But consider this: my friend who worked in the postal service for 30 years has a pension for life of 60% salary and gauranteed health care. He retired at 55. My cousin who worked for the streets department in NYC has a simialr deal. Another firend is an MD with the Veterans administration and will be out after 20 yrs service. Work for the goverment???? I would do it in a heart beat if I could but its too late for me. ME- 53 y/o MD ,tired of the grind and now with a busted 401k and some prexisting conditions. Thats what I get for essentially working for the insurance compainies and middlemen in healthcare!!
And...once you get over the student loans- and devote all your time to your patients for 30 years- you can come out poor because you had to save for your own retirement, and then pay for your own health care- so Docs tend to try to accumulate enough to keep them and their spouse at some standard of liviing in their old age.
I am a radiologist, and I feel sorry for some of the current crop of primary care MD's. It seems they were never exposed to taking care of outpatients . All their training was hospital based, so they saw only very sick patients, (the only ones being admitted today ) and never saw them after they left the hospital, so they have no idea how to manage a patient with an "acute " complaint- so they order tests- too many xrays! Every patient with a headache must get a CT, every patient with back pain gets Spine films - Chest discomfort? rule out dissection! This has nothing to do with malpractice. I had an MD order a shoulder (3 films) , elbow (4 films) , forearm (2 films) and wirst (4 films) series on a patient because of "pain"- It didnt occur to them that it was a radiculopathy from cspine degenerative dz.
There is no sanity to how these regs are interpreted- and you cant complain or they label you as risking their hospital accrreditiation! Becasue of how "HIPPA" was interpreted at our Hospital, You are not allowed to call a patient's name in our waiting room. We have a special email system that the reseptionist uses to describe what the patient is wearing- thats how a tech finds them. The best story I have is that we had "mock" inspections all month before JCAHO and the insepctions did not pick up on an electric cord that was draped over the floor in a technologist xray room. A few days later the tech tripped over the cord and broke her arm. So much for the safety that this process provides.
Bravo! I am an MD in a suburban hospital and the Joint Commission regs - which make sense to some degree get OVER- interpreted by someone who has a desk job in the hopsital (sorry- usually an RN who has removed themsleves from patient care) and their "productivity" is measured by how much over interpretation they can come up with - measured by how much they can change current process to "comply"
with the regs. I have to have an RN do a complete assesment on every patient who has a breast cyst that I aspirate. The paperwork takes longer than the procedure! And the patient who comes in 3 times during a week has to go thru the whole paperwork process each time. And the patients who are debased and abused by all this paperwork then get angry with....ME because I am "the doctor"
Very well thought out plan - first time Ive seen someone with a plan that covers so many of the issues- Can I share one other point - I am a 53 y/o physician- when I leave my practice I , like many in other fields will not have a medical insurance plan and will be in the free market. I also will not have any pension plan- also like many of my fellow citizens- I find myself and my colleagues chasing well paying positions, and yes, generating fees just to save enough to secure my retirement (If I dont get an MI before then).And during my years in practice I would have taken much less in salary and fees if I could have been gauranteed a health plan and some security in retirement in exchange for giving a lifetime of care to patients. , Had I taken a civil service job 30 years ago, or worked for the postal service I would be taken care of. It doesnt add up after spending a career in medicine of all things.
The hospital l work at charges $300 for an ultrasound if you dont have insurance and pay cash. But the blues ins pays us only $75. Here is the kicker: We are not allowed to give a patient a cash discount and tell them , ok give me $50 because supposedly then the blues will force me to accept my "best price" for all their patients too. I was told this by a hospital administrator .Too many Catch 22's in healthcare.