Posted on 08/18/2012 11:36:19 AM PDT by don-o
Were you at our wedding?
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So true. They try to play us all the time. We have 1 doctor who is on to them, and the other (head boss) is only now adhering to NOT calling in scripts for such abusers.
We at the front desk are also the "front line" to the abusers. They call in, asking for scripts and we tell them if they are in so much pain, they need to come in, there is something wrong (which is true).
They hem and haw, but we stand firm. They mostly do not come in. Probably went and sought another doctor to get their fix.
I wouldn’t be surprised if she could do that. Surgeon was the one occupation I supposedly wasn’t suited for according to a high school aptitude test (finger dexterity not fast enough), but I got ill and never did much of anything. But programming or operating a robot surgeon — that I could do!
Do you want someone who was unwilling, if necessary to learn the craft, to work that hard carving up your innards?
I think the message is not that we hate obama, but we hate, regret, and forsee the destruction of the best health care system in the world. Even more, he is dismanteling our Contitution and our Republic. We have few 'tool' with which to make these points. Obama has already defined us as people who care no more for people than that we would cut off a persons leg for $50,000. Obama is the man full of hate and resentment.
Given how difficult it is to get into Med School, I strongly suspect the schools could accept twice as many students with no observable decrease in overall quality of the graduated doctors.
Control of resident working hours was already evolving in that direction — localities and the free market would have fixed any problems just fine, but instead fascists took over that decision making process.
You keep ragging on this issue like it’s new thinking that sometimes residents get too tired to be as safe as if they were more rested. Of course can be problems if people are too tired. There are ALSO problems when patients get handed back and forth and the doctors spend all their time and energy trying to re-acquire and re-memorize that the hell is going on with patients when they have to “change shifts” like a dang union job. Now you are seeing that. HOURS and HOURS of notes and hand-off conferences to pass patients around, all fertile ground for MORE and NEW mistakes. The law of unintended consequences HAPPENS when centralized control freaks are allowed to circumvent free market evolution.
120 hour weeks, even back then, were RARE, and they are not what a clock-puncher thinks of as 120 hours. When 120 hour weeks happened, here is what REALLY happens if you are stuck with that type of schedule for a while: you don’t do anything else and it’s not that much different that MOTHER’S hard working life!
Those are 17 hours a day average weeks, but you EAT at work, and you sit down and rest some and are not off the clock for that rest. You grab a newspaper and read it between cases. You call some people on the phone. You even take some NAPS in that 120 hours and are on the clock. You sometimes shower and clean up at the hospital on the clock. You are living your life at the hospital just like a submariner in battle. Its requires dedication and sacrifice, but it is DOABLE.
So you get 7 hours average OFF a day and for that 7 hours you probably will basically sleep the entire time and then go back to work. The US military does this too when in combat. Add in your naps and youth and the fact that you have adapted to the situation: you are functional, and it’s hard, and it requires dedication, but it is not the disaster you think.
How many Freepers already sleep basically 6-7 hours a day? If you work 10 hours and then work at home 7 hours and sleep 6-7 hours you are doing the same dang thing as residents did back in the day of medicine.
Bottom line, and this is why you have me irritated:
The FREE MARKET and the SEVERAL STATES are supposed to makes these decisions, NOT a FASCIST CABAL comprised of various “private” (fake) regulating boards that are fully controlled by the FEDS kissing up to whatever the Feds want. (Wimp boards whose kiss-up members say “if we don’t require this thing that the government czar wants, then the government will make us do it (however unconstitutional). I say MAKE the fascists pass a law if that is what they want, don’t coerce fake private boards to do it for you, but that’s the Clintonian/Obama Fascist modus operandus in a nutshell.)
Don’t play into that by making it look like the illegal private-public actions of these coerced boards are a good think. Fight on the fringe with us!
The advent of EMR has basically decimated the ranks of medical transcriptionists. Now instead of the work being done by Americans telecommuting at home for $15-20/hour, it is being sent to a 3rd world country like India, to be done for a few dollars an hour. However, American transcriptionists had to abide by myriad regulations, such as HIPAA, and the HighTech law which carries a penalty of $125,000 for any worker who divulges private medical information about a patient. The MTs in India have no such laws governing that, and personal/medical information is ripe for the pickings over there.
Well, the experiment has already been done.
Between 1967 and 1972, the USMS class size was increased from 8900 to 18 000.
Since then, by most objective measures, quality has declined.
Wanna try for 34 000?
The new docs are amazing to watch. Terrifying. Most of them started on robots.
Am hoping to be able to opt out of medicare in a few years and give good independant docs my business.
As a provider myself, I plan to slash my fees and see people at copay rates.
I think most folks (including me) have only a vague idea of what HIPAA entails. Would a smart political campaign maybe calculate an actual dollar amount that this and all regs add to med costs? Something like $25 of every $100? I don't have a clue if that's anywhere close. But, I am certain there IS a number.
You must be a PA or a NP. Watch out, however. Government’s next step will be to make licensure contingent on participation. They did it in Massachusetts a number of years ago and Obama will try to do it nationally also.
What?
Your statements:
“Well, the experiment has already been done.”
“by most objective measures, quality has declined”
(1) The population increased too. Did you account for that? No. No “experiment” was done. Where do you get that? Some doctors may see too many patients now to have optimal quality TODAY, because they do not get paid enough per patient any more due to fascist interventions in the free market, so they tend to try to do too much). Therefore in my opinion, we need the fascist interventions stopped and WE NEED MORE DOCTORS and would get more if the free market was not suppressed.
(2) “by most objective measures, quality has declined”
NO WAY you have any reasonable measures. You should cite your source on quality. Even if you have a “good” source I will not believe the result because it would be grossly at odds with long-term observations of those who have been around.
The present physicians graduating on the whole are AMAZING. They are required to do a MUCH MUCH harder job than anyone had to do in 1967 through 1972. Just look at the PDR alone. It was probably 500-700 pages of drugs printed 9.5 x 7.5 (guessing but close) with a readable font. Now it is about 4000 thin pages at 11 x 8.5 at least, with font that requires use of a magnifying glass, loaded with legalese, and doctors are responsible for all of it that falls within their sphere of practice.
A general surgeon nowadays has to be able to do the same operation both “open” and endoscopically for a myriad of operations, over twice as much capability. If they can do something endoscopically and send you home the same DAY compared to cutting you open through muscle and keeping you in the hospital for a WEEK (if you were lucky), how the hell can you claim their “quality” is worse than a 1970 surgeon? You can’t. You are shooting from the hip. HOme the same day compared to a week later with a giant scar through muscle and a long recovery is no comparison.
There are MANY more procedures with MANY more devices and materials than before with way better results. Quality is no comparison BETTER.
Same exact thing in internal medicine, family practice, and many other areas.
Those of you in this thread railing against use of robots and simulations are equally NAIVE. They are great learning and maintenance of skill devices and permit constant practice of things that occur rarely and under stress. Why don’t you guys complain about the NAVY using sims if you are so convinces it is bad? No one is using those to replace actual experience.
American Medicine can and will continue to be the best, not perfect, but responding whenever the time is right to advances in science and new thoughts as they arise, a FREE MARKET thing.
The only thing stopping it, just like the only thing stopping practically all things American, is FASCISM as FORCED upon us by VIOLENT ELITISTS like OBAMA and CLINTON and those that them and their minions cause to think poorly about reality until they are enslaved.
What’s a “USMS”? United States Master Swimmers?
If the quality declined around 1970, the overall quality of the pool of applicants was also affected by a bunch of brain-fried hippies showing up at the same time.
A guy I know applied to med school in the ‘80s (before I actually met him) and got accepted. But, to do so, he had to produce his report cards BACK TO THE THIRD GRADE, WHEN HE WAS NINE YEARS OLD.
If the school had to go back to Third Grade grades to distinguish between two different applicants, there is essentially no difference between them; if they take the top 0.2% of applicants instead of the top 0.1%, there’s not going to be a resulting big decrease in quality.
What if you don’t have two interns because it’s not worth it to practice?
Are med school applications dropping-off?
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