Posted on 09/18/2007 11:15:14 AM PDT by JZelle
What in blazes are you talking about? I don’t recall any section of the constitution that deals with the graduate education system. Could you please quote that section for me. I know the match program has been in place for decades and has survived numerous court challenges, so you are full of bull-cookies on it’s constitutionality.
Secondly, the work week for residents is now limited by law to no more than 80 hours. Wow, what a hard life. Try not leaving the hospital for a month at a time like we did and then maybe I will feel a bit sorry for the poor overworked souls in residency today.
You are also full of crap about the “reams” of research showing that long hours do not lead to good training. I would very much like you to quote Medline references to substantiate your hypothesis. Lack of sleep will lead to poor judgment, but long days with few rest periods is what todays doctors are all in for. If you can’t hack in residency, you probably need to be a Dermatologist.
Almost completely fee for service, Clients don’t malinger, Clients don’t look for dope, Clients don’t whine and complain.
The choice used to be doctor or lawyer. Now it’s just lawyer. Or plumber/welder. I would opt for the building trades if I were doing the career thing again now.
Wow, you just about eliminated all the ivy-league professions; what are you trying to talk him into, becoming a plumber?
” well. Money isn’t everything, and we desperately need physicians who are actual Americans - as opposed to the plethora of FMGs from India, Pakistan, and elsewhere - to carry on the proud traditions of medicine in America.
“
You hit a nerve with that one. Many positions in Med school and other required positions to become a doctor are held for foreigners. I know of American med students who have been passed by for foreign students. I know of hospital positions held for foreigners.
When I had to go to urgent care a couple months ago, the attending physician was going from room to room - speaking Spanish to patients (his voice could be heard through the curtains). I was the only one he spoke English to, in the hour I was there. The waiting room was packed with Hispanic people and children.
I asked him how those people pay for their medical care. He said, “They don’t. You and I do.” He then proceeded to tell me that Med schools are begging for students. They no longer have full classrooms. He said PA (Physician Attendants) classes are full to the brim, though.
He waved his hand at all the rooms (with the Spanish speaking patients) and said because of this, it is getting harder and harder to make a decent living as a MD.
Didn’t Ron Jeremy do a whole series of films about Dr. Proctor’s life?
The entire practice of medicine, anywhere in the country, has been effectively outlawed for anyone who declines to participate in the “match” system, and spend at least one year working insane hours with no recourse when the work hour rules are violated (name one program that has ever had any sanctions imposed on it for violating the work hour rules; name one resident who has ever filed a formal complaint about repeated work hour violations and been transferred to a different residency program as a result). The current, often disregarded, limits include a 24 hour shift. There’s no shortage of medical literature about the ill effects of going that long without sleep, both on the mental and physical health of the individual going without sleep, and in the impaired judgement and slow reaction time associated with that length of sleep deprivation. There is also no shortage of medical/psychiatric/psychological literature about the effects of sleep deprivation on ability to learn and retain information.
As it stands now, technically someone can legally practice medicine in the US after only one year of this abusive program. In practice, since the government and government-regulated insurance programs have become the payers for the overwhelming majority of medical care, it is impossible to practice without spending at least 4 years in one of these abusive programs, and getting certification by one of the boards that the government recognizes. What if I want to be treated by a doctor who has maintained good personal health practices and made family and community a priority throughout his/her adult life? I can’t, because the government has outlawed that. Where does the Constitution permit government to do that, both to would-be doctors and to patients?
Oops, it’s actually 30 hours at a stretch. And few residency programs enforce the limits.
http://www.boston.com/news/local/articles/2006/09/06/young_doctors_exceeding_work_limits/
And the medical establishment fought tooth and nail to prevent even these sorry excuses for limits from being imposed, despite the large numbers of patients dying from medical errors or omissions due to sleep-deprived residents. The bottom line is that nobody can be reasonably assured of getting high quality medical care, under the auspices of doctors who’ve gotten enough sleep to be fully functional, if you need a procedure or special care that’s available only in major hospitals, all of which are teaching hospitals. Doesn’t matter how much you can pay, or many times your fair share you’ve paid into the government programs, you still have to settle for the same shoddy standard of care from overworked/underslept doctors, as all the people who aren’t paying squat, have never been net payers into the government programs they’re relying on, and in many cases are being treated for self-inflicted ailments associated with smoking, drinking, recreational drug use, overeating, and inactivity.
I have no intention of becoming any kind of doctor. Why would I want to, when I’m making as much as most doctors without ever having had to endure such abuse?
I'm just saying that medicine is wide open with opportunity. It is limited only by the limits that you impose on yourself.
Tell him to let the Air Force pay for his MD, serve out his commitment and then get a JD. He can work defending the good doctors from the bad lawyers.
Not going to happen. His grandparents were USAF physicians, and his dad has a JD. He is not confrontational enough to be a trial attorney.
It has to do with realizing that medicine is your life and that you have to be mentored in a craft. There is a way to determine who is willing to answer a call after 18-24 hours on call. That is called commitment.
You have to learn structure, function, malfunction, repair of the human machine....plus the compassion for patients and the ability to detach in order to observe and attempt to heal. You do that by living, breathing, eating and sleeping medicine. Total commitment.
I want a doctor that has been trained in the hardest, most rigorous program. I want the neurosurgeon that did his 5 years of general surgery, 2-3 years of neurosurgical training plus a fellowship in order to take my kid into surgery and muck about in their brain removing tumors and not something else.
The reams of "research" about time and mistakes was recently debunked. The socialist in medicine are the ones trying to make medicine a 9-5 job. If the training methods in the US are so "inferior" why do all the world's best physicians usually train or were trained in the U.S.
If our medical "industry" is so "bad", why do the richest people in the world insist on being treated in the United States. It's cause our system is a competitive system and it rewards brutal hard work and dedication while letting all the rest of the world shaking their heads and wondering why doctors in this country work so hard.
That's the way they're trained.
Which doctor would you want to see you in the ER...the one that starts his/her evaluation, looks at the clock and says..."tsk, tsk..I've put in my 8-10 hours time to give the old cerebral cortex a little R&R." or the doctor that will stick it out for the several hours of tests, exams and radiologic studies that will be necessary in order to determine a serious or not serious condition?
The some new doctors are already looking at the clock, limiting their work loads and trying to cherry pick some patients.... some doctors are , well, "doctors" and are dedicated professionals. I'm choosing the doc that will bust his balls to help me.
YOU many want to be treated exclusively by doctors who have the mentality that “medicine is my life”, and are happy to forego a healthy family life, optimal personal physical and mental health, and other features of a normal life, and are operating in a physiologically impaired state while treating you. But I don’t want to be treated by doctors like that, and the government should not be able to force the entire practice of medicine into one mold.
As for being treated in an emergency room, that’s exactly where I’ve had some really scary experiences with obviously sleep-deprived doctors (before the current work hour limits were put in place, but in a lot of hospitals, there’s been little actual change in response to the official limits). I’d like to be treated in an emergency room which has been staffed with enough doctors that there is no need for any of them to be working shifts that put them beyond their physiological ability to perform at their best. Economically, this would require eliminating federal mandates for treatment of illegal aliens, drug addicts, and others who are non-paying and often suffering from self-inflicted conditions. The free market would take care of the rest. Voluntary charity would treat as many of the illegals and self-inflicteds as qualified medical staff FREELY choose to treat and/or private donors FREELY choose to pay for.
The practice of medicine is not an exception to the bedrock principle that freedom is a good thing.
vaudine
“What if I want to be treated by a doctor who has maintained good personal health practices and made family and community a priority throughout his/her adult life? I can’t, because the government has outlawed that. Where does the Constitution permit government to do that, both to would-be doctors and to patients?”
You are free to see Homeopathic physicians that have not “done an abusive residency”. You are free to see a chiropractor who can “adjust your spine” and cure your migraines. You can see a podiatrist that will make you shoe inserts to help your hypertension. All this quackery is paid for by the “Government and Insurance Boogie Men” you seem to want to rant about.
If you choose to be treated by a physician of allopathic medicine, then you have of your own free will choosen to support the traditional and evidence based therapies they espouse. If you don’t want to, I have the name of a great witch doctor in the downtown area that will kill a chicken, burn it’s entrails and make you all better.
I agree 110% The system even allows Surgeons like Dr. James Balserak a Known Butcher from Tucson AZ to operate on our poor soldiers over in IRAQ. This guy couldn’t operate out of a toy box and is a danger to society.
Need I say more!!!!
Mel D MD
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