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onceahardman
Jan 3, 2009, 2:27 PM
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Hi dj69...
I meant to get to the subject of liability, but when I got wrongfooted about insurance companies, never got around to it.
My opinion is, there needs to be limits on liability for failed medical procedures. NO doctor is perfect, but if a particular doctor has several charges of malpractice, the medical board should pull his/her license. But the award amounts are too high, for problems that are simple statistical realities.
In OB/GYN, there is a significant, non-zero chance that mother and/or baby will suffer an injury or death, no matter who is running the show. Things sometimes go wrong. Awards in the tens of millions are, IMO, excessive.
The legal lobby, (which finds a sympathetic ear from most congressman, senators, and nearly all judges), tends to disagree. It is one of the main "meal tickets" for the legal industry. Putting caps on liability is perhaps the quickest fix for a big part of the problem.
Of course, all my kids were born without excessive difficulty. Maybe I'd think differently if malpractice occurred. But I'd like to think not.
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dj69
Jan 3, 2009, 5:36 PM
Post #152 of 209
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I agree with you one hundred percent, once a hard man. The Lawsuits filled these days are excessive and some are just plain idiotic. I once read somewhere that a certain gentlemen crashed his RV when he put it on cruise control and went in back to make coffee. I cannot recall the exact figure he was rewarded, but I remember thinking it was exorbitant to say the least. Now I am well aware this in no way, shape or form involves the health care system, however it is an excellent example of how people abuse the legal system. It is obvious that the gentlemen involved in this crash should have lost, and had his license revoked, however in the end he received a large sum of money, and a new RV. Perhaps if people stopped suing left right and centre in hope of multi-million dollar settlements then these premiums would go down. I think it's important to note that it's a minority of Americans doing this, however often times everyone is forced to pay for the actions of a reckless minority. Perhaps yet another factor is the massive variance in malpractice premiums, for instance OB/GYN's in Minnesota, Mississippi and North Carolina where paying on average 17, 45 and 31 thousand dollars respectively. While on the other end of the spectrum OB/GYN's in Florida, Dade county Florida, and Clark county Nevada had average premiums of 103,201 and 142 thousand dollars. Admittedly there are several factors that contribute do these fluctuations, however I do not believe such large fluctuation of over one-hundred thousand dollars are justified.
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HarklessDO
Jan 3, 2009, 6:11 PM
Post #153 of 209
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I am not sure why I am doing this but after reading the last couple pages of the thread I though I would jump in as the only doctor that I have seen that is contributing.
Lets start with salaries. Yes most Ob's do make in the 200,000. How do we rectify this with their loss of income into the negative range. The answer is this there are next to no private OB's anymore. This is especially true in States like mine where the malpractice hammer swings ever so hard. So this means that a hospital pays them say 200,000 dollars to be ob docs and takes the loss just so they can offer the service. Also hoping that they make the money back in labs and xrays and ultrasounds that the obs generate. This being said in a non reformed malpractice state it is impossible to make money (or nearly) as a OBgyn in private practice unless they only do gyn surgery where the malpractice is lower than if they deliver babies.
More on salaries. There are some specialties that do make a killing. Radiology, derm, ortho to name a few. I am a FP and upon me getting out of residency I will be upper middle class which I am not complaining about but I will never be filthy rich.
From a medical school standpoint. Most of us come out with over 200,000 in loans now. As a primary care doc this is daunting to pay. You have essentially bought a nice house you will never see. You also must remember that while you business (for example) majors were out there making money since you were 22. I have been in the land of perpetual delayed gratification till I get my first real job at 30-32 depending on your path to medical school. This means that you have an 8 year head start and didn't pay the loans or the time I did. I hope I would be rewarded financially for this.
Now onto insurance companies. They have us by the balls and dictate much of what we can prescribe, tests we can order, and generally make the bigger profit of anybody in the whole healthcare system. Some more than others but lets face it they do well.
Now lets get into some socialized medicine talk. Let me start by saying I am not for it. The first discussion takes us back to the first which is malpractice. The biggest reason that healthcare has gotten so expensive is a that most doctors order senseless tests out of defensive medicine hoping to keep the lawyers at bay. The numbers are not entirely accurate but approx 98% of your healthcare dollars get spent in the last two years of your life and 98% of those get spent in the last two weeks of your life. Why because doctors do everything even futile things because we fear being sued. On that note. My malpractice goes up whether I was wrong or not. As soon as I have been named I am screwed. Right or wrong does not matter to malpractice carriers.
Is there a role for the government? Sure. Is healthcare a right? Absolutely not. What is the role. I think the biggest thing the government can do is set guidelines of what acceptable care is. This means that if I am doing the right thing as a doctor you can't sue me as long as I adhere to what is considered the standard of care. Also there is a ethical dilema of when to say enough is enough as long as the goverment is footing the bill. If you want to pay for useless chemo that is fine but should the government(medicare) be paying for pancreatic Cancer chemo that has 0% chance of working, I think not.
There are lots of problems with our healthcare system but if anyone is expecting Obama to come riding in on his noble steed and fix it all, it is not going to happen. As long as the majority of politicians are lawyers nothing will ever be fixed.
I will end it there but I am sure there will be more to come.
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jt512
Jan 4, 2009, 4:16 AM
Post #154 of 209
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HarklessDO wrote: From a medical school standpoint. Most of us come out with over 200,000 in loans now. As a primary care doc this is daunting to pay.
Oh, come on. If you restrained yourself to living on what the average American lives on, you could pay that loan off in three years.
Jay
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HarklessDO
Jan 4, 2009, 4:42 AM
Post #155 of 209
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you can't be serious. Just cause you make 100,000 or whatever it is does not mean you take it home. The average FP is about 130-150,000. Are you really that mad at people for making money to be that ridiculous. Three years come on lets be serious.
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reno
Jan 4, 2009, 4:53 AM
Post #156 of 209
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jt512 wrote: reno wrote: My ex-father-in-law, a retired OB/GYN, lost money the last two years he was in practice. That is, he spent more money to be a doctor (malpractice insurance, office rent, payroll, and so forth) than he made. Tell me again how, exactly, he was overpaid, JT? The average salary of an OB/GYN is about $200,000, according to published sources. That doesn't include benefits. I don't know what your father-in-law's problem was, if any.
Average salary, you say?
Heh. One would think a statistician PhD/CPA/Nutritionist/Self-proclaimed smart guy would know the flaws in citing the "average" salary. Guess not.
It couldn't have been the $100,000 malpractice insurance premium, could it?
I mean, since you're so knowledgeable about the practice and business of medicine and all, I figured you'd know.
(This post was edited by reno on Jan 4, 2009, 5:08 AM)
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reno
Jan 4, 2009, 5:02 AM
Post #157 of 209
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jt512 wrote: HarklessDO wrote: From a medical school standpoint. Most of us come out with over 200,000 in loans now. As a primary care doc this is daunting to pay. Oh, come on. If you restrained yourself to living on what the average American lives on, you could pay that loan off in three years.
Jay, since you seem to be the expert on how much a physician makes, please inform everyone on how much of that salary the average physician takes home, after expenses.
No Google searching allowed.
My guess, and I'm spitballing here, is that you ain't even close. I'd wager that you're not within 50%, actually.
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milo607
Jan 4, 2009, 5:14 AM
Post #158 of 209
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I am with Harkless - doctors are not the cost problem. It is lawyers! And don't expect Obama and the rest of the Dems to fix that problem. If and when they socialize the healthcare system I am sure they will build in the ability to sue the government every time something goes wrong. So then I get to pay for your healthcare, and you get to sue me when it sucks!
I by the way have the lowest ranked HMO plan in our area - and I am quite satisfied. I busted my knee climbing and got an MRI with 2 days, and surgery a week later(would never happen with socialized medicine). Cost me $50 plus $25 per visit for PT.
The health care system isn't perfect, but many need to quit bitching, and get a better job/insurance plan. Or you could just make me and every other taxpayer cover you....
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jt512
Jan 4, 2009, 5:41 AM
Post #160 of 209
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reno wrote: jt512 wrote: HarklessDO wrote: From a medical school standpoint. Most of us come out with over 200,000 in loans now. As a primary care doc this is daunting to pay. Oh, come on. If you restrained yourself to living on what the average American lives on, you could pay that loan off in three years. Jay, since you seem to be the expert on how much a physician makes, please inform everyone on how much of that salary the average physician takes home, after expenses. No Google searching allowed. My guess, and I'm spitballing here, is that you ain't even close. I'd wager that you're not within 50%, actually.
What expenses? We're talking about salaried employees. How much do you take home after your "expenses."
Jay
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jt512
Jan 4, 2009, 5:45 AM
Post #161 of 209
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HarklessDO wrote: you can't be serious. Just cause you make 100,000 or whatever it is does not mean you take it home. The average FP is about 130-150,000. Are you really that mad at people for making money to be that ridiculous. Three years come on lets be serious.
Actually, when I said "3 years" I forgot about income tax. See how much I enjoy not being a tax accountant anymore?
Jay
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reno
Jan 4, 2009, 5:48 AM
Post #162 of 209
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jt512 wrote: reno wrote: jt512 wrote: HarklessDO wrote: From a medical school standpoint. Most of us come out with over 200,000 in loans now. As a primary care doc this is daunting to pay. Oh, come on. If you restrained yourself to living on what the average American lives on, you could pay that loan off in three years. Jay, since you seem to be the expert on how much a physician makes, please inform everyone on how much of that salary the average physician takes home, after expenses. No Google searching allowed. My guess, and I'm spitballing here, is that you ain't even close. I'd wager that you're not within 50%, actually. What expenses?
I rest my case. You really DON'T know, do you?
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jt512
Jan 4, 2009, 5:58 AM
Post #163 of 209
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reno wrote: jt512 wrote: reno wrote: jt512 wrote: HarklessDO wrote: From a medical school standpoint. Most of us come out with over 200,000 in loans now. As a primary care doc this is daunting to pay. Oh, come on. If you restrained yourself to living on what the average American lives on, you could pay that loan off in three years. Jay, since you seem to be the expert on how much a physician makes, please inform everyone on how much of that salary the average physician takes home, after expenses. No Google searching allowed. My guess, and I'm spitballing here, is that you ain't even close. I'd wager that you're not within 50%, actually. What expenses? I rest my case. You really DON'T know, do you?
If you want to rest your case, you first have to make your case. What expenses?
Jay
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HarklessDO
Jan 4, 2009, 11:48 AM
Post #164 of 209
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Only about 50% of doctors are salaried. The percentage may be higher amongst ob's I am not sure of that stat. But I when done in June will be private. After my revenue guarantee of one year I am on my own. And even before that with my revenue guarantee. I have to pay taxes (yes some of do pay these) , employees, keep my lights on, malpractice, my own insurance, owe yeah I would like my kids to eat and maybe get a toy occasionally, owe yeah forgot those pesky loans, and owe yeah pay my credit cards that I had to run up while I was taking 40+ credits a semester in medical school and had no way to make money, oh yeah and I guess I should pay myself.
Yeah what was I thinking, expenses? How silly of me.
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jt512
Jan 4, 2009, 1:17 PM
Post #165 of 209
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HarklessDO wrote: Only about 50% of doctors are salaried. The percentage may be higher amongst ob's I am not sure of that stat. But I when done in June will be private. After my revenue guarantee of one year I am on my own. And even before that with my revenue guarantee. I have to pay taxes (yes some of do pay these) , employees, keep my lights on, malpractice, my own insurance, owe yeah I would like my kids to eat and maybe get a toy occasionally, owe yeah forgot those pesky loans, and owe yeah pay my credit cards that I had to run up while I was taking 40+ credits a semester in medical school and had no way to make money, oh yeah and I guess I should pay myself. Yeah what was I thinking, expenses? How silly of me.
You should be ashamed to make a post like this. Get a little perspective.
In the meantime, explain to our genius-in-residence, Reno, what the difference, in terms of who bears the responsibilities for the costs of a medical practice, is between a salaried doctor and one in private practice.
Jay
(This post was edited by jt512 on Jan 4, 2009, 1:28 PM)
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HarklessDO
Jan 4, 2009, 1:27 PM
Post #166 of 209
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Tell me what to be ashamed of and I will consider it.
I think your wild accusations that doctors are living like kings (and if you check I did say there are some that do) and don't deserve to be compensated is something shameful. Let me tell you working 80 hours a week for pennies during residency putting myself in the whole over 200,000 dollars just to have some idiot who didn't like there scar ruin my carear is the shameful thing. I fully admit there are things that doctors can do better but I am not going to apologize for making money. The next time you go to the ER be glad he makes 200,000 dollars because no one would put themeselves through this if there weren't some incentives. Mine are not financial but let me tell you most doctors would rather make 60,000 being an engineer that have to deal with the pressure of this job knowing that every desicion means life and death and the lawysers are always waiting to swoop.
Please save your liberal people that make money are evil for someone else.
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jt512
Jan 4, 2009, 1:43 PM
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HarklessDO wrote: Tell me what to be ashamed of and I will consider it.
For complaining about being in the top 1% of income worldwide.
In reply to: ...most doctors would rather make 60,000 being an engineer that have to deal with the pressure of this job and the lawysers are always waiting to swoop...
That is false on its face; however, I do understand that the situation wrt malpractice litigation in the US is unfair to doctors.
Jay
(This post was edited by jt512 on Jan 4, 2009, 1:44 PM)
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HarklessDO
Jan 4, 2009, 2:02 PM
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Unfortunately Jay it is all to true. What you fail to factor into any of your equations are lifestyle. I am not going to put any kind of guessing % on it but the majority of doctors would much rather do something else.
The lifestyle is terrible. Price per hour you do not do as well as most proffesionals. And when you go home at the end of the day most doctors are not done working and at the sound of a beeper you have to snap back into action. You must be just as sharp at 2 in the afternoon with a full nights rest as you are at 2 in the morning with no rest.
Don't get me wrong I love what I do and quite honestly don't know what else I would do because the only other things I enjoy don't pay any money. That being said I will make a comfortable life and feel that I deserve it. Yes and in these economic times I am in one of the most reccesion proof jobs and feel bad for anyone who is struggling. But we all make choice and we all have oppurtunites and it how we respond to that will determine how successful you are.
I came from nothing and my mother struggled for everything that me and my brothers had. I studied and did well in school and I am where I am now. I am happy to make the money. I deserve it. I also give more away than I care to count because I want to help others. There is nothing to be ashamed of for being a high salary earner.
Answer me this. Has anyone poorer than you ever given you a job? The answer is no. I will generate jobs for others. I will not have to depend on a goverment program to cover my existence. I have in the past and have vowed never to do it again. We should all strive to be as high of earners as we can so that we can help those below us and give our families the best life we can.
You still fail to answer my question of why I should be ashamed.
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reno
Jan 4, 2009, 2:07 PM
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jt512 wrote: If you want to rest your case, you first have to make your case. What expenses?
Uh, the expenses that come with practicing medicine, Jay. You know, like filing paperwork with the insurance companies, paying rent for the office, etc.
You know.... expenses.
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jt512
Jan 4, 2009, 2:33 PM
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reno wrote: jt512 wrote: If you want to rest your case, you first have to make your case. What expenses? Uh, the expenses that come with practicing medicine, Jay. You know, like filing paperwork with the insurance companies, paying rent for the office, etc. You know.... expenses.
Salaried doctors don't pay rent for office space, Reno. Nor do they pay out of pocket for filing insurance claims. That's why they become salaried doctors. They trade off income for not having to do that stuff. On average, doctors who go into private practice make a lot more money than the salaries I quoted.
Jay
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reno
Jan 4, 2009, 2:39 PM
Post #172 of 209
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jt512 wrote: reno wrote: jt512 wrote: If you want to rest your case, you first have to make your case. What expenses? Uh, the expenses that come with practicing medicine, Jay. You know, like filing paperwork with the insurance companies, paying rent for the office, etc. You know.... expenses. Salaried doctors don't pay rent for office space, Reno.
Not all doctors are salaried, Jay. Other than Hospitalists and Emergency Physicians, that is.
And you've never answered my original question.
(This post was edited by reno on Jan 4, 2009, 2:40 PM)
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jt512
Jan 4, 2009, 2:42 PM
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reno wrote: jt512 wrote: reno wrote: jt512 wrote: If you want to rest your case, you first have to make your case. What expenses? Uh, the expenses that come with practicing medicine, Jay. You know, like filing paperwork with the insurance companies, paying rent for the office, etc. You know.... expenses. Salaried doctors don't pay rent for office space, Reno. Not all doctors are salaried, Jay.
And the unsalaried ones make more money than the salaried ones, so what's your point?
Jay
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reno
Jan 4, 2009, 2:53 PM
Post #174 of 209
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jt512 wrote: reno wrote: jt512 wrote: reno wrote: jt512 wrote: If you want to rest your case, you first have to make your case. What expenses? Uh, the expenses that come with practicing medicine, Jay. You know, like filing paperwork with the insurance companies, paying rent for the office, etc. You know.... expenses. Salaried doctors don't pay rent for office space, Reno. Not all doctors are salaried, Jay. And the unsalaried ones make more money than the salaried ones, so what's your point?
Really? How much more, Jay?
Above, you said this:
In reply to: What expenses? We're talking about salaried employees.
So, after claiming that doctors don't have expenses, you now claim that they do.
There's hope for you yet.
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onceahardman
Jan 4, 2009, 3:26 PM
Post #175 of 209
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In reply to: For complaining about being in the top 1% of income worldwide.
That is just so ignorant.
So doctors should "be ashamed" for making more than a 12 year old in India making Oriental rugs for a few pennies a day?
Maybe everybody should make the same amount, regardless of the contribution made to society.
Perhaps then we could all be equally miserable.
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