If you can read this, either the style sheet didn't load or you have an older browser that doesn't support style sheets. Try clearing your browser cache and refreshing the page.

(Washington Post)   The latest degree that is quickly becoming a bad value: MD   (washingtonpost.com) divider line 123
    More: Interesting, Health Affairs, Aaron Schock, Balanced Budget Amendment, Medicine study  
•       •       •

11893 clicks; posted to Main » on 15 Feb 2013 at 2:24 PM (1 year ago)   |  Favorite    |   share:  Share on Twitter share via Email Share on Facebook   more»



123 Comments   (+0 »)
   
View Voting Results: Smartest and Funniest

Archived thread

First | « | 1 | 2 | 3 | » | Last | Show all
 
2013-02-15 03:15:05 PM
Just teach at hospitals. Doesn't look that hard. Well not as hard as learning to be an auto mechanic.
 
2013-02-15 03:18:03 PM
The economic recovery continues.
 
2013-02-15 03:22:38 PM

potterydove: So they're in the same boat as most other professions.  We have too many people with degrees and not enough skilled trades(wo)men.


Everyday I'm thankful that I went to a technical school instead of a collage. Having a welding certification is worth a thousand liberal arts degrees.
 
2013-02-15 03:32:50 PM

GUTSU: potterydove: So they're in the same boat as most other professions.  We have too many people with degrees and not enough skilled trades(wo)men.

Everyday I'm thankful that I went to a technical school instead of a collage. Having a welding certification is worth a thousand liberal arts degrees.


10/10
 
2013-02-15 03:35:31 PM

noitsnot: Tommy Moo: Bad for med students, good for us. This is hitting literally every field. Why shouldn't they share in the suffering? The single largest reason health care costs so much in this country is because of the outlandish salaries of doctors. Let's dump a glut of competent doctors on the market until the invisible hand finally does its job and lowers salaries down to the point where people will actually have to weight the costs vs. benefits of entering the field of medicine. Currently it's a no brainer: if you can get into med school, you go, because you are 100% guaranteed a life of Corvettes and naked underwear models.

Ding ding ding!  Yes - this!  Finally we are seeing some alternative mechanisms for healthcare happening (surgical centers, NPT's) and competition and benefit reform (MOAR PLEASE) are beating some sense into "the way it's always been done".

I talked to my anesthesiologist neighbor about internships and residency, how they work 12 hour shifts and isn't that a terrible and dangerous idea, given how it's been shown that performance drops and errors rise after about 5 hours of being on a shift.  His response was "It's not a problem because they're used to it."  Basically 1) That's how we always have done it, 2) Those studies don't apply because we are supermen


It is nothing more than hazing.  The old docs had to do it and they were fine, so the young docs will do it to because dammit, I had to so they have to live like hell too.

My fiancee is currently working 15 hr shifts with 1 hour off before doing 4 hours of free clinic work.  by currently, I mean February.  Our VD yesterday was takeout sushi for lunch because she would be asleep by 2 pm to be ready to be at work at 8:30 that night.
 
2013-02-15 03:40:05 PM

LockeOak: GUTSU: potterydove: So they're in the same boat as most other professions.  We have too many people with degrees and not enough skilled trades(wo)men.

Everyday I'm thankful that I went to a technical school instead of a collage. Having a welding certification is worth a thousand liberal arts degrees.

10/10


I'm going to tell you a little secret, No one cares if you have a degree in political science, communications, photography, or sociology. Learning how to be a plumber, welder, electrician, or mechanic will probably land you a job, and actually has real world applications.
 
2013-02-15 03:40:16 PM

LockeOak: GUTSU: potterydove: So they're in the same boat as most other professions.  We have too many people with degrees and not enough skilled trades(wo)men.

Everyday I'm thankful that I went to a technical school instead of a collage. Having a welding certification is worth a thousand liberal arts degrees.

10/10


There is a lot of value to the liberal arts.  That value isn't measured in money, though.  Kinda like how GDP doesn't measure things that aren't measured in money (ie, the important things).

That said, I have kids, and I intend to make sure that real world applicability of post-HS plans is discussed with at least one person (me).  College will not be mandatory but encouraged, useless majors will not.  Tradeschools will be encouraged if their personalities seem to fit, as you can't outsource welding or HVAC.

/grampa was a plumber, didn't graduate HS and did fractional math faster than your iPhone.
//majored in Philosophy
///8 adults in my family, 19 degrees from BA through MD (x2)
 
2013-02-15 03:48:50 PM

alywa: Tommy Moo: The single largest reason health care costs so much in this country is because of the outlandish salaries of doctors.

Physicians do make a lot of money in the US.  However, there is much blame to go around for our ridiculous healthcare costs.  Multi-layer insurance structures with corresponding multiple overheads.  Litigious sentiments creating a "defensive medicine" atmosphere.  Poor preventative healthcare coverage.  Fat, unhealthy population.  Poor IT / data sharing leading to duplication of testing / services.  Reimbursement based on testing / volume instead of results (which is a difficult metric to measure, btw).  Huge numbers of uninsured patients who abuse the system and never pay bills, leading to higher charges for services for those who do.  Lobbying by pharma / device manufacturers to cover and pay dearly for meds / implants / devices / scans / etc.  Increasing availability of ever-more expensive and sophisticated diagnostic / treatment modalities.  Longer average life expectancies.  A society which doesn't accept death very well and consequently wants "everything done".  Breakdown of extended family structure leading to more people in long-term care facilities.  The list goes on...

Take your pick... they are all part of the problem


Bullshiat. The problem is those useless mds who should have majored in pure math. I have no sympathy for anyone who is not a math major with an advanced degree. And math majors don`t need sympathy! Hey Dr Barista, diagnosis this cup as needing a refill
, loser sauce!

/is that about right?
 
2013-02-15 03:53:59 PM

TofuTheAlmighty: alywa: What a horseshiat article.  According to this  http://www.statehealthfacts.org/comparemaptable.jsp?ind=434&cat=8  there were 17,300 US medical school graduates in 2011.

So there are two bottlenecks, not just one. Doesn't make the article horseshiat. I agree, though, that we need more med schools. The AMA has done a damn good job constraining the supply of docs (and thus inflating the prices of schools and doctors) by refusing to accredit new schools.

What went unstated in the article - the number of residencies is limited because hospitals themselves refuse to pay residents and demand taxpayers foot the bill. That's a huge pile of horseshiat. Hospitals make money hand over fist but the public has to subsidize their profits?


"Artifical" limiting of med school spots is not necessarily an evil, profit driven thing. Nearly every resident I've spoken with agrees that the bottom 5-10% of their graduating class (the ones who failed courses and had to retake them or made it through by one lucky answer) are not physicians they would visit if they were sick. Most go so far as to say the school pushed these students through, and question whether they should be practicing at all. Then there are the students who can't get into a US school and go to the Carribean (where residency match rates can be truly scary).

At the risk of sounding like a douche, it's not a job every one can just do. I might prefer to be launching shiat into space, but unfortunately I suck at math. You can't say more med school spots are the answer, unless you're prepared to deal with less talented physicians. In my area of the country at least (Southeast), there are spots in most schools that weren't taken by what most of you would consider a particularly qualified applicant.

Bottom line is the number of potentially good doctors that can be turned out per year, i.e. surgeons you'd trust your life to, is finite and I think we're near it in some regions.

I also think the number could be drastically increased by making residency cheaper or helping poor children get better educated. You need incentive to attract top students, or you need to better educate everyone.
 
2013-02-15 03:58:05 PM
no it is a great value, if you can find a residency position.

congress in the 1997 balanced budget act, AFTER BEING LOBBIED TO DO SO BY THE AMA, capped the number of residency slots that medicare paid for (the vast majority of funding for residency) tat 1997 levels to ensure a shortage of doctors and the attendant massive increase of salary for what was already by far the most lucrative profession in the history of the world.

greed, that's what drives our nations medical regulation.
 
2013-02-15 04:01:40 PM

Occam's Disposable Razor: TofuTheAlmighty: alywa: What a horseshiat article.  According to this  http://www.statehealthfacts.org/comparemaptable.jsp?ind=434&cat=8  there were 17,300 US medical school graduates in 2011.

So there are two bottlenecks, not just one. Doesn't make the article horseshiat. I agree, though, that we need more med schools. The AMA has done a damn good job constraining the supply of docs (and thus inflating the prices of schools and doctors) by refusing to accredit new schools.

What went unstated in the article - the number of residencies is limited because hospitals themselves refuse to pay residents and demand taxpayers foot the bill. That's a huge pile of horseshiat. Hospitals make money hand over fist but the public has to subsidize their profits?

"Artifical" limiting of med school spots is not necessarily an evil, profit driven thing. Nearly every resident I've spoken with agrees that the bottom 5-10% of their graduating class (the ones who failed courses and had to retake them or made it through by one lucky answer) are not physicians they would visit if they were sick. Most go so far as to say the school pushed these students through, and question whether they should be practicing at all. Then there are the students who can't get into a US school and go to the Carribean (where residency match rates can be truly scary).

At the risk of sounding like a douche, it's not a job every one can just do. I might prefer to be launching shiat into space, but unfortunately I suck at math. You can't say more med school spots are the answer, unless you're prepared to deal with less talented physicians. In my area of the country at least (Southeast), there are spots in most schools that weren't taken by what most of you would consider a particularly qualified applicant.

Bottom line is the number of potentially good doctors that can be turned out per year, i.e. surgeons you'd trust your life to, is finite and I think we're near it in some regions.

I also think the number co ...


sure, france has over 60% more physicians than the UNITED STATES so by your estimation they must be suffering dearly for it.
oh wait, they have the best outcomes in the world, and pay a much cheaper rate for it than us too.

really really sad that you are pumping a talking point that has resulted in millions of americans going without medical care.
 
2013-02-15 04:03:48 PM
Hm - well if you take "get rich" off the list of why people want to become doctors, maybe you might end up with better doctors who care about helping people instead of how many boob-jobs they can fit in before golf.
 
2013-02-15 04:12:10 PM
Occam's Disposable Razor:

"Artifical" limiting of med school spots is not necessarily an evil, profit driven thing. Nearly every resident I've spoken with agrees that the bottom 5-10% of their graduating class (the ones who failed courses and had to retake them or made it through by one lucky answer) are not physicians they would visit if they were sick. Most go so far as to say the school pushed these students through, and question whether they should be practicing at all. Then there are the students who can't get into a US school and go to the Carribean (where residency match rates can be truly scary).

Meh, went to a Caribbean medical school. matched into an incredibly competitive field, and am now chief resident.  Classes are the same, books are the same, USMLE is the same (and my school has higher average Step1 scores than US students), so your argument is highly unconvincing . . .
 
2013-02-15 04:12:41 PM
Been a shiatty value for a while, actually, compared to others.

As part of a programming class, I made a program where you could put in your major, years of school, and average starting salary, and it would spit out numbers telling you how 'worth it' your degree was.  Some of the highest returns over a lifetime were trade schools and engineering, some of the lowest (but still positive) were doctors and lawyers.  This is assuming you're the standard run of the mill student who doesn't get full rides or big scholarships, just the standard 'here you are sign on the dotted line' grants/loans.  Basically, I found out that the average MD doesn't make nearly enough to make up for all the requirements, cost, opportunity costs, etc that must be fulfilled.

Imagine if you had to put down a year of your own money to get an intensive degree, work a bunch of free hours, be under a lot of stress, etc, all to start a job at $10/hr.  When you would have made much much more money just working your way up from minimum wage, or going to trade school, etc.

The art and humanities type students got the worst deal:  They were significantly behind people that worked their way up from minimum wage.  Like, way way behind.  Like, they would have had better job prospects if they took the cost of college and spent it all on hookers and blow and forwarded them to the correct addresses.
 
2013-02-15 04:13:50 PM

JohnAnnArbor: Tommy Moo: The single largest reason health care costs so much in this country is because of the outlandish salaries of doctors.

Not really, but nice try.  Think about the enormous amount of paperwork required by three levels of regulation: the hospital (document everything to avoid getting sued), the insurance companies (document everything and you MIGHT get paid, some day), and government (document everything because we said so and/or so that you MIGHT get paid half the cost of the procedure, some day).

Add on top of that hospital systems that feel the need to build absolute palaces instead of what's actually needed (expensive entraceways, giant atria, etc.) and things are stupidly expensive.  I don't think every hospital should look like a bad 1970s Soviet hospital, but we can do without the expensive "architectural statement" every time a new building goes up, can't we?


All of that is also true in other countries. What makes the US special? Doctors here make three times the salary of comparable doctors in the number two country. More than half of your hospital bill goes to pay the doctor's $300,000 salary. There are many jobs that require 8-10 years of schooling in the country that pay a very respectable $70-$100k salary.

www.mnhospitals.org
 
2013-02-15 04:18:27 PM

relcec: Occam's Disposable Razor: TofuTheAlmighty: alywa: What a horseshiat article.  According to this  http://www.statehealthfacts.org/comparemaptable.jsp?ind=434&cat=8  there were 17,300 US medical school graduates in 2011.

So there are two bottlenecks, not just one. Doesn't make the article horseshiat. I agree, though, that we need more med schools. The AMA has done a damn good job constraining the supply of docs (and thus inflating the prices of schools and doctors) by refusing to accredit new schools.

What went unstated in the article - the number of residencies is limited because hospitals themselves refuse to pay residents and demand taxpayers foot the bill. That's a huge pile of horseshiat. Hospitals make money hand over fist but the public has to subsidize their profits?

"Artifical" limiting of med school spots is not necessarily an evil, profit driven thing. Nearly every resident I've spoken with agrees that the bottom 5-10% of their graduating class (the ones who failed courses and had to retake them or made it through by one lucky answer) are not physicians they would visit if they were sick. Most go so far as to say the school pushed these students through, and question whether they should be practicing at all. Then there are the students who can't get into a US school and go to the Carribean (where residency match rates can be truly scary).

At the risk of sounding like a douche, it's not a job every one can just do. I might prefer to be launching shiat into space, but unfortunately I suck at math. You can't say more med school spots are the answer, unless you're prepared to deal with less talented physicians. In my area of the country at least (Southeast), there are spots in most schools that weren't taken by what most of you would consider a particularly qualified applicant.

Bottom line is the number of potentially good doctors that can be turned out per year, i.e. surgeons you'd trust your life to, is finite and I think we're near it in some regions.

I also think the number co ...

sure, france has over 60% more physicians than the UNITED STATES so by your estimation they must be suffering dearly for it.
oh wait, they have the best outcomes in the world, and pay a much cheaper rate for it than us too.

really really sad that you are pumping a talking point that has resulted in millions of americans going without medical care.


What does France have in the way of primary education? What do med students pay for training there? I know we can educate more excellent docs, but I think we need to attract more people to medicine or have a better educated population overall. I agree that our outcomes are crappy in some areas, but more doctors won't automatically make it better and could make it worse.
France is a different culture with different attitudes. Not a straight up comparison.

Also I'll admit I've just got anecdotal (read: no) evidence, but when it's taking students multiple attempts to pass a national board, maybe they should be looking for another career with lower stakes. It's not an easy answer.
 
2013-02-15 04:21:48 PM

GUTSU: LockeOak: GUTSU: potterydove: So they're in the same boat as most other professions.  We have too many people with degrees and not enough skilled trades(wo)men.

Everyday I'm thankful that I went to a technical school instead of a collage. Having a welding certification is worth a thousand liberal arts degrees.

10/10

I'm going to tell you a little secret, No one cares if you have a degree in political science, communications, photography, or sociology. Learning how to be a plumber, welder, electrician, or mechanic will probably land you a job, and actually has real world applications.


A trade is quite valuable, I agree. I was referring more to the fact that he was denigrating a degree from a liberal arts "collage."

/BS, PhD Biology
//just got a marine biology job in NZ
///woohoo
 
2013-02-15 04:22:08 PM

PatoDeAgua: Occam's Disposable Razor:

"Artifical" limiting of med school spots is not necessarily an evil, profit driven thing. Nearly every resident I've spoken with agrees that the bottom 5-10% of their graduating class (the ones who failed courses and had to retake them or made it through by one lucky answer) are not physicians they would visit if they were sick. Most go so far as to say the school pushed these students through, and question whether they should be practicing at all. Then there are the students who can't get into a US school and go to the Carribean (where residency match rates can be truly scary).

Meh, went to a Caribbean medical school. matched into an incredibly competitive field, and am now chief resident.  Classes are the same, books are the same, USMLE is the same (and my school has higher average Step1 scores than US students), so your argument is highly unconvincing . . .


Maybe you hit a good school. If you did the work and got the scores, that's fantastic, but I personally know people from schools with 60-70% match rates. That's scary to me if I'm an incoming first year, no?

Once you've taken the Step and matched, you're on equal footing with anyone else. Please don't think I was attacking Carribean schools.

Do you disagree that you had classmates who weren't qualified to practice? I know I did.
 
2013-02-15 04:22:28 PM

JohnAnnArbor: alywa: Medical schools are very expensive to build / create.

Michigan's expanding their options: Oakland U, Western Michigan U, and Central Michigan U all are adding/recently added medical schools.  WMU's is from a $100-million anonymous grant.  (Those awful rich people.)


You mean a state is not sitting around waiting on the Feds to do something but is taking action itself?  I am shocked.
 
2013-02-15 04:31:57 PM

loonatic112358: alywa: What a horseshiat article.  According to this  http://www.statehealthfacts.org/comparemaptable.jsp?ind=434&cat=8  there were 17,300 US medical school graduates in 2011.  The chart in TFA clearly shows nearly 25,000 PGY-1 spots.  The increasing number of applicants is due to an influx of applications from foreign trained MDs.

Relatively few foreign MDs get spots compared to their US trained peers.  The ones that do are usually very good (though I've seen some bad ones, and often language barriers are tough). They are also usually filling in spots that went unfilled.  I knew absolutely 0 people from my US medical school class that didn't get a residency position.

The real issue isn't residency spots, it's medical school slots in the US.  Medical schools are very expensive to build / create.  Our current system is simply too small for our population.  With the boomer population at Medicare age, a much smaller Gen X and Millennial pool to pick from, and increasing sub specialization, there most definitely will be a shortage of US trained primary MDs.  Expect to see more foreign trained physicians and allied professionals (NP, PAs) in the primary care roles in the years to come.  Not necessarily a bad thing, but it is the way things are moving.

So more docs who went for medical school in greneda?


SGU (along with Ross and AUC) has a very good reputation for producing quality doctors but that's fine.
 
2013-02-15 04:33:48 PM

Tommy Moo: JohnAnnArbor: Tommy Moo: The single largest reason health care costs so much in this country is because of the outlandish salaries of doctors.

Not really, but nice try.  Think about the enormous amount of paperwork required by three levels of regulation: the hospital (document everything to avoid getting sued), the insurance companies (document everything and you MIGHT get paid, some day), and government (document everything because we said so and/or so that you MIGHT get paid half the cost of the procedure, some day).

Add on top of that hospital systems that feel the need to build absolute palaces instead of what's actually needed (expensive entraceways, giant atria, etc.) and things are stupidly expensive.  I don't think every hospital should look like a bad 1970s Soviet hospital, but we can do without the expensive "architectural statement" every time a new building goes up, can't we?

All of that is also true in other countries. What makes the US special? Doctors here make three times the salary of comparable doctors in the number two country. More than half of your hospital bill goes to pay the doctor's $300,000 salary. There are many jobs that require 8-10 years of schooling in the country that pay a very respectable $70-$100k salary.

[www.mnhospitals.org image 562x406]


I realize anecdote does not equal fact but I'd like to dispute that. My most recent foray into the world of medicine involved the premature birth of my daughter, she spent 24 days in NICU before she was released. The portion of the bill that was presented by the medical center's "contractors" which included a lengthy list of doctors, techs and specialists came in at just under $50,000, total.

The portion of the bill that stated simply "room charges" was in excess of $70,000. So in my case, more than half of my bill was spent paying for a room that I'm quite sure had been paid for dozens of times before my little one showed up.

Mind you that the $50k bill and the $70k bill do not represent the total amount billed to me, merely the portions of the billing that appeared to be related directly to "people" and "places".
 
2013-02-15 04:38:56 PM

Tommy Moo:
All of that is also true in other countries. What makes the US special? Doctors here make three times the salary of comparable doctors in the number two country. More than half of your hospital bill goes to pay the doctor's $300,000 salary. There are many jobs that require 8-10 years of schooling in the country that pay a very respectable $70-$100k salary.

[www.mnhospitals.org image 562x406]


In other countries doctors work less hours (in the case of surgical specialties about 1/2 the hours), get way more sick leave/maternity leave/vacation time, earlier retirement with better retirement benefits, and nearly free education. The tuition paid by the average med student adds up to about 250k, and you can't begin to pay that off until after residency, so add interest on that. Also, European countries import a greater percentage of their doctors so you are much more likely to get a recent grad from New Delhi U. who started learning English 6 months ago.

Just looking at the money: the average primary care doctor makes (minus education costs) roughly the same as a plumber over the course of their career.
 
2013-02-15 04:43:16 PM

YEREVAN: FTFA: Who else, after all, can show up at dinner and claim to have spent her day saving lives?

Police, Fire, EMS, Nurses...

/ Dragonslayers?
/ Nanobots?
/ Guinness brewers?


Dermatologists.

25.media.tumblr.com

/hot
 
2013-02-15 04:43:58 PM

Tommy Moo: More than half of your hospital bill goes to pay the doctor's $300,000 salary. There are many jobs that require 8-10 years of schooling in the country that pay a very respectable $70-$100k salary.


Your graph shows 51.4% for employees not doctors. Part of that 51.4% goes to the CEO all the way down to the janitor.
 
2013-02-15 04:44:11 PM

TelemonianAjax: LockeOak: GUTSU: potterydove: So they're in the same boat as most other professions.  We have too many people with degrees and not enough skilled trades(wo)men.

Everyday I'm thankful that I went to a technical school instead of a collage. Having a welding certification is worth a thousand liberal arts degrees.

10/10

There is a lot of value to the liberal arts.  That value isn't measured in money, though.  Kinda like how GDP doesn't measure things that aren't measured in money (ie, the important things).

That said, I have kids, and I intend to make sure that real world applicability of post-HS plans is discussed with at least one person (me).  College will not be mandatory but encouraged, useless majors will not.  Tradeschools will be encouraged if their personalities seem to fit, as you can't outsource welding or HVAC.

/grampa was a plumber, didn't graduate HS and did fractional math faster than your iPhone.
//majored in Philosophy
///8 adults in my family, 19 degrees from BA through MD (x2)


More power to you, it's just that a lot of people overvalue a collage degree, they believe that it guarantees them a job. When you mentioned "the important things" I assume you mean writers and artists? I don't believe you need a degree to become one.
Although people should try and get a job at something they like, I personally enjoy metalworking so welding was a good fit.
 
2013-02-15 04:44:17 PM

PatoDeAgua: Occam's Disposable Razor:

"Artifical" limiting of med school spots is not necessarily an evil, profit driven thing. Nearly every resident I've spoken with agrees that the bottom 5-10% of their graduating class (the ones who failed courses and had to retake them or made it through by one lucky answer) are not physicians they would visit if they were sick. Most go so far as to say the school pushed these students through, and question whether they should be practicing at all. Then there are the students who can't get into a US school and go to the Carribean (where residency match rates can be truly scary).

Meh, went to a Caribbean medical school. matched into an incredibly competitive field, and am now chief resident.  Classes are the same, books are the same, USMLE is the same (and my school has higher average Step1 scores than US students), so your argument is highly unconvincing . . .


This.
Also from a Carib school with a higher Step 1 score average than the US :) You really need to be specific when you say Caribbean med schools.  There are shiat ones and there are a handful of great ones (much like the US -http://www.ama-assn.org/amednews/2011/12/05/prsa1205.htm ).  Not to mention there are plenty of students that graduate from the crappier ones and still become very successful because it's all taught the same - a 2 year long step course with, in our case (I assume you went to Ross or SGU) reputations for better clinical prep.  You can do amazing or fail out completely in the Caribbean, it's entirely up to the student.  The difference is they don't hold our hand or let us repeat unlimited times like they do in the US (difficult to get in, impossible to fail out).  Go ahead and check on Ross and SGU's match lists and decide what exactly "scary" means.  Talk about a blanket statement.
 
2013-02-15 04:47:14 PM
I do not understand the Feds involvement anyway as the supply of doctors is a State /regional thing and unless the Feds are going to tell doctors where to practice their involvement seems stupid.

Seems to me States shoudl take the lead on this. California, for example , is facing a big doctor shortage. Could not the state offer a residency programs, even helping cover the costs of med school? In exchange the Doctor would have to agree to work as a state employee in a Public health clinic some undeserved area for 5 years Failure to complete med school or serve as agreed would be treated as a tax debt subject to wager garnishment etc. or if feeling generous a standard student loan plus 10%.

This could even work for out of state med schools as long as they come back to the state to fulfill their commitment. Of course there would be some need to specify which specialist the state was going to finance most likely GP, OB/GYN etc. You know the ones with the shortages.

You could extend this to PAs and nurses also.
 
2013-02-15 04:48:48 PM

CWeinerWV: PatoDeAgua: Occam's Disposable Razor:

"Artifical" limiting of med school spots is not necessarily an evil, profit driven thing. Nearly every resident I've spoken with agrees that the bottom 5-10% of their graduating class (the ones who failed courses and had to retake them or made it through by one lucky answer) are not physicians they would visit if they were sick. Most go so far as to say the school pushed these students through, and question whether they should be practicing at all. Then there are the students who can't get into a US school and go to the Carribean (where residency match rates can be truly scary).

Meh, went to a Caribbean medical school. matched into an incredibly competitive field, and am now chief resident.  Classes are the same, books are the same, USMLE is the same (and my school has higher average Step1 scores than US students), so your argument is highly unconvincing . . .

This.
Also from a Carib school with a higher Step 1 score average than the US :) You really need to be specific when you say Caribbean med schools.  There are shiat ones and there are a handful of great ones (much like the US -http://www.ama-assn.org/amednews/2011/12/05/prsa1205.htm ).  Not to mention there are plenty of students that graduate from the crappier ones and still become very successful because it's all taught the same - a 2 year long step course with, in our case (I assume you went to Ross or SGU) reputations for better clinical prep.  You can do amazing or fail out completely in the Caribbean, it's entirely up to the student.  The difference is they don't hold our hand or let us repeat unlimited times like they do in the US (difficult to get in, impossible to fail out).  Go ahead and check on Ross and SGU's match lists and decide what exactly "scary" means.  Talk about a blanket statement.


I corrected myself in my next comment. I fight the stigma of being from a deep south med school myself, and I'm sorry to offend anyone with that generalization about the Carribean. I just hadn't seen match rates like that elsewhere, though I imagine they're out there.

Like I said, prove your stuff on Step, show you can be a good resident, and it doesn't matter where you sat while reading the texts.
 
2013-02-15 04:50:28 PM
TelemonianAjax:
My fiancee is currently working 15 hr shifts with 1 hour off before doing 4 hours of free clinic work.  by currently, I mean February.  Our VD yesterday was takeout sushi for lunch because she would be asleep by 2 pm to be ready to be at work at 8:30 that night.

I hear you. I was looking forward to a nice two day weekend with my wife. Usually she just gets one day off. Nope! Medical conference this weekend. She does get part of Sunday off. Oh well.. that sweet sweet residency pay makes it all worthwhile =)
 
2013-02-15 04:52:53 PM

BigLuca: Tommy Moo:
All of that is also true in other countries. What makes the US special? Doctors here make three times the salary of comparable doctors in the number two country. More than half of your hospital bill goes to pay the doctor's $300,000 salary. There are many jobs that require 8-10 years of schooling in the country that pay a very respectable $70-$100k salary.

[www.mnhospitals.org image 562x406]

In other countries doctors work less hours (in the case of surgical specialties about 1/2 the hours), get way more sick leave/maternity leave/vacation time, earlier retirement with better retirement benefits, and nearly free education. The tuition paid by the average med student adds up to about 250k, and you can't begin to pay that off until after residency, so add interest on that. Also, European countries import a greater percentage of their doctors so you are much more likely to get a recent grad from New Delhi U. who started learning English 6 months ago.

Just looking at the money: the average primary care doctor makes (minus education costs) roughly the same as a plumber over the course of their career.


You can easily pay off $250k in debt in three years by living below your $300k salary, or you can pay it off over twenty years without feeling it. A $2000 monthly education bill isn't exactly bringing you hardship when you bring home $15,000 a month after taxes. Education repayment takes your $300k salary and reduces it to a $270k salary. Big whoop. They still make three times as much as PhDs.

And that's not even getting into the fact that the loans are easily forgiven by doing a few years of work in underprivileged areas. Plus I'm pretty sure loan interest is deferred when you're in residency.

If med school wasn't a sweet ass deal, there wouldn't be a million undergrads banging at the door every year.
 
2013-02-15 04:53:39 PM

Akuinnen: Tommy Moo: More than half of your hospital bill goes to pay the doctor's $300,000 salary. There are many jobs that require 8-10 years of schooling in the country that pay a very respectable $70-$100k salary.

Your graph shows 51.4% for employees not doctors. Part of that 51.4% goes to the CEO all the way down to the janitor.


Yes but it is hard to hate on "greedy" doctors if yo look at it like that.

As withe most things you can blame the scumsuckingmaggotlawyers:

Look at malpractice insurance:
http://www.ehow.com/about_5514154_average-cost-medical-malpractice-i ns urance.html

While Nevada malpractice insurance rates are between middle to high in comparison with all other states, doctors of many types in Nevada--including general internists, pediatricians and general practice doctors--earn a higher average salary than doctors in any other state. In 2009, one of the highest rates of insurance in Nevada is for OB/GYNs, who may pay between $85,000 for malpractice liability insurance per year up to $142,000 per year for a premium plan by a prominent insurance company. Although the average annual salary for such doctors was around $180,000 in 2009, malpractice insurance can still be a huge financial burden.
Florida has some of the highest rates of liability insurance. Moreover, the deviation between low and high averages varies in Florida more widely than in almost any other state. For instance, a doctor in internal medicine in Florida could expect to pay in excess of $56,000 per year for insurance as of 2009, in contrast with Minnesota's $4,000. General surgeons paid in between $90,000 per year and $175,000 per year or more. OB/GYNs once again could expect the highest rates, with liability coverage ranging from $100,000 to $200,000 per year.
 
2013-02-15 04:56:19 PM

Tommy Moo: JohnAnnArbor: Tommy Moo: The single largest reason health care costs so much in this country is because of the outlandish salaries of doctors.

Not really, but nice try.  Think about the enormous amount of paperwork required by three levels of regulation: the hospital (document everything to avoid getting sued), the insurance companies (document everything and you MIGHT get paid, some day), and government (document everything because we said so and/or so that you MIGHT get paid half the cost of the procedure, some day).

Add on top of that hospital systems that feel the need to build absolute palaces instead of what's actually needed (expensive entraceways, giant atria, etc.) and things are stupidly expensive.  I don't think every hospital should look like a bad 1970s Soviet hospital, but we can do without the expensive "architectural statement" every time a new building goes up, can't we?

All of that is also true in other countries. What makes the US special? Doctors here make three times the salary of comparable doctors in the number two country. More than half of your hospital bill goes to pay the doctor's $300,000 salary. There are many jobs that require 8-10 years of schooling in the country that pay a very respectable $70-$100k salary.

[www.mnhospitals.org image 562x406]


And how many of those professions involve life and death decisions? How many of those professions require a quarter to a half a million dollars in tuition fees?

You simply sound butthurt that your profession isn't as lucrative.
 
2013-02-15 04:57:05 PM

CWeinerWV: Nearly every resident I've spoken with agrees that the bottom 5-10% of their graduating class (the ones who failed courses and had to retake them or made it through by one lucky answer) are not physicians they would visit if they were sick


Q: What to you call person who graduated at the bottom of his med school class ?

A: Doctor
 
2013-02-15 05:01:30 PM

Occam's Disposable Razor: CWeinerWV: PatoDeAgua: Occam's Disposable Razor:

"Artifical" limiting of med school spots is not necessarily an evil, profit driven thing. Nearly every resident I've spoken with agrees that the bottom 5-10% of their graduating class (the ones who failed courses and had to retake them or made it through by one lucky answer) are not physicians they would visit if they were sick. Most go so far as to say the school pushed these students through, and question whether they should be practicing at all. Then there are the students who can't get into a US school and go to the Carribean (where residency match rates can be truly scary).

Meh, went to a Caribbean medical school. matched into an incredibly competitive field, and am now chief resident.  Classes are the same, books are the same, USMLE is the same (and my school has higher average Step1 scores than US students), so your argument is highly unconvincing . . .

This.
Also from a Carib school with a higher Step 1 score average than the US :) You really need to be specific when you say Caribbean med schools.  There are shiat ones and there are a handful of great ones (much like the US -http://www.ama-assn.org/amednews/2011/12/05/prsa1205.htm ).  Not to mention there are plenty of students that graduate from the crappier ones and still become very successful because it's all taught the same - a 2 year long step course with, in our case (I assume you went to Ross or SGU) reputations for better clinical prep.  You can do amazing or fail out completely in the Caribbean, it's entirely up to the student.  The difference is they don't hold our hand or let us repeat unlimited times like they do in the US (difficult to get in, impossible to fail out).  Go ahead and check on Ross and SGU's match lists and decide what exactly "scary" means.  Talk about a blanket statement.

I corrected myself in my next comment. I fight the stigma of being from a deep south med school myself, and I'm sorry to offend anyone with that generalizati ...


No prob, there was a delay there in posting.  Yeah it's just rough because we get such a undeserved bad rap but those that work with us know better.  I got rejected from a US school with a crap reputation and is now on probation but yet their graduates don't have to deal with this stigma.
 
2013-02-15 05:04:36 PM

hasty ambush: CWeinerWV: Nearly every resident I've spoken with agrees that the bottom 5-10% of their graduating class (the ones who failed courses and had to retake them or made it through by one lucky answer) are not physicians they would visit if they were sick

Q: What to you call person who graduated at the bottom of his med school class ?

A: Doctor


That wasn't me! Like most students I don't know where everyone stands in my class and a lot of med schools don't even have grades so I don't have an opinion on that one.
 
2013-02-15 05:07:57 PM

Tommy Moo: BigLuca:
Just looking at the money: the average primary care doctor makes (minus education costs) roughly the same as a plumber over the course of their career.

You can easily pay off $250k in debt in three years by living below your $300k salary


Primary care doctors don't make $300k, so I'm not sure why you are quoting and replying to BigLuca with that number.
 
2013-02-15 05:11:58 PM

Occam's Disposable Razor: Also I'll admit I've just got anecdotal (read: no) evidence, but when it's taking students multiple attempts to pass a national board, maybe they should be looking for another career with lower stakes. It's not an easy answer.


you are ingnoring the part where congress capped residencies in 1997 at 1997 levels in order to increase profit for doctors. your argument is that its a nice way to weed out the incompetent, that essentially people are stupider here than the rest ofthe world and aren;t as prepared to be docotors as they are in france, and also people are stupider here than they were 15 years ago when the cap was put in place by congress IN ORDER TO INCREASE SALARIES. your argument is asinine.
 
2013-02-15 05:12:48 PM

Akuinnen: Tommy Moo: BigLuca:
Just looking at the money: the average primary care doctor makes (minus education costs) roughly the same as a plumber over the course of their career.

You can easily pay off $250k in debt in three years by living below your $300k salary

Primary care doctors don't make $300k, so I'm not sure why you are quoting and replying to BigLuca with that number.


Yes, he has some serious misconceptions of the field. Doctors that make $300,000+ a year have specialized, which requires 14 total years of school.
 
2013-02-15 05:29:14 PM
I wonder if the US should experiment with the idea of admitting people to a five- or six-year medical school straight out of high school, like in some other countries.  One of the limiting factors on being a doctor is the soul-crushing amount of time involved in getting through all the schooling.
 
2013-02-15 05:31:51 PM
Political Denouement

/makes ideologue happy
//screws everyone else
 
2013-02-15 05:33:05 PM

Johnsnownw: Akuinnen: Tommy Moo: BigLuca:
Just looking at the money: the average primary care doctor makes (minus education costs) roughly the same as a plumber over the course of their career.

You can easily pay off $250k in debt in three years by living below your $300k salary

Primary care doctors don't make $300k, so I'm not sure why you are quoting and replying to BigLuca with that number.

Yes, he has some serious misconceptions of the field. Doctors that make $300,000+ a year have specialized, which requires 14 total years of school.


Until some people no longer want to go to med school, doctors are overcompensated. The end-all-catch-all statistic is the number of applicants to med school. You can rationalize how much doctors are paid all you want, but as long as twice as many people are applying as there are positions, the social consensus is that the benefits of being a doctor outweigh the costs. In every other field people are saying "Screw this; it's not worth it." No one in the history of this nation has ever said "Screw med school. It's not worth 8 years to only be guaranteed 100% employment with a six figure salary." When that happens, the compensation will have balanced out with the cost of entry.
 
2013-02-15 05:41:35 PM
Build more med schools, train more doctors, and pay them less. That will be a major step toward reining in health care costs. The Japanese did that, and they use WAY more health care than we do, with all the fancy tests you can name, with a much better outcome and a much lower overall cost. Doctors shouldn't make CEO money; they should make engineer money.
 
2013-02-15 06:01:45 PM

Akuinnen: TelemonianAjax:
My fiancee is currently working 15 hr shifts with 1 hour off before doing 4 hours of free clinic work.  by currently, I mean February.  Our VD yesterday was takeout sushi for lunch because she would be asleep by 2 pm to be ready to be at work at 8:30 that night.

I hear you. I was looking forward to a nice two day weekend with my wife. Usually she just gets one day off. Nope! Medical conference this weekend. She does get part of Sunday off. Oh well.. that sweet sweet residency pay makes it all worthwhile =)


I'm enjoying being the primary breadwinner for the only time in our lives it is feasible. As I pointed out to her, her starting salary is literally only available in my profession of I am the governor (state level political staff - all the insecurities of budgets and contracts, none of the union protection!).
 
2013-02-15 06:40:21 PM
I took a hard look at going to medical school; even to taking the MCATs.  That was when the talk of cutting down on Medicare and Medicaid reimbursements was really starting.  I saw the huge decline in physician quality of life that would impose, and decided the juice just wasn't worth the squeeze.

So I went to pharmacy school instead.  Finishing up my PGY-2 in oncology this summer.

(And now I'm sitting at my desk at 7pm on a Friday night, writing some voriconazole pharmacokinetics and dosing notes.  Whoo.  Hoo.)
 
2013-02-15 06:47:40 PM
I got my MD from DeVry college, so I've got that going for me.
 
2013-02-15 07:09:02 PM

Tommy Moo: Johnsnownw: Akuinnen: Tommy Moo: BigLuca:
Just looking at the money: the average primary care doctor makes (minus education costs) roughly the same as a plumber over the course of their career.

You can easily pay off $250k in debt in three years by living below your $300k salary

Primary care doctors don't make $300k, so I'm not sure why you are quoting and replying to BigLuca with that number.

Yes, he has some serious misconceptions of the field. Doctors that make $300,000+ a year have specialized, which requires 14 total years of school.

Until some people no longer want to go to med school, doctors are overcompensated. The end-all-catch-all statistic is the number of applicants to med school. You can rationalize how much doctors are paid all you want, but as long as twice as many people are applying as there are positions, the social consensus is that the benefits of being a doctor outweigh the costs. In every other field people are saying "Screw this; it's not worth it." No one in the history of this nation has ever said "Screw med school. It's not worth 8 years to only be guaranteed 100% employment with a six figure salary." When that happens, the compensation will have balanced out with the cost of entry.


Where is this 8 years you speak of? You don't make six figures after 8 years...11-12, yes. Also, plenty of people drop out of Med school. If you have the ability, it's your own fault for not going into a profession that has guaranteed 100% employment. Again, you simply sound butthurt.

I'm also unclear as to why you think doctors are overpaid. What about their jobs do you find doesn't warrant their current compensation?
 
2013-02-15 07:17:27 PM
Health care costs would go down a lot if all medicine was over the counter. Nothing like going to a doc to get a prescription for every ear infection
 
2013-02-15 07:20:54 PM
They need to license paradoctors to replace GPs.Trained mainly in triage and dealing with colds and flu, etc. Anything out of the ordinary, they can refer to the next tier "full" doctor or specialist.

GPs are vastly over trained anyway. 10 years out of med school, they can probably function fine remembering 20% of what they were originally taught, as long as they keep current on updated or new drugs.
 
2013-02-15 07:31:05 PM

Pointy Tail of Satan: They need to license paradoctors to replace GPs.Trained mainly in triage and dealing with colds and flu, etc. Anything out of the ordinary, they can refer to the next tier "full" doctor or specialist.

GPs are vastly over trained anyway. 10 years out of med school, they can probably function fine remembering 20% of what they were originally taught, as long as they keep current on updated or new drugs.


I think the future will clearly be 4 year technical degrees that train people to do the physical parts of being a physician with computers like these link
For routine stuff and classically trained MDs for complex things.
Computer would ask for vital signs and symptoms, you ask generated questions, input answers, it tells you what labs to run, and boom-diagnosis. It could better track drug interactions as well.
 
2013-02-15 08:10:09 PM
assets.ilounge.com

Serioiusly? No one?
 
Displayed 50 of 123 comments

First | « | 1 | 2 | 3 | » | Last | Show all

View Voting Results: Smartest and Funniest


This thread is closed to new comments.

Continue Farking
Submit a Link »






Report