today when MULTIPLE small hospitals around me are opening up residencies. The goal is to pump out cheap labor and to have the prestige of being a training facility. My wife just graduated from a nurse practitioner program, and it was a joke....by her own admission it was a joke...and she passed her boards with ease and was the honor graduate in her class. In 10 years the US will be flooded with VERY poorly trained US medical grads that never went through any of the academic or professional rigor that prior physicians endured. That rigor is 100 percent necessary to train people to function. Our medical training system is being undermined. You may think that that PA or NP that you're seeing knows what they're doing, but MOST new grads don't. The knowledge is very superficial, and I guess MD/DO education will soon follow suit. They will work for less than I'm making now because they'll have huge loans to pay, but the care won't be equivalent. TLDR: new docs aren't getting trained appropriately. They also aren't training them in the proper use of a paragraph. @Zardoz The paperwork in the Electronic Medical Record probably took 5 times longer than the procedure.  |
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Posted: 1/23/2021 7:42:19 PM EDT
[#27]
Quote HistoryQuoted: when I was an intern I had a med student assigned to me. Now I could do scutt work in no time. When I left med school I did maybe 90-100 blood gasses. So when I offered the med student a chance to do one on a patient his response was' No Thanks, I did one once, you are getting paid to do it" ONE FUCKING blood gas and he was an expert... I sent him to the library and finished all work in half an hour. Those students don’t work with me a second time |
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Posted: 1/23/2021 7:44:18 PM EDT
[#28]
Quote HistoryQuoted: @Zardoz The paperwork in the Electronic Medical Record probably took 5 times longer than the procedure. Quote HistoryQuoted: Quoted: Quoted: Quoted: I graduated my emergency medicine program 9 years ago. I trained at a level 1 trauma center and had 3 years of extremely rigorous training as well as 4 previous years at a state medical school. 2 years ago a medical school opened in my little rural town that accepted applicants that barely made it out of college. I was tasked by one to write a letter of recommendation and I told her "think about other options". She was accepted....horrible grades and lackluster motivation. Fast forward to today when MULTIPLE small hospitals around me are opening up residencies. The goal is to pump out cheap labor and to have the prestige of being a training facility. My wife just graduated from a nurse practitioner program, and it was a joke....by her own admission it was a joke...and she passed her boards with ease and was the honor graduate in her class. In 10 years the US will be flooded with VERY poorly trained US medical grads that never went through any of the academic or professional rigor that prior physicians endured. That rigor is 100 percent necessary to train people to function. Our medical training system is being undermined. You may think that that PA or NP that you're seeing knows what they're doing, but MOST new grads don't. The knowledge is very superficial, and I guess MD/DO education will soon follow suit. They will work for less than I'm making now because they'll have huge loans to pay, but the care won't be equivalent. TLDR: new docs aren't getting trained appropriately. They also aren't training them in the proper use of a paragraph. @Zardoz The paperwork in the Electronic Medical Record probably took 5 times longer than the procedure. @C-4 That's because you are actually authoring the "How To" manual for the next generation of doctors the OP Speaks of.  |
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Posted: 1/23/2021 7:46:02 PM EDT
[#29]
Quote HistoryQuoted: @Quigley Some of the ridiculous amounts of testing in the ER and hospitalists by recent grads is astounding. They diagnosed a 28 year old healthy guy having a migraine aura with a stroke and gave him t-PA. You can blame the lawyers for much of that. The standard of care is also an order of magnitude different for us in the ED. |
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Posted: 1/23/2021 7:47:55 PM EDT
[#30]
Quote HistoryQuoted: Tell me about it. Years ago the hospital I worked with had shit for coders. The 6 ED docs had a contract that split any “profit” over costs 1/2 to the hospital 1/2 to the 6 docs. One year we had a slight surplus of about $40,000. We split $20,000 6 ways. They audited the shit for brains coders and found they left $2,500,000 on the table. I could have had 1/6 of $1,250,000. Quote HistoryQuoted: Quoted: The coders aren’t the administrative dead weight. In fact, many (? most) places don’t do enough to make sure they have good coders and large sums of money are left on the table. Tell me about it. Years ago the hospital I worked with had shit for coders. The 6 ED docs had a contract that split any “profit” over costs 1/2 to the hospital 1/2 to the 6 docs. One year we had a slight surplus of about $40,000. We split $20,000 6 ways. They audited the shit for brains coders and found they left $2,500,000 on the table. I could have had 1/6 of $1,250,000. The hospital that out clinic is affiliated with filed for bankruptcy. I wouldn’t let the CEO run a hot dog stand. The money they wasted was epic. |
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Posted: 1/23/2021 7:48:28 PM EDT
[#31]
Quote HistoryQuoted: This thread is a perfect example of a selection bias at work. The market for fresh grads is wacky though. We have 2 out of our 11 EM residents graduating without a firm lead on a job yet. Last year 1 had her job cancelled due to covid |
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Posted: 1/23/2021 7:50:27 PM EDT
[#32]
Quote HistoryQuoted: From speaking to a few 3rd year EM residents during this interview trail, a lot of them are pursing fellowships because of this to hopefully make them more marketable down the line. Unless your facility needs an EMS fellow, toxicologist or intensivist. There are not really any fellowships that make a big difference in my opinion. |
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Posted: 1/23/2021 7:50:45 PM EDT
[#33]
Quote HistoryQuoted: You can blame the lawyers for much of that. The standard of care is also an order of magnitude different for us in the ED. Quote HistoryQuoted: Quoted: @Quigley Some of the ridiculous amounts of testing in the ER and hospitalists by recent grads is astounding. They diagnosed a 28 year old healthy guy having a migraine aura with a stroke and gave him t-PA. You can blame the lawyers for much of that. The standard of care is also an order of magnitude different for us in the ED. Interestingly, from a legal perspective, their actions are completely defensible, even though it was the completely wrong thing to do. |
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Posted: 1/23/2021 8:06:55 PM EDT
[#34]
Quote HistoryQuoted: I never heard of this person and just briefly looked him up. Among other things he's a "bioethicist". Is he really evil? Do you like death panels? |
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Posted: 1/23/2021 10:06:53 PM EDT
[#35]
Quote HistoryQuoted: @lostintejas One of the contributing factors for this is a lot of docs are salaried or fixed hourly wage. The local hospitalists get a fixed pay for each 12-hour shift, regardless of how many patients they admit/manage. They fight the ER constantly about admitting the patient because the case is too complex, they “don’t feel comfortable”, and that the patient should be transferred to a tertiary care hospital. My answer to that would be “GET FUCKING COMFORTABLE!” You won’t get good if you never take care of sick patients. Except for my very first year where it was a guaranteed salary, I’ve either worked for what was collected from insurance minus overhead, or for RVU’s (Relative Value Units). If I don’t bill for patients, I don’t get paid. It motivates you to work. @C-4 Hospitalists are a newer revelation and non existent in the areas I worked. I'm talking about practitioners and ER doctors. I guess ER docs could fall into that category. When surgeons walk past doctors to talk to EMS crews, it should tell the story. When internal medicine doctors who have patients admitted to them consider your assessment more important than an ER, it should say even more. The better ones talked to us. ER docs were the ones I was referring to mostly, but yes, they all played the part. I've had them go as far as putting on self gratifying skits in front of family and asking why we brought patients to them. Amazing, and no, I'm not exaggerating. I fear for the trade these days. The .gov has put so much garbage out, and the less than spectacular have their 2 cents to add, and all the moving points of focus, really make for a low assessment of the profession. I feel it has been slipping for years, but people are very suspicious any more. I'll say this. When I was in a near fatal wreck, the trauma surgeons were great. If not for my wife things may not have turned out as well as they did in the ICU, but the docs were great. I got a fresh graduate. He put me back together is ways that not may had seen or read about in these parts. I enjoyed the NP that cared for me in ICU and the surgeon that I drew. Nice kid, though LostWife said he looked 13. She exaggerates, he looked every bit of 16. LOL We learned later I was his first case. |
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Posted: 1/24/2021 10:11:15 AM EDT
[#36]
Quoted: If they don’t just abolish the health insurance industry with single payer healthcare, you’re probably spot on. Quoted: The coders aren’t the administrative dead weight. In fact, many (? most) places don’t do enough to make sure they have good coders and large sums of money are left on the table. Quoted: Don't worry. In a few years doctors will be replaced with computer programs and robots. |
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Posted: 1/24/2021 6:30:46 PM EDT
[#37]
Quote HistoryQuoted: @Zardoz The paperwork in the Electronic Medical Record probably took 5 times longer than the procedure. lol, that's probably true; actually inserting the tube took the guy about a minute and a half (it was just a small "pigtail"). A 2-minute procedure always seems to require 10-15 minutes of preparation, and a similar time to chart it. |
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Posted: 1/24/2021 6:39:24 PM EDT
[#38]
Quote HistoryQuoted: Iatrogenic deaths usually hover around the 3rd through the 6th leading causes of death in the US. It's no surprise. We had an inmate who died b/c of a pain reliever adminiistered by the doctor. The Code Blue Team jumpstarted him but he was brain dead afterward. Anyway, all his arrest was struck from the record and he kinda disappeared after that. No record of him being in custody. I guess there was no liability that way. |
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Posted: 1/24/2021 6:45:21 PM EDT
[#39]
+1
In surgery, a disturbing statistic is that most attending surgeons don’t trust chief residents with basic, elective surgical cases, like like appy, lap chole. Ironically, most grads apply for fellowships hoping to get the training in 1year they were supposed to get in 5 years (or 6 years, depending on mandatory research). I’ve encountered 3 new grads in my almost 30 year career who weren’t safe to operate without another surgeon stopping them from making major mistakes. When I took part 2 of board-certification, aka, “The Oral Boards,” we were run around an hotel for 90 minutes: three 30 minutes inquests with 2 surgeons per room. In the 90s, I was told the room to room run was designed to make you stressed, sweaty, under pressure/stressed to see how you behave under pressure. Now, they all get a participation trophy, and the failure rates for the oral boards are higher than ever, even without stressing them like we did. The new grads used to the work hour restrictions of residency can’t function in the real world. Yes, they have mountains of debt, but I’m consistently amazed that their first question is always about vacation coverage & time off, never about building a practice focused in their desired area of interest .... I weep for the future of healthcare, because administrators think doctors are interchangeable “providers” until they aren’t. Administrators value their budgets over patient care and budget saving inexperience because, right now, most complications get paid for, so....do the math. |
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Posted: 1/24/2021 7:04:10 PM EDT
[#40]
Have been dealing with docs and hospitals for 10 years now, it's a screwed up system for sure, lucky that I've had good ins.
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Posted: 1/24/2021 7:09:55 PM EDT
[#41]
My sister is a Chem PhD and when she was teaching kept a list of students who had no business being doctors but somehow managed to get accepted to med school despite her best efforts.
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Posted: 1/24/2021 7:10:13 PM EDT
[#42]
I weep for the future of healthcare, because administrators think doctors are interchangeable "providers" until they aren't. Administrators value their budgets over patient care and budget saving inexperience because, right now, most complications get paid for, so....do the math. It was about a week later that a psychiatrist the hospital hired had a supposed psychotic break and went on an international crime spree. Thanks Mr. Hospital Man! |
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Posted: 1/24/2021 7:17:12 PM EDT
[#43]
Quote HistoryQuoted: As long as Form 27B/6 is filled out correctly, the wrong leg won’t be cut off. https://www.cnbc.com/2018/02/22/medical-errors-third-leading-cause-of-death-in-america.html I'm sure this will get better with lower standards |
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Posted: 1/24/2021 7:19:46 PM EDT
[#44]
Quote HistoryQuoted: Been a thing for a while now. Half the time, the nurses are suggesting courses of treatments to the docs because the docs just can’t figure out the next step. I have utmost respect for a doctor who knows his or her stuff, but a lot of the newer ones are lazy and just flat out dangerous. Yup. I'm not a doctor. If I'm asking the doctor what to do, it's because I have no fucking idea, and I need someone that knows more to tell me what the next steps are. Not because I need them to look at me with terror, and ask what my opinion is. |
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Posted: 1/24/2021 7:36:21 PM EDT
[#45]
Quote HistoryQuoted: This is great news. It's how the free market works. Where there is demand, supply follows. We've been hearing about a shortage of doctors for years. The idea that we should maintain an artificial shortage of anything is wrong. There needs to be Ed Brown pistols and Hi-points. Be the Ed Brown of doctors and you'll always be busy, no matter what you charge. Those that can afford an Ed Brown won't suddenly buy only High-points. But those that cannot will still have access. Edit: it is incumbent on the purchaser to do their research to figure out which is the Ed Brown and which is the Hi-point. When I want a lawyer, financial adviser, auto mechanic or lawn guy, I do the same. You're going to the doctors in whatever network your health insurer has negotiated agreements with. Either that, or you're paying a big chunk of money yourself...and that assumes you have healthcare at all. Many don't, especially with unemployment right now. Your health insurer, in turn, negotiates with the providers for care options that are attractive to your employer to provide, and profitable for them to support. Some insurers provide "quality" metrics, which usually rely on surveys, and/or metrics on paperwork and process. Providers aren't interested in improving your health, or providing needed services...they are interested in high margins. That's why we have the most expensive healthcare system in the world, and not enough hospital beds to deal with critically ill pandemic patients. Plenty of mammogram vans though! The healthcare system in the US is perfectly designed to benefit everyone who participates, except people who need healthcare. Now, if your comment is strictly around practitioners, you only have to look to our H1B visa program, and some of your own local doctors, to see what's going to happen there. |
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Posted: 1/24/2021 7:49:10 PM EDT
[#46]
Quote HistoryQuoted: Providers aren't interested in improving your health, or providing needed services...they are interested in high margins. That's why we have the most expensive healthcare system in the world, and not enough hospital beds to deal with critically ill pandemic patients. Plenty of mammogram vans though! Except that's not how docs make money |
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Posted: 1/24/2021 8:23:43 PM EDT
[#47]
Quote HistoryQuoted: +1 In surgery, a disturbing statistic is that most attending surgeons don’t trust chief residents with basic, elective surgical cases, like like appy, lap chole. Ironically, most grads apply for fellowships hoping to get the training in 1year they were supposed to get in 5 years (or 6 years, depending on mandatory research). I’ve encountered 3 new grads in my almost 30 year career who weren’t safe to operate without another surgeon stopping them from making major mistakes. When I took part 2 of board-certification, aka, “The Oral Boards,” we were run around an hotel for 90 minutes: three 30 minutes inquests with 2 surgeons per room. In the 90s, I was told the room to room run was designed to make you stressed, sweaty, under pressure/stressed to see how you behave under pressure. Now, they all get a participation trophy, and the failure rates for the oral boards are higher than ever, even without stressing them like we did. The new grads used to the work hour restrictions of residency can’t function in the real world. Yes, they have mountains of debt, but I’m consistently amazed that their first question is always about vacation coverage & time off, never about building a practice focused in their desired area of interest .... I weep for the future of healthcare, because administrators think doctors are interchangeable “providers” until they aren’t. Administrators value their budgets over patient care and budget saving inexperience because, right now, most complications get paid for, so....do the math. One problem is that residents are increasingly being used as NP's or mid levels or MAs. They don't learn how to make those decisions because they are never allowed to during residency. Case in point with surgery, used to resident would start getting experience and exposure starting their first year. Now, it's mostly screening pages from the nurses before passing them up to your "upper level" who passed it to the chief, who then runs it by the attending. End result, a culture of not taking initiative and not thinking critically because when you do you get slapped down hard. Likewise, whereas before you get case experience and build up your skills and knowledge with less and less supervision, now government mandates and a "don't do anything unless told to do it" culture leads to the production of lots of assistants but few people actually able to be an attending. Let's also not start on the insurance and billing system. I'll use an example, I can do an epidural in my office for $400, at an ASC for $400+$1000 facility fee or at a hospital OR for $400+2000 hospital fee for the same damn thing. The system seems to be dead set on introducing as much waste and minimizing care as much as possible. |
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Posted: 1/24/2021 9:05:24 PM EDT
[#48]
In the interest of full disclosure, I am a hospitalist PA for the past 17+ years.
I work with a doctor that while I do not know where he went to med school he did graduate from residency and completed a sports medicine fellowship. While he’s a nice enough guy he’s kind of a moron. When I was doing my clinical year I met a resident who had actually graduated from my PA program. Long story but she had attended med school in the Caribbean. When she graduated she could not get a residency and decided to go to PA school. My school was known to be a very good and very hard one and what she told me was “I thought it would be easy since I was a doctor but it was hard. “ As it turns out she graduated 2’years before me and actually at that point was the only person from my school to not pass their boards on the first try. Like anything, there are good and bad practitioners and the key as a kid-level is to know your limits but for 85% of the day to day stuff I think mid-levels do a great job. Don’t get me started on NPs and their use of the title “doctor” because they graduated from a doctorate program. |
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Posted: 1/24/2021 9:17:51 PM EDT
[#49]
I remember when I had been in health care 9 years.
Vaguely. Welcome, OP. |
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Posted: 1/24/2021 9:22:49 PM EDT
[#50]
Quote HistoryQuoted: +1 In surgery, a disturbing statistic is that most attending surgeons don’t trust chief residents with basic, elective surgical cases, like like appy, lap chole. Ironically, most grads apply for fellowships hoping to get the training in 1year they were supposed to get in 5 years (or 6 years, depending on mandatory research). I’ve encountered 3 new grads in my almost 30 year career who weren’t safe to operate without another surgeon stopping them from making major mistakes. When I took part 2 of board-certification, aka, “The Oral Boards,” we were run around an hotel for 90 minutes: three 30 minutes inquests with 2 surgeons per room. In the 90s, I was told the room to room run was designed to make you stressed, sweaty, under pressure/stressed to see how you behave under pressure. Now, they all get a participation trophy, and the failure rates for the oral boards are higher than ever, even without stressing them like we did. The new grads used to the work hour restrictions of residency can’t function in the real world. Yes, they have mountains of debt, but I’m consistently amazed that their first question is always about vacation coverage & time off, never about building a practice focused in their desired area of interest .... I weep for the future of healthcare, because administrators think doctors are interchangeable “providers” until they aren’t. Administrators value their budgets over patient care and budget saving inexperience because, right now, most complications get paid for, so....do the math. IM did away with oral boards years (like decades) ago and it's been downhill since then |
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