What's a doc to do - The Times They Are A-Changing

Free Republic ^ | August 18, 2012 | astounded

[don-o]

My wife of 32 years has been a general surgeon in private practice since 1985. She came up thought the Old Boys Network, when female surgeons were few. We went through graduate school and residency on the south side of Chicago for 5 years, giving up our young married life to a commitment to people. We lived in a one bedroom 800 square foot apartment behind Michael Reese Hospital, on 31st and King Drive, as minority white folks, sacrificing all for 80-120 hour workweeks (before PC got in the way and now the puss* surgical residents have limited hours).

In private practice, she works typically 12-14 hour days, 6 days per week. We had no government loans, supported ourselves, and have saved diligently and progressed. Now, Obama is trying to take it all away. Well, guess what? She will retire, in her last prime years, rather than become a clerk to the leftist entitlement mentality. We well remember the night Obama made those statements on national TV about greedy doctors. I cannot tell you all politely about my white-hot rage and hatred toward Obama and his wife. I so despise them that I cannot stand the sound of his lispy, lilting cadence, I cannot tolerate the sight of his sneering, awful arrogance, his ugly, awful fraud of a spouse.

I cannot tolerate “Americans’ who support Obama, and have cut ties to family and friends who do. I pray we here, the Tea Party, and thinking Americans can rid us of this plague, this malignancy, this utter fraud of Affirmative Action, from OUR White House.

32 posted on Saturday, August 18, 2012 11:48:24 AM by astounded (Barack Obama is a clear and present danger to the USA)

[don-o]

My fellow 98'er posted this comment in another thread. I thought it deserved a wide audience. Posted with his permission

[don-o]

ping

[astounded]

Thanks!

[DuncanWaring]

... sacrificing all for 80-120 hour workweeks (before PC got in the way and now the puss* surgical residents have limited hours).

From the perspective of potential patient, I really don't want someone who works 120-hour weeks carving up my innards.

[HiTech RedNeck]

Tea Party may or may or not be of a lot of help right now. Many won’t vote for the only person poised to be able to oust the Bummer this fall.

[HereInTheHeartland]

It's time for people need to sit up; rub their eyes and get a cup of coffee and clear their head.
Four more years of this guy is just not an option.

[don-o]

Real life personal experience is powerful.

[don-o]

Good grief! Though I have no first hand experience, I know that those hours are common in the medical field. Or do you just mouse around looking for a beef?

[Marie]

My husband is in the army. We echo your sentiments.

[presently no screen name]

It's time for people need to sit up; rub their eyes and get a cup of coffee and clear their head.

Send it to the sleepy GOP. What 'possessed' mitt/GOP for MrRomneyCare to be the one to run against MrObamaCare?

[KC Burke]

A vile change in national culture has also opened up a new opportunity to re-invent yourselves and how you live. Sure, in a way, you are going Galt, but there is a positive side to a new life with a richness born of your already proven and marshalled talents for caring for others.

There are few in this world qualified as you both are to do things like open an orphanage, set up a small school or training center, champian a rural town or sail around the world.

After we have rid ourselves of this next election cycle and get a new group in Washington, I hope you relish what the rest of your life can hold if you recognize what you have been given.

[astounded]

I understand your perspective, but the rationale back then was that a surgeon needed to be ready to be awakened at 2am to go into the hospital to perform an operation that may take 4 to 5 hours; after working a full 12 to 14 hours day prior, starting surgery by 6:30am or so, maybe getting home for dinner by 7 or 7:30pm.

The training is not the same today, and I’d much prefer an old-school surgeon in the middle of the night than a younger one who trained under the new restrictions.

[don-o]

Hasn’t that horse been beat to death YET?

[upchuck]

Bump!

[don-o]

ping

[astounded]

I will still work for some years, as we need to maintain health insurance. She is thinking of working as a locum tenens doc in underserved areas. I’ve also suggested she help out at the free clinic in our town. Florida ultimately calls us, to get out of the corrupt cesspool of Illinois. There are many, many opportunities in soutwest Florida for this sort of contribution.

[presently no screen name]

Hasn’t that horse been beat to death YET?

Not sure. Is the GOP dead YET?

I'm sure there is a doctor in the house who may want to revive it.

[NoGrayZone]

I read that comment and saw the suggestion about a vanity post.

Good idea, glad to see it was done! No way in heck will doctors, especially the good ones, work under barry.

I don't know if there are any restrictions in that monstrous “bill” that would allow doctors to practice on a cash only basis.

I am looking for one now.

[DuncanWaring]

I’m in the aircraft-instrument business.

About 20 years ago, a guy on another project in my department was clocking 100-110 hours per week.

There was a fair amount of quiet discussion about “How much useful work can he be doing?”. And this is in a line of work where if you screw-up, someone else will normally catch it later on in the development process.

If a doctor has to get up at 2AM to be at the hospital before the dawn for an operation, they ought to be out the door by mid-afternoon so they be in bed by a reasonable hour.

How many iatrogenic complications were introduced by surgeons working 120-hour weeks?

[don-o]

What is it that you want to happen on November 6?

[DuncanWaring]

Ping.

[johniegrad]

From the perspective of potential patient, I really don't want someone who works 120-hour weeks carving up my innards.

He's referring to residency training. They've cut back on that now. Not sure it makes for any better of a surgeon. They get less experience and you want that experience in the OR in the middle of the night with trauma or an acute abdomen.

[BooBoo1000]

Sorry to read your post Doctor.I don't feel like some posters, if I need surgery at 2:00 AM, I would sure be glad to see you or your fine wife walk into the Operating Room. I hope you both can find a worthwhile venture that can use your skills, and still allow both of you to have some quality life together

[PA Engineer]

I have shared many of your experiences. We were married during the final year of my Wife's residency. From there she had a public health pay back and Fellowship at the NIH. We were moving all over the place. I can't give to many details in a public forum, but I can say she has built the largest Neurology practice worldwide in her specialty with scheduled waits of six months. We will have been married 26 years this December.

She is heartbroken by what they have done to medicine. She knows all to well what the death panels mean for her patients.

Her patients have benefited the most by advances in both surgery and pharmaceuticals. The last 20 years have been miraculous. What was a certain trip to a nursing home and hospice, is now a chronic and manageable disease with many treatment options. This is already beginning to change. Imagine when over 3000 patients will be told to "just take the pill." Obama said it and it is written into the obamacare bill.

She is also preparing for her out.

[BooBoo1000]

Sorry to read your post Doctor.I don't feel like some posters, if I need surgery at 2:00 AM, I would sure be glad to see you or your fine wife walk into the Operating Room. I hope you both can find a worthwhile venture that can use your skills, and still allow both of you to have some quality life together

[bboop]

As a patient, I can only hope that not all good doctors show Obama they hate him by quitting the profession. I do not look forward to 3rd-rate doctors stepping into the void. Surely there is a way to use your training and expertise for the good of humanity. Maybe just treat conservatives?

It doesn’t leave us patients much, does it? ... to be darned if you’ll work under Obama’s rules?

[bboop]

As a patient, I can only hope that not all good doctors show Obama they hate him by quitting the profession. I do not look forward to 3rd-rate doctors stepping into the void. Surely there is a way to use your training and expertise for the good of humanity. Maybe just treat conservatives?

It doesn’t leave us patients much, does it? ... to be darned if you’ll work under Obama’s rules?

[TXnMA]

Nope, it is still kickin’ here on FR — an the insistence of the Boss...

[johniegrad]

After 32 years in practice, I left 6 weeks ago to retire at age 59. The partners I left behind have never been so discouraged by the future of medical care. We all worked in a health care “system” that bought into all the changes and is doing all in its power to assure compliance with everything the government spits out. In the process, they have set up a “corporate compliance” department that answers only to the board of directors comprised of a few physicians, health care administrators, and civilians. This department has become essentially a Gestapo and is run by a couple of attorneys who, I swear, must hate physicians. Now there is no room for anything for standardization of processes, excruciating compliance with government mandates, and “scorecards” rating physician performance. It’s enough to make you puke and the ethical decision making is strictly done on the basis of reimbursement for the organization.

[don-o]

ping

[don-o]

ping - I know you have had a lot of contact with the medical system recently. Interested in your comments, if you have any.

[johniegrad]

Sorry, the second to last sentence should have read, “Now there is no room for anything but standardization ...” not “for”.

[NoGrayZone]

If it were not for the intern, working those 80-120 hour work weeks, I would not be here today.

In 1989, I had a ruptured cyst on my ovary (didn’t know at the time). I knew something was wrong so I had my bf drop me off at the emergency room. The 1st doctor to examine me dismissed me as to having cramps.

The 2nd, an intern, working those 80 - 120 hour work weeks said the 1st doctor was wrong and gave 2 possible diagnosis. He then recommended a 2nd doctor. He KNEW it was something serious.

The 2nd doctor came in. If it were not for that intern, I would have been dismissed by the 1st doctor...to go home and die.

My ruptured cyst caused a tear on my ovary, which led to internal bleeding. The intern listened to my symptoms....the pain I started to feel all over my body (which was caused by the poison from the cyst entering my bloodstream...causing the pain).

If it were NOT for this intern, who TOLD ME the 1st doctor was wrong, I would have been sent home....to die of internal bleeding.

[pieceofthepuzzle]

I know how she feels, and have had each and every one of those emotions. When I look around at those who support him and his philosophy, I just want to extricate myself from the world they live in. I don't want to be part of that ‘community’. They can do to me whatever the ‘government’ and freeloading jerks like Obama let's them do, but they can never own me, and I will never be a part of them.

[Nateman]

From Atlas Shrugged:

“I quit when medicine was placed under State control, some years ago,” said Dr. Hendricks. “Do you know what it takes to perform a brain operation? Do you know the kind of skill it demands, and the years of passionate, merciless, excruciating devotion that go to acquire that skill? That was what I would not place at the disposal of men whose sole qualification to rule me was their capacity to spout the fraudulent generalities that got them elected to the privilege of enforcing their wishes at the point of a gun. I would not let them dictate the purpose for which my years of study had been spent, or the conditions of my work, or my choice of patients, or the amount of my reward. I observed that in all the discussions that preceded the enslavement of medicine, men discussed everything — except the desires of the doctors. Men considered only the ‘welfare’ of the patients, with no thought for those who were to provide it. That a doctor should have any right, desire or choice in the matter was regarded as irrelevant selfishness; his is not to choose, they said, only ‘to serve.’ That a man who’s willing to work under compulsion is too dangerous a brute to entrust with a job in the stockyards never occurred to those who proposed to help the sick by making life impossible for the healthy. I have often wondered at the smugness with which people assert their right to enslave me, to control my work, to force my will, to violate my conscience, to stifle my mind — yet what is it that they expect to depend on, when they lie on an operating table under my hands?” -Ayn Rand

[astounded]

That’s very interesting, thank you! I know my wife has patients constantly asking her what Obamacare will do to medicine. She has a lot of little old people she has been caring for, in some cases, over two decades. They are begging her not to retire, what will they do? You see, she still takes Medicare patients, but many younger practices don’t. And, if we don’t rid ourselves of Obama and repeal Obamacare, seniors will be out of luck. There will be months-long waits, Medicare payment to doctors and hospitals will be ratcheted down, and docs will not be able to take on new patients on Medicare and maintain their practices. This is a critical situation, the survival of American medicine - the best bar none in the world - depends on freeing the USA from Obama and the left.

[KC Burke]

I also think we are going to see off-shore medical boutiques — living in the carribian could be fun.

[ladyjane]

I find the ‘take the pill’ requirement interesting.

Have any of you out there tried to get any pain medication recently? I just had an accident, my personal physician wasn’t available, and I really needed some pain meds. LOL - it was unbelievable what I went through.

If people think they’re going to get real pain medication and get it easily they are wrong. The future looks very grim. I’m going to start stockpiling some meds in case Aunt Tillie gets denied them.

[grumpygresh]

As a practicing physician, I feel your pain. The Federal government is leaning very hard on physicians, and those in their 50s and 60s will retire or substantially modify their practices. There are 3 major threats to physicians: rationing of care, reduced reimbursement, and increased regulation. The first two will drive physician practices into bankruptcy, and the last one could land doctors in prison.
Primary care docs will be the first to abandon government payers, and instead opt for boutique and cash pay practices which of course will reduce supply for those on Medicare, Medicaid and exchanges. Specialists will be forced to join hospital corporations, but they will have fewer incentives to be productive. Providers working for hospitals will realize that although they will be in high demand, the available pools of money will be limited. Unable to demand high salaries, providers will negotiate for better work conditions (fewer hours, more vacation), which means less access for patients.

[don-o]

How do countries with socialized medicine seem to make it work?

I ask because I have a friend of German heritage who throws that at me all the time and I confess to be somewhat at a loss of facts and figures.

[NoGrayZone]

I work for an endodontist (root canal specialist) and the FDA has recently been cracking down on pain meds, because of the abuse.

We used to give out Vicoden ES like it was candy (we all knew the druggies vs. the people who really needed them).

We rarely give it out anymore. All doctors were given their marching orders.....NO MORE PAIN MEDS.

[astounded]

...”They get less experience and you want that experience in the OR in the middle of the night with trauma or an acute abdomen.”...

Exactly. I’m only sitting here now, on FR, because said wife was called back in after being at the hospital since 6:30 this morning (she is on call all this weekend). I put lunch in front of her at about 1:30pm, she ate it in 5 minutes while talking to an OR nurse who was setting up, and went back. She will be doing a bowel resection all afternoon (free air), and likely will field many calls tonight as she is on ER call too. That’s when you get all the stars of the Knife and Gun Club, who are typically dirtballs and also don’t generally pay. At Reese, I had to take fresh clothes to her because she was covered with blood from a dirtball who was shot and needed his chest cracked in the trauma center. Not fun....

Its’ sort of like, “lather, rinse, repeat” around here sometimes. But, I’ve grown accustomed to it.

[DuncanWaring]

Rather than having one intern working 120 hours per week, wouldn’t it make more sense to have two interns working 60 hours per week each?

The rate of iatrogenic complications suggests there are a lot of doctors making mistakes they might not be making if they were wide-awake.

[astounded]

...”NO MORE PAIN MEDS”....

This is someting new, too. Do you know how many Americans are driving around in a Vicodin- or Oxycontin-induced fog these days? Drug seekers are rampant, and it’s epidemic in states like Florida.

[DoughtyOne]

I certainly identify with those comments, whether a physician or not.

All of us have cause to be repulsed by this ignorant pretender.

I honestly remain somewhat skeptical our own team is serious.  Comments about not getting a balanced budget until 2040, just leave m scratching my head.

I wish we had a person who truly believed in Conservatism, someone I could really get behind, someone who hadn't voted in the affirmative to automatically cut our military, if something we haven't been able to do in over a decad didn't come to pass first.

We're in one mell of a hess here.

Come on Freepers, if you haven't already, pencil yourself in.  Lets get this FReepathon over with.

[LibWhacker]

In private practice, she works typically 12-14 hour days, 6 days per week.

She has her own practice, good. As long as she understands she wasn't the one that built that. j/k!!!

[greeneyes]

How long does vicoden last? I have a few pills leftover, so thought I would save them for a really need it time.

[astounded]

“As a patient, I can only hope that not all good doctors show Obama they hate him by quitting the profession.”

Really? You think good doctors are quitting because they “hate” Obama? I personally loathe everything about Barack Obama. I submit most doctors hate what he is doing to the medical profession in the USA, and taht is why they ar quitting. It’s becoming untenable.

[astounded]

“How do countries with socialized medicine seem to make it work?”

Most don’t. Germany is an exception. The UK NHS is abysmal, populated by non-UK physicians from third-rate medical schools, many, many muslims. It’s a mess.

[pterional]

American medicine was compromised with the start of medicare and has been deteriorating since the government has gotten between the patient and doctor. After implementing Obama care it will be intolerable for those who have seen better days.

What can be outsource is being done at an alarming rate. Radiologist are no longer needed to read films that can be sent to Australia or India. The rest of medicine is being in-source by bring large numbers of foreign medical grads (FMG) or training people to do the work that was once done by a physician. Your future care provider will be a Nurse, physician assistant or a FMG.

The other alarming trend is electronic medical record. This has been spun as a positive to the public allowing physicians in another locations to have your records but in my opinion this is another way Government will control your physician and you. The software tracks every page of information that your physicians views the date and time they viewed the information and they will know every aspect of your life ( physical and mental health) and will use this information for data mining. This is big brother on steroids. The software companies that have developed the electronic medical record are in bed with the government and they are getting wealthy.

My advise to older physicians is work and save as long as you can mentally bear it. There is a breaking point when the aggravation of Government intervention, control and taxation (> 75%) will make medicine a bad job. The new doctors, FMGs and other care providers will have never known what it feels like to have public respect, independence, and financial reward for hard work and delayed gratification.