Quoted: Stop lowering the standards for doctors who, through their incompetence, contribute to the rising cost of malpractice insurance.

Affirmative action....some time ago the doctors quit getting numerical scores at somepoint in their education. Instead of hiring a doc who got 800 outta 1000 (whatever the system) you got to hire a guy who passed. I forget the details and cannot find the reference right now.
Hmmmm. Do I want an abdominal surgery from the high score guy or the affirmative action guy?
Well....you can't make that decision.

Stop treating those who won't pay. That is what is really driving up the costs for the rest of us.

No insurance? No cash? No credit card? NO TREATMENT.

Quoted: Re-introducing the free market back into medical care would go a long way to fixing things.  It's become an alien concept that people should actually PAY for their own medical care. No one asks my advice but a mandatory deductible would be a place to start.  Also gets a lot of people screaming right away too.<G> Dennis Jenkins

Agreed.  The free market can solve a LOT of problems.

Here's an interesting factoid:

Of the total insurance premiums used to cover hospital and physician care, this research showed that 21 percent is spent on insurance administration. Another 13 percent is used to cover other administrative tasks. Only 66 percent is used for patient care.

Quoted: Here's an interesting factoid: Of the total insurance premiums used to cover hospital and physician care, this research showed that 21 percent is spent on insurance administration. Another 13 percent is used to cover other administrative tasks. Only 66 percent is used for patient care.

You also have to consider how many of those premium dollars have to be used for profit to pay dividends back to the stockholders.  Last time I knew there were very few, if any, true mutual companies writing health insurance policies.

SBG

Quoted: Quoted: I passed my state contractors exam last year and if your a Doctor that does'nt make you more important than anyone. You live in a house that a contractor built and practice medicine in a Hospital that a contractor built........ contractors exam does not equate medical licensure.  Now, if you have specific complaints, aire them instead of making grandiose claims that have no merit, and also note that no where did I stand up and proclaim that Physicians are the pinnacle of all that is great.  But, I can assure you that standards have not been lowered for admittance into medical schools and in fact they are getting far more stringent despite the slowly decreasing application pool due to physicians telling people not to go into medicine so they won't have to put up with ingrate patients and bureaucratic bullshit hoisted on us by the government

Quoted: I typed out a long rant about why doctors in a hospital setting attempt to keep people hospitalized for as long as possible, why they perform unneeded procedures repeatedly on the same patients, and why they push terminal patients to be FULL CODES.....but I erased it because it was hard to read and you really don't care.  So instead, let me give you a small sampling of what I had to say: Ventilator-dependant patients in LTAC settings.   Pulmonologists will get a person who is a DNR and would really is at the end of life and convince a family member that the patient should be intubated "for a day" to "let them rest a little."  This is crap and everyone there except the family understands that.   The patient is then orally intubated on AC for a week or so, dragging it out.  At several points, the pulmonologist will perform bedside bronchoscopy, which is entirely not indicated, and get paid well by Medicare for doing so. After 2 weeks of being orally intubated, the pulmonologist will start very aggressive weaing orders, placing the patient on IMV, dropping the rate q2h, placing on CPAP withing hours, and then of course, failing to wean, back on AC. At this point, the family will feel guilty about extubating the patient because the patient will obviously die immediately.  The doctor of course gets paid well for every day of ICU monitoring and the frequent bronchoscopies. Eventually, the patient will get a tracheostomy whicht he family will agree to because it looks so much better than the huge endotracheal tube crammed down their throat.  Nice paycheck for the surgeon there.

Someone is bitter because they didn't get into medical school.

Quoted: Nearing the end of Medicare coverage, the doctor will finally discuss DNR and let the patient die.

What about the other 98% of ICU patients whose families refuse to make DNR:  "We realize she's 98 and has acute renal failure and necrotic bowel, but we want to give her a chance."  

Quoted: There is little to no oversight for this as the hospitals and the doctors all make their buck.   Doctors and hospitals have influential lobbies.

Damn you, I'm going to make you pay for my busted gut.

Quoted: Quoted: I passed my state contractors exam last year and if your a Doctor that does'nt make you more important than anyone. You live in a house that a contractor built and practice medicine in a Hospital that a contractor built........ contractors exam does not equate medical licensure.  Now, if you have specific complaints, aire them instead of making grandiose claims that have no merit, and also note that no where did I stand up and proclaim that Physicians are the pinnacle of all that is great.  But, I can assure you that standards have not been lowered for admittance into medical schools and in fact they are getting far more stringent despite the slowly decreasing application pool due to physicians telling people not to go into medicine so they won't have to put up with ingrate patients and bureaucratic bullshit hoisted on us by the government

I'm sorry, but I came in contact with approx. 20- 30 physicians daily in my 25+ years as a medical sales rep. Also as a licensed Medical Laboratory Techolongist. I think I have just a little bit of experience in dealing with the great intellect of physicians. Actually it's pretty scary on how much physicians don't know about medicine. Yes, they passed the state board. Big deal. Most doctors don't go into medicine to follow the hypocritical oath. They go in it for the money and power.The reason some are not recommending going into medicine is because it is getting harder to make a fortune bleeding the insurance and Medicare systems. I'm glad we have physicans, but I know so many who are crook's and set around trying to come up with some new procedure to make them more money. Most of them also treat their staff like sh--. I'm so glad to be out of that business. Go set for the Florida Contractors exam and report back to me how you did.....Doctor's are not God inspite of how most of them feel.........

Don't get sick. or hurt.

Quoted: Stop treating those who won't pay. That is what is really driving up the costs for the rest of us. No insurance? No cash? No credit card? NO TREATMENT.

Preach it, brotha!

Quoted: Here is a list of typical standard charges for 'Private' treatment of  'small' proceedures in the  UK...not socialized treatment... you pay in full or your insurer does. Length of stay Total price Tonsillectomy 1 night £1,591 Colonoscopy inc. histology Day case £1,177 Gastroscopy inc. histology Day case £773 Appendicectomy 2 nights £2,668 Inguinal hernia 2 nights £1,646 Varicose veins both legs 1 night £3,017 Total abdominal hysterectomy, & bilateral salpino-oophorectomy (inc. sub total hysterectomy) 6 night) £4,339 Vaginal hysterectomy (inc. laparascopically assisted) 6 nights £4,339 Caesarean section (excluding Consultants fees) 2 nights £2,352 Cataract and lens implant – bilateral 1 night £3,292 Impacted wisdom teeth 1 night £1,172 Arthroscopy therapeutic 1 night £2,145 Carpal tunnel decompression (general anaesthetic) 1 night £1,097 Dupuytren’s fasciectomy – multiple digit 1 night £1,820 Hip replacement (excluding prosthesis) 8 nights £6,676 Knee replacement (excluding prosthesis) 8 nights £7,324 Vasectomy Day case £449 Dollar  exchange rate is about 1.8ish to 1. Any US medical people want to chime in with US equivalent charges? ANdy

So you get to pay twice, and you have a marketplace that is distorted by a two tier medical system.

Pretty hard to compare the apples and oranges.

Quoted: raise sales tax to 12%

BZzzzt!  Wrong!  Sales tax in Canada is 15% and medical care is still eating up 60% of the state (provincial) budgets.  Try again.

Quoted: The "problem" is created by the fact that we are making radical new breakthroughs in medical technology.  You can still get 1960's level care for a decent price.  Everyone, naturally, wants the best care available.  That costs money.  Nothing in life is free.

This is definitely a good part of the problem.  

I have a patient who is a physician who started his practice as an internist in 1946.  He mostly used about 1/2 dozen drugs in his practice including dilantin, aspirin, digoxin and sublingual nitroglycerin.  Penicillin was only given in the hospital.  Morphine and insulin could only be dispensed by specialized physicians.

Why do you think drugs were not included in the original Medicare bill?  They cost almost nothing!  Then again, if your infection was resistant to penicillin, you died.  New drugs = R&D money.  

Quoted: As an earlier poster mentioned - follow the money. Huge chunks of it go to the drug companies. I know they have to recover research and evelopment costs, but pills that cost a fraction of a cent to produce selling for three or four dollars each? They also still seem to make a profit selling in countries with controlled costs, where ths same drugs sell for much less than in the US. The lies and misinformation about the quality of the drugs in countries such as UK, Canada, France, Germany etc are just that -- lies. if anything, many of these countries have tighter controls than the US and thus less chance of bogus or out of date drugs than in the US -- witness the flu vaccine problems last year. The US drug companies would have been more than happy to take delivery and sell that vaccine to US consumers if the UK hadn't shut down the factory.

You know all this because you work for a drug company? The FDA? Overseas Pharma Enforcement?


I thought so.

Quoted: Quoted: I passed my state contractors exam last year and if your a Doctor that does'nt make you more important than anyone. You live in a house that a contractor built and practice medicine in a Hospital that a contractor built........ contractors exam does not equate medical licensure.  Now, if you have specific complaints, aire them instead of making grandiose claims that have no merit, and also note that no where did I stand up and proclaim that Physicians are the pinnacle of all that is great.  But, I can assure you that standards have not been lowered for admittance into medical schools and in fact they are getting far more stringent despite the slowly decreasing application pool due to physicians telling people not to go into medicine so they won't have to put up with ingrate patients and bureaucratic bullshit hoisted on us by the government

Now if that doesn't hit the nail square and drive it thru 3 2x4s nothing will.

Ipsi is right on the money bud. i really wish some of you would give it a shot so you would hve ANY- FUCKING- IDEA what it is like putting up you obnoxious ingrates, insurance assholes who don't have the brains to wipe their own fucking nose, and gov't pricks who think because they got soem sweet civil service job that they have any idea how to anything other than slow the eintrie system to a dysfunctional standstill while wasting my time and that of my staff.

I have said it for years:

They don't pay us the big bucks for our intellect, knowledge, education or expertise but because no one would put up with all the bullshit for less.

Yup, I really wish some of you would give it a shot because you have no idea.

I am glad I am done with it.  There is sure no glamour in draining your fricking butt abscess or in doing pelvics on obnoxious STD-ridden skank hos or listening to you whine about how much you need vicodin after you intentionally injured yourself to get your fix or coming in and blowing a half hour of my time listening to you whine because you are so fucking pathetic no one else will listen to your bullshit and I have to because I am stuck in this tiny windowless room with your sorry ass or how you can't work this week becuase you aren't really sick but it is nice out today or how your fucking kids are so obnoxious their teacher insists on them taking ritalin because you are a dirtbag loser with 4 kids from 3 different men and can't be bothered to even bathe them or wash their clothes or how your kid is still sick and WTF is my problem that they ain't better though you have given them only 2 doses of their antibiotic out of 20 or what do I mean it is time for you to leave the detox unit after 6 days of milking the system for free food, free drugs, room and board or what is my problem that I won't give a Rx for 200 percocet, afterall you have to make a living or that you don't want your husband having visitation so he must have sexually abused his daughter and you want me to look up her crotch or how you just can't work the 20hrs per week that workfare requires for you to get your AFDC it's just too much for your fat 20 year old ass.

Yeah, there were nice normal people also. About 40% most days.

Quoted: I'm sorry, but I came in contact with approx. 20- 30 physicians daily in my 25+ years as a medical sales rep. Also as a licensed Medical Laboratory Techolongist. I think I have just a little bit of experience in dealing with the great intellect of physicians. Actually it's pretty scary on how much physicians don't know about medicine. Yes, they passed the state board. Big deal.

well, la-dee-da.  The person who claims to know all about medicine is a liar.  What you fail to realize is that not knowing everything does not make a physician incompetent.  When's the last time you spent 120 hours a week studying?  gone 9 days with 11 hours of sleep to study for finals?  skipped bathing because you didnt' have the time to waste due to an upcoming test?  If the art of medicine was simply regurgitating route memorization out of a book, any computer could do it, but it's not.  And this doesn't even begin to discuss the failure of your reasoning to address why medicine has so many subspecialties.  Nor does this even begin to touch on the fact that medicine changes on a daily basis, I come home after an 60-90 hour week and I still study, and attempt to keep up by reading journals and going back and studying, do you do something similar?  
 

Quoted: Most doctors don't go into medicine to follow the hypocritical oath. They go in it for the money and power.The reason some are not recommending going into medicine is because it is getting harder to make a fortune bleeding the insurance and Medicare systems.

I'm glad you are the prognosticator of all that physicians are and the motives behind why they do what they do.   This is what pisses me off.  You don't have a problem paying a plumber $60-75 or have any doubt that your wage is fitting your work.  When's the last time you collected only 20-40% of what you billed?  How would you like that?  How would you like your hard work denigrated because someone assumes any fucking chimp with a hammer can build?  Physician salaries are the only, yes ONLY group of peoples pay who have not kept up with the average increase in pay raises over the past 20 years, and in fact, they make less now when you factor in inflation than they did 5-10 years ago.  NOT to mention the astronomically increasing cost of going to school.  Where you $150K in debt when you finished your technical training?  and that's only the cost of a state subsidized program, most private medical schools can easily run 300-400k.  And then top that off with the ungodly hours of internship and residency when we make$35k a year for "80" hours a week, and I put 80 in quotes since that is what every says they work due to new regulations, but that's not what happens in real life.  

Quoted: I'm glad we have physicans, but I know so many who are crook's and set around trying to come up with some new procedure to make them more money. Most of them also treat their staff like sh--. I'm so glad to be out of that business. Go set for the Florida Contractors exam and report back to me how you did.....Doctor's are not God inspite of how most of them feel.........

well la-de-da, i love how you come into this thread with a smug sense of superiority yet have the gall to denigrate another profession due to the same qualities your showing here, i got a word for ya buddy, hypocrite.  assumptions and stereotypes serve no purpose but to inflame and give comfort to those who are either jealous or ignorant of the reality of the situation.  And while I doubt I'd pass the test if I took it today, I have no qualms of boasting that it wouldn't be a challenge and I could pass it if I were to prepare for it.  Could you say the same about the USMLE?

Quoted: Quoted: Quoted: I passed my state contractors exam last year and if your a Doctor that does'nt make you more important than anyone. You live in a house that a contractor built and practice medicine in a Hospital that a contractor built........ contractors exam does not equate medical licensure.  Now, if you have specific complaints, aire them instead of making grandiose claims that have no merit, and also note that no where did I stand up and proclaim that Physicians are the pinnacle of all that is great.  But, I can assure you that standards have not been lowered for admittance into medical schools and in fact they are getting far more stringent despite the slowly decreasing application pool due to physicians telling people not to go into medicine so they won't have to put up with ingrate patients and bureaucratic bullshit hoisted on us by the government Now if that doesn't hit the nail square and drive it thru 3 2x4s nothing will. Ipsi is right on the money bud. i really wish some of you would give it a shot so you would hve ANY- FUCKING- IDEA what it is like putting up you obnoxious ingrates, insurance assholes who don't have the brains to wipe their own fucking nose, and gov't pricks who think because they got soem sweet civil service job that they have any idea how to anything other than slow the eintrie system to a dysfunctional standstill while wasting my time and that of my staff. I have said it for years: They don't pay us the big bucks for our intellect, knowledge, education or expertise but because no one would put up with all the bullshit for less. Yup, I really wish some of you would give it a shot because you have no idea. I am glad I am done with it.  There is sure no glamour in draining your fricking butt abscess or in doing pelvics on obnoxious STD-ridden skank hos or listening to you whine about how much you need vicodin after you intentionally injured yourself to get your fix or coming in and blowing a half hour of my time listening to you whine because you are so fucking pathetic no one else will listen to your bullshit and I have to because I am stuck in this tiny windowless room with your sorry ass or how you can't work this week becuase you aren't really sick but it is nice out today or how your fucking kids are so obnoxious their teacher insists on them taking ritalin because you are a dirtbag loser with 4 kids from 3 different men and can't be bothered to even bathe them or wash their clothes or how your kid is still sick and WTF is my problem that they ain't better though you have given them only 2 doses of their antibiotic out of 20 or what do I mean it is time for you to leave the detox unit after 6 days of milking the system for free food, free drugs, room and board or what is my problem that I won't give a Rx for 200 percocet, afterall you have to make a living or that you don't want your husband having visitation so he must have sexually abused his daughter and you want me to look up her crotch or how you just can't work the 20hrs per week that workfare requires for you to get your AFDC it's just too much for your fat 20 year old ass. Yeah, there were nice normal people also. About 40% most days.

Don't like the job don't do it, no one forced you to do butt abcesses or deal with STD ridden skanky hoes.

There is no excuse for charging some of the ways they do. They charge you X amount of dollars for one thing, the insurance company says they will only pay X amount of dollars/. They pay that X amount and no one cares. Hospital does nothing. Don't have insurance and say you're only going to pay X amount of dollars. Too fucking bad, you pay it all.

Puh-lease. $500 drill bits, $800 screws to go into an ankle. $50 ace bandages.

I hope you never complain if you think something else is over priced

Quoted: They don't pay us the big bucks for our intellect, knowledge, education or expertise but because no one would put up with all the bullshit for less. Yup, I really wish some of you would give it a shot because you have no idea.

, and the congregation said?  amen.........

Quoted: I Was in the medical field fo 28 years(medical sales).

No, no you were not.  You were no more in the medical field than the UPS guy (bless his heart for all the ammo deliveries) who delivers medical supplies.  

Quoted: The problem with cost is there is too much "Fat". Meaning, There is too much administration, nurses, a person for this and a person for that. The doctors need to do more of the procedures and chop out a lot of staff.

Yes, trimming more nurses from hospitals is the answer.  Now you've just proven how much of an idiot you really are.

Eliminating medical and liability insurance would do more to make medicine affordable than anything. The system would collapse overnight, but the companies that want to stay in business would do so by charging prices that have some basis in reality. The drug companies would just have to go without their multi-million dollar ad campaigns and the ***hole plastic surgery doc down the street would have to put off buying his fourth Lamborghini until next year.

Right now everybody charges such high prices because they know they can. Insurance will pay- heck- insurance companies are the only entities big enough to pay these outrageous prices today. Liability costs are also at fault, but not nearly to the extent that the politicians want us to think.

Galland

H1B visas for foreign docs. A little competition never hurt anyone.

Illegals get a doc from their country of origin. We'll call it "Just like home" medicine.

Quoted: Stop lowering the standards for doctors who, through their incompetence, contribute to the rising cost of malpractice insurance.

 

Quoted: Don't like the job don't do it, no one forced you to do butt abcesses or deal with STD ridden skanky hoes. There is no excuse for charging some of the ways they do. They charge you X amount of dollars for one thing, the insurance company says they will only pay X amount of dollars/. They pay that X amount and no one cares. Hospital does nothing. Don't have insurance and say you're only going to pay X amount of dollars. Too fucking bad, you pay it all. Puh-lease. $500 drill bits, $800 screws to go into an ankle. $50 ace bandages. I hope you never complain if you think something else is over priced

I personally love the job, but I get fucking sick of the ungrateful snots who whine about that which they have little to no knowledge.  fine, if you don't want to pay for the drill bits or screws, we'll use the $0.50 cent ones from Ace, just don't come bitching when it gets infected or your body rejects it due to the contaminates on the surface that can't be washed away.  Not to mention you're looking at a direct comparison and ignoring that the majority of hospitals do not make a profit.  DO NOT MAKE A PROFIT.  And again, let's get back to insurance/medicare, the reason you see many outrageous prices are due to hospitals trying to make up for the loses they're mandated to take by treating them.  Insurance isn't too bad most of the time, but medicare is horrible about paying $10 for a test that costs 30 to perform, or even worse, paying $18 for all tests when standard of care dictates $80 worth of testing, so how does that makes sense?  and how do you make up for that?  you pass the cost on to someone else, or you shut down your doors, it's as simple as that.

JohntheTexican:

Your 2% figure doesn't  take into account the huge amount of defensive medicine in the country...

Say you are young and healthy, and you have a chest wall sprain while lifting a box.  Because it hurts, and it is after hours, you go the ER.

You give the history.  Right away, the Nurse and ER doctor know it is a chest wall sprain.   HOWEVER, because of the incidence of lawsuits in the ER, you get a "Chest Pain" workup to be sure there are no cardiac issues.  That means Cardiac Enzymes, being hooked up to a monitor, and a 12 lead EKG.  The ER Doc  looks at all these, and says you are fine, and gives you a muscle relaxant and/or pain pill (same thing he would have done in 10 minutes if he didn't have to practice defensive medicine).  

Now because of the incidence of lawsuits, your visit that was 2+ hours (and could have been 10 minutes) cost the rent of the ER room for 2 hours (figure $200/hr).  The Cardiac Enzymes and other misc. tests (call it $100+), the EKG (which has to be read by a Cardiologist--JUST IN CASE the ER doc that has done it for years happens to miss a 1mm elevation in one of the leads), etc.  

That is the true cost of malpractice, not just the $$ paid out.

Same thing for a Migraine headache--guess what, even though you've had them for years, because you came to the ER, you have to get a head CT in the off chance it is a bleed.

Once Assholes like John Edwards are unable to channel dead babies (btw--that bit of legal snake oil sales caused a large jump in the number of C-sections across the country-many of them that wouldn't have been done before), and there is a set standard of care that is fair to both the patient and the physician (and exempts the Doctor from lawsuits if he follows that standard), the true cost of Malpractice will be hidden.


John316:

I'm sorry, but I came in contact with approx. 20- 30 physicians daily in my 25+ years as a medical sales rep. Also as a licensed Medical Laboratory Techolongist.

Problem is, as a Medical sales rep, you were often trying to sell something to the Drs (in some cases, not what they wanted).  I have never had a problem with any sales reps (and my attendings and the other local physicians also), and am fairly friendly with most of them.    Additionally, I am BB(ASCP) certified--never had more than a very few physicians that were assholes (including working in 2 teaching facilities for over 13 years).  

Finally, the "High Cost" of healthcare (as is seen in several posts) is often an overinflated $$ figure--the 20k bill that your insurance pays $5k for.    Consider that if a Medicaid patient shows up for the same procedure, the hospital is lucky to get $1500 for it, and if an illegal alien shows up, they will get nothing (however, under EMTALA, they cannot refuse lifesaving care).  

Had a Dr. from Canada come and visit my attending (old buddy of his that moved to Canada several years back).  He was amazed that we (Podiatrists) could get an elective CT done within a day, and an MRI within a week--even in urgent situations, the wait in Canada is still weeks in some cases, if not longer.    

WAAAAAAAA!!!!!!!

Quoted: Here is a list of typical standard charges for 'Private' treatment of  'small' proceedures in the  UK...not socialized treatment... you pay in full or your insurer does. Length of stay Total price Tonsillectomy 1 night £1,591 Colonoscopy inc. histology Day case £1,177 Gastroscopy inc. histology Day case £773 Appendicectomy 2 nights £2,668 Inguinal hernia 2 nights £1,646 Varicose veins both legs 1 night £3,017 Total abdominal hysterectomy, & bilateral salpino-oophorectomy (inc. sub total hysterectomy) 6 night) £4,339 Vaginal hysterectomy (inc. laparascopically assisted) 6 nights £4,339 Caesarean section (excluding Consultants fees) 2 nights £2,352 Cataract and lens implant – bilateral 1 night £3,292 Impacted wisdom teeth 1 night £1,172 Arthroscopy therapeutic 1 night £2,145 Carpal tunnel decompression (general anaesthetic) 1 night £1,097 Dupuytren’s fasciectomy – multiple digit 1 night £1,820 Hip replacement (excluding prosthesis) 8 nights £6,676 Knee replacement (excluding prosthesis) 8 nights £7,324 Vasectomy Day case £449 Dollar  exchange rate is about 1.8ish to 1. Any US medical people want to chime in with US equivalent charges? ANdy

Apples and oranges.  The reason that physicians, myself included, order so many questionably unecessary tests is because we practice defensive medicine.  I order the $1500 MRI because I can't afford a lawsuit, not because the patient may need it.  I can't just be 90% positive the patient doesn't have a particular disease, I have to be 100% positive.

If Great Britain's system is anything like Canada's, you do not get multi-million dollar settlements because all the plaintiff's medical costs are taken care of by the gov't.  'Pain & Suffering' and punitive damages are extremely modest by U.S. standards.  

I ordered far fewer tests when I worked at the VA because I didn't have to worry about the patient suing me.  Same care but less costly.  The problem with the VA is that care is drastically rationed so there were very long waiting lines (sound familiar?) and many of the newer technologies were not immediately available.

Quoted: Quoted: raise sales tax to 12% BZzzzt!  Wrong!  Sales tax in Canada is 15% and medical care is still eating up 60% of the state (provincial) budgets.  Try again.

Who said anything about Canada?

Quoted: Don't like the job don't do it

I don't anymore. I still like medicine but couldn't stand the sight of self absorbed pompous assholes like you who made each and every day a living hell.  I've got a feeling by the time you get to the age where you need regular health care you are going to be in for one helluva rude awakening.  Not that some of you simpletons would even realize it.

Quoted: Quoted: Don't like the job don't do it, no one forced you to do butt abcesses or deal with STD ridden skanky hoes. There is no excuse for charging some of the ways they do. They charge you X amount of dollars for one thing, the insurance company says they will only pay X amount of dollars/. They pay that X amount and no one cares. Hospital does nothing. Don't have insurance and say you're only going to pay X amount of dollars. Too fucking bad, you pay it all. Puh-lease. $500 drill bits, $800 screws to go into an ankle. $50 ace bandages. I hope you never complain if you think something else is over priced I personally love the job, but I get fucking sick of the ungrateful snots who whine about that which they have little to no knowledge.  fine, if you don't want to pay for the drill bits or screws, we'll use the $0.50 cent ones from Ace, just don't come bitching when it gets infected or your body rejects it due to the contaminates on the surface that can't be washed away.  Not to mention you're looking at a direct comparison and ignoring that the majority of hospitals do not make a profit.  DO NOT MAKE A PROFIT.  And again, let's get back to insurance/medicare, the reason you see many outrageous prices are due to hospitals trying to make up for the loses they're mandated to take by treating them.  Insurance isn't too bad most of the time, but medicare is horrible about paying $10 for a test that costs 30 to perform, or even worse, paying $18 for all tests when standard of care dictates $80 worth of testing, so how does that makes sense?  and how do you make up for that?  you pass the cost on to someone else, or you shut down your doors, it's as simple as that.

Doctor told her that the body rejects the hardware 80% of the time anyways! And they might have to go back in!

If you're going to charge $800 for a drill bit, we damn well better get to keep it too!

Now I don't agree with medicare, that's just plain old bullshit. But you don't pass the cost down to the people who actually pay. You find a way to make medicare pay.

I'm all for limiting liability payouts exept when gross negligence has occured.  

Example, patient goes in to have left leg amputated and the right leg is amputated.

Let's face it.  Most people hate going to the doctor and wait too long in some cases.  With all of our science, they still can't[won't] cure most things and the drugs that are used come with problems all their own.  

Also, if your illness or injury is life threatening and you die as a result of it, how is it the doctors fault if he doesn't save your ass?

Quoted: Quoted: Quoted: raise sales tax to 12% BZzzzt!  Wrong!  Sales tax in Canada is 15% and medical care is still eating up 60% of the state (provincial) budgets.  Try again. Who said anything about Canada?

What other Socialized Medical Utopia did you have in mind.

Quoted: Quoted: Quoted: Don't like the job don't do it, no one forced you to do butt abcesses or deal with STD ridden skanky hoes. There is no excuse for charging some of the ways they do. They charge you X amount of dollars for one thing, the insurance company says they will only pay X amount of dollars/. They pay that X amount and no one cares. Hospital does nothing. Don't have insurance and say you're only going to pay X amount of dollars. Too fucking bad, you pay it all. Puh-lease. $500 drill bits, $800 screws to go into an ankle. $50 ace bandages. I hope you never complain if you think something else is over priced I personally love the job, but I get fucking sick of the ungrateful snots who whine about that which they have little to no knowledge.  fine, if you don't want to pay for the drill bits or screws, we'll use the $0.50 cent ones from Ace, just don't come bitching when it gets infected or your body rejects it due to the contaminates on the surface that can't be washed away.  Not to mention you're looking at a direct comparison and ignoring that the majority of hospitals do not make a profit.  DO NOT MAKE A PROFIT.  And again, let's get back to insurance/medicare, the reason you see many outrageous prices are due to hospitals trying to make up for the loses they're mandated to take by treating them.  Insurance isn't too bad most of the time, but medicare is horrible about paying $10 for a test that costs 30 to perform, or even worse, paying $18 for all tests when standard of care dictates $80 worth of testing, so how does that makes sense?  and how do you make up for that?  you pass the cost on to someone else, or you shut down your doors, it's as simple as that. Doctor told her that the body rejects the hardware 80% of the time anyways! And they might have to go back in! If you're going to charge $800 for a drill bit, we damn well better get to keep it too! Now I don't agree with medicare, that's just plain old bullshit. But you don't pass the cost down to the people who actually pay. You find a way to make medicare pay.

Why don't you start billing the .gov for what you do and then come tell us about it.
The .gov gives us no choice in what we get or in who our pts are.

Quoted: I'm sorry, but I came in contact with approx. 20- 30 physicians daily in my 25+ years as a medical sales rep. Also as a licensed Medical Laboratory Techolongist. I think I have just a little bit of experience in dealing with the great intellect of physicians. Actually it's pretty scary on how much physicians don't know about medicine. Yes, they passed the state board. Big deal. Most doctors don't go into medicine to follow the hypocritical oath. They go in it for the money and power.The reason some are not recommending going into medicine is because it is getting harder to make a fortune bleeding the insurance and Medicare systems. I'm glad we have physicans, but I know so many who are crook's and set around trying to come up with some new procedure to make them more money. Most of them also treat their staff like sh--. I'm so glad to be out of that business. Go set for the Florida Contractors exam and report back to me how you did.....Doctor's are not God inspite of how most of them feel.........

 Dude, you should really go into comedy.

Quoted: Doctor told her that the body rejects the hardware 80% of the time anyways! And they might have to go back in! If you're going to charge $800 for a drill bit, we damn well better get to keep it too!

The percentage of rejections is coming down and the 80% number is older, it's been a year since i read the current stats though, so I'm unsure of the exact numbers.  and if you want the drill bit, ask for it, I don't think I've ever seen a patient told no they can't have it or anything else they're charged for.

Quoted: Now I don't agree with medicare, that's just plain old bullshit. But you don't pass the cost down to the people who actually pay. You find a way to make medicare pay.

yeah, you tell the government what they pass is bullshit and then don't do it when they've also written laws that they can sue and/or revoke your license if you don't follow their rules The government makes the rules and DICTATES what they pay, we don't get a say in it.

I still don't see why it's a bad thing that maintenance on the absolute most important thing in the world, your life, is expensive.  Obviously there's no point to be wasteful or corrupt, but neither would bargain basement be the place to shop.

I want to expound a bit here:

Physicians and Hospitals are covered by something called EMTALA (see my post above).

Emergency Medical Treatment And Active Labor Act.

That means the Federal Government passed a law applying to all physicians and hospitals.  We HAVE to provide Emergency Care (and treat women in Active Labor).   Someone comes to the office with an infection and no insurance--we have to treat them.  Someone comes to the ER with a broken bone, we have to treat them.  We have to provide care until they can be sent safely to a more suitable (i.e.--Charity or Medicaid/County hospital).  

Emergency treatment is kind of a sliding scale...we can be cited/fined (large $$) if we don't provide emergency care.   What is "Emergency Care"...how the hell should I know?   If someone shows up in the ER with a runny nose...they are at the ER (and, until they get the full workup, you don't know if they are dripping CSF, or just normal snot).     That means Well Insured/Underinsured/Uninsured and even illegal aliens get treated.    The Gov.org, in their infinite wisdom, didn't bother to figure out how the hospitals replace their costs for people that don't pay, just said they have to treat them.


Also, I did my first year of residency at Cook Co. Hospital in Chicago.   Very, VERY close to Socalized medicine.   Try 24-36 hour waits to be seen in the ER.  Specialty clinics locked out for new patient appointments, primary care clinics that took 3 to 6 months to get in to see the residents.    Elective Hip/Knee replacements waiting 5+ YEARS to get their new joints (not because the Residents/attendings didn't want to do the surgeries...there just wasn't funding for the joints themselves).  19 OR Rooms running full time (7 idled because of lack of staff), and it still takes a week to get a patient in to do an amputation (I did more digital amputations and I & D's of Deep infections/Gas Gangrene in the ER than I ever was able to get into the OR).

Am I bitching?  Hell yes....even as a resident (now in a small community hospital).  I spent 30 minutes on the phone trying to get authorization from an insurance co. (that generally has good coverage) just for Celebrex for one of my patients.    

Would I do something else?  Probably not...not looking forward to repayment of $200k in student loans (expensive going to school with a family)...but I still enjoy the challenges.    Does medicine suck sometimes, yes it does.  Do I know (or my attendings) know everything?  No possible way--nobody can know everything about their specialty in medicine.  Experience helps tremendously, as does good basic training.


AFARR

Quoted: I still don't see why it's a bad thing that maintenance on the absolute most important thing in the world, your life, is expensive.  Obviously there's no point to be wasteful or corrupt, but neither would bargain basement be the place to shop.

<bid>I'll do your coronary bypass right here on my kitchen table for $2K<bid>

<bid>I'll do your coronary bypass right here on my kitchen table for $2K<bid>

Hell, I'll do it with my Buck Knife and some fishing line for 10 AR mags and a couple of rusty AK mags.

Eugenics.

Quoted: The hospital that sends you bills is likely classified as a "not for profit organization". Great, so how did my kidney stone episode end up costing a total of 37 thousand dollars?   Where'd all that money go to if it's not for profit? I paid only 1700 bucks thanks to good insurance, fortunately,  but for the amount of work done to me, I frankly can't see any SANE way to say it was worth 37 grand.     Pushing the head of the lithotriptor machine into my lower back and letting it go click, click, click for a few minutes is in no way worth the 10,000 dollars that the hospital billed for, each time! A cat scan taking ten minutes was worth 5000 bucks?   Are you out of your freaking MIND? The system is screwed.

+1

+0.02:
A few years ago, I came down with strep throat.  I needed a bottle of amoxicillin.  Costs about ten bucks.  No problem, right?  Er, sorry, I was in the U.S. at the time.  So I had to go to a physician.  But my physician had stopped practice, so I had to find a new one.  I called eight offices and none of them would see me without a "new patient exam" -- ten minutes of "have you ever had XXXXXX?  Have you ever had YYYYYY?  Do you smoke?  Do you drink?  Do you have sex with men?  Do you have sex with women?"

The lowest cost I could find to get a prescription issued to me was $210.  Plus another $10 for the pills.

Let's contrast this with Taiwan and Thailand.

Taiwan (actual):  I get a sore throat.  I go to the pharmacy, say "I need some amoxicillin, twenty 100mg tablets."  They say "er, have you seen a doctor?"  I say "No, it's a simple throat infection (COUGH COUGH)."  They say "oh!  ok!  Here.  Uh ... (calculator clicking) ... 200 NT."  (About US$6.20 at the current exchange rate.)

Thailand (hypothetical, since I never had a sore throat there):  I get a raging case of the clap a sore throat.  I go to the pharmacy, say "I need some amoxicillin, twenty 100mg tablets."  They say "Op op op OPOPOP op?"  I write down, on the sheet of paper they shove at me, "amoxicillin 100mg X 20".  They say "Op op OP!"  (calculator clicks) 200 baht (about US$4.95).  (Actual situation with antibiotics -- I walked in, said "I need some doxycycline for malaria prevention", and they handed me a bunch of blister-packs for five bucks.)

In actual practice in Thailand, I went to Bumrungrad Hospital in the middle of Bangkok, just off Sukhumvit Soi 3 (and just a short walk from Bamboo Beer Bar, where they have a pretty good Lebanese food stand).  I'd smashed my shoulder in a motorcycle accident in Taiwan and needed an MRI to determine how bad the cartilage damage was.

The MRI cost roughly US$245.  Visits with eight physicians in six different departments (dental, dermatology, ENT, a couple of orthopaedic docs, a GP, and something else I can't remember at the moment) added about another $250.  The most expensive was the skin doc, who froze a few precancerous sunspots (ok, ok, "actinic keratoses", happy now?) off my forehead.  He charged just under US$40 for fifteen minutes of frostbite.  Most of them were about US$20.  All of them (except maybe the dentist -- I just don't trust the filling he replaced, felt strange for a long time) were entirely competent, and several had trained in the U.S.

I highly recommend Bumrungrad for anyone in need of non-research-grade care.  I probably wouldn't touch them for a serious cancer or brain surgery, but for the day-to-day stuff that I've had -- injuries, infections, skin problems, and so on -- they're just dandy.  If you're in the vicinity (Singapore, Malaysia, Taiwan, Thailand) and need some good, cheap, and fast ordinary medical care, drop by:
www.bumrungrad.com/
They also have relatively cheap cosmetic surgery.

Dont get sick.

Quoted: Quoted: Quoted: Stop lowering the standards for doctors who, through their incompetence, contribute to the rising cost of malpractice insurance.   Just curious, but when was the last time you past a medical licensing exam?   I passed my state contractors exam last year and if your a Doctor that does'nt make you more important than anyone. You live in a house that a contractor built and practice medicine in a Hospital that a contractor built........

If I ever need my appendix taken out with a rusty handsaw, I'll send you an IM.

Quoted: Quoted: The hospital that sends you bills is likely classified as a "not for profit organization". Great, so how did my kidney stone episode end up costing a total of 37 thousand dollars?   Where'd all that money go to if it's not for profit? I paid only 1700 bucks thanks to good insurance, fortunately,  but for the amount of work done to me, I frankly can't see any SANE way to say it was worth 37 grand.     Pushing the head of the lithotriptor machine into my lower back and letting it go click, click, click for a few minutes is in no way worth the 10,000 dollars that the hospital billed for, each time! A cat scan taking ten minutes was worth 5000 bucks?   Are you out of your freaking MIND? The system is screwed. +1 +0.02: A few years ago, I came down with strep throat.  I needed a bottle of amoxicillin.  Costs about ten bucks.  No problem, right?  Er, sorry, I was in the U.S. at the time.  So I had to go to a physician.  But my physician had stopped practice, so I had to find a new one.  I called eight offices and none of them would see me without a "new patient exam" -- ten minutes of "have you ever had XXXXXX?  Have you ever had YYYYYY?  Do you smoke?  Do you drink?  Do you have sex with men?  Do you have sex with women?" The lowest cost I could find to get a prescription issued to me was $210.  Plus another $10 for the pills.

You have to be a doctor to understand why we don't prescribe pills without getting a history and performing a physical.  I asked a patient once if he had any medical problems:  "Nope".  During the physical exam, I went to listen to his heart and asked him what the "big scar is on your chest?".  "Oh, I had bipass surgery."  You would think that would be an important fact to let me know about.

Quoted: Quoted: I'm sorry, but I came in contact with approx. 20- 30 physicians daily in my 25+ years as a medical sales rep. Also as a licensed Medical Laboratory Techolongist. I think I have just a little bit of experience in dealing with the great intellect of physicians. Actually it's pretty scary on how much physicians don't know about medicine. Yes, they passed the state board. Big deal. well, la-dee-da.  The person who claims to know all about medicine is a liar.  What you fail to realize is that not knowing everything does not make a physician incompetent.  When's the last time you spent 120 hours a week studying?  gone 9 days with 11 hours of sleep to study for finals?  skipped bathing because you didnt' have the time to waste due to an upcoming test?  If the art of medicine was simply regurgitating route memorization out of a book, any computer could do it, but it's not.  And this doesn't even begin to discuss the failure of your reasoning to address why medicine has so many subspecialties.  Nor does this even begin to touch on the fact that medicine changes on a daily basis, I come home after an 60-90 hour week and I still study, and attempt to keep up by reading journals and going back and studying, do you do something similar?     Quoted: Most doctors don't go into medicine to follow the hypocritical oath. They go in it for the money and power.The reason some are not recommending going into medicine is because it is getting harder to make a fortune bleeding the insurance and Medicare systems. I'm glad you are the prognosticator of all that physicians are and the motives behind why they do what they do.   This is what pisses me off.  You don't have a problem paying a plumber $60-75 or have any doubt that your wage is fitting your work.  When's the last time you collected only 20-40% of what you billed?  How would you like that?  How would you like your hard work denigrated because someone assumes any fucking chimp with a hammer can build?  Physician salaries are the only, yes ONLY group of peoples pay who have not kept up with the average increase in pay raises over the past 20 years, and in fact, they make less now when you factor in inflation than they did 5-10 years ago.  NOT to mention the astronomically increasing cost of going to school.  Where you $150K in debt when you finished your technical training?  and that's only the cost of a state subsidized program, most private medical schools can easily run 300-400k.  And then top that off with the ungodly hours of internship and residency when we make$35k a year for "80" hours a week, and I put 80 in quotes since that is what every says they work due to new regulations, but that's not what happens in real life.   Quoted: I'm glad we have physicans, but I know so many who are crook's and set around trying to come up with some new procedure to make them more money. Most of them also treat their staff like sh--. I'm so glad to be out of that business. Go set for the Florida Contractors exam and report back to me how you did.....Doctor's are not God inspite of how most of them feel......... well la-de-da, i love how you come into this thread with a smug sense of superiority yet have the gall to denigrate another profession due to the same qualities your showing here, i got a word for ya buddy, hypocrite.  assumptions and stereotypes serve no purpose but to inflame and give comfort to those who are either jealous or ignorant of the reality of the situation.  And while I doubt I'd pass the test if I took it today, I have no qualms of boasting that it wouldn't be a challenge and I could pass it if I were to prepare for it.  Could you say the same about the USMLE?

God has spoken.............

Quoted: Quoted: Stop lowering the standards for doctors who, through their incompetence, contribute to the rising cost of malpractice insurance.

Doctors are to blame for medical malpractice lawsuits, not the lawyers who bring them.  You really expect people to believe that doctors are without error in all that they do?  

Doctors mess up for whatever reasons and get sued for it.  Then we, the people, have to listen to the same doctors whine about how they have to pay for more insurance as a result of their mistakes.

God has spoken.............

No wonder you didn't get along with the Doctors as a sales rep and lab technologist.

One of the Doc's here in WA was paying (he retired) $5,500 per month insurance. A radiologist, $80,000 per year.

Used to work in a ER, we had 1 female complain of abdominal pain. Blood work, tests, some pain killers, all until she found out she wasnt pregnant, she then left. We sort of figured that was a $1000 pregnancy test. And yes, this was in the middle of the night.

What jarheaddoc said was spot on.

Quoted: God has spoken............. No wonder you didn't get along with the Doctors as a sales rep and lab technologist.

Only 25 + years and hated every minute kissing their ass so I could make more money thatn most of them.

Quoted: Quoted: A few years ago, I came down with strep throat.  I needed a bottle of amoxicillin.  Costs about ten bucks.  No problem, right?  Er, sorry, I was in the U.S. at the time.  So I had to go to a physician.  But my physician had stopped practice, so I had to find a new one.  I called eight offices and none of them would see me without a "new patient exam" -- ten minutes of "have you ever had XXXXXX?  Have you ever had YYYYYY?  Do you smoke?  Do you drink?  Do you have sex with men?  Do you have sex with women?" The lowest cost I could find to get a prescription issued to me was $210.  Plus another $10 for the pills. You have to be a doctor to understand why we don't prescribe pills without getting a history and performing a physical.  I asked a patient once if he had any medical problems:  "Nope".  During the physical exam, I went to listen to his heart and asked him what the "big scar is on your chest?".  "Oh, I had bipass surgery."  You would think that would be an important fact to let me know about.

I'm sorry, C-4, not to be a prick, but that really is a bullshit excuse.

I've taken amoxicillin before, and have no allergies to it.  A ten second "have you taken this before?" followed by "yeah, about eighteen months ago" should be more than sufficient -- you don't need to know about my heart murmur, my back injury, my shredded left knee from falling on ice, or whether I take it up the ass from anyone other than the IRS in order to say "ok, yeah, that looks like strep, go get some amoxicillin".

P.S. -- the nurses at Bumrungrad are HOTTT.  I have a serious "nurse naughty" fetish now.