[jonKranked]

Saw this today:

http://www.cnn.com/2009/HEALTH/08/25/harris.primary.care.doctor/index.html

And its good to know it wasn't just the tinfoil.

Some highlights:

People are making a huge assumption in this reform effort that as we extend coverage to millions who don't have health insurance, there will be doctors there to actually provide the health care. Fewer and fewer medical students are choosing primary care and many primary care doctors are leaving the field.

I am in my 22nd year in practice, now caring for 3,600 patients. Having me in the system has resulted in savings in the hundreds of thousands of dollars each and every year. My financial incentive to hang in there and work harder is that I now make less than half what I did 20 years ago. This year I will make even less.

Isn't it a shame that after all this time and with skills honed by decades of experience, many of us can no longer afford to work as a physician?

 

[jimmydean]

Toshi has our backs.

 

[sanjuro]

Wait a second:

How many dozens of chest pain patients have I seen in the last month for whom I didn't order an EKG, get a consult, set up nuclear imaging or send for a catheterization?

Hundreds of hours seem wasted until one day they open their eyes and want to take care of themselves. My reward for years of struggle is a few hundred dollars at best. The savings to society for my hard work and never-give-up attitude is in the tens of thousands of dollars.

The doctor is complaining that instead of expensive tests, treatments and medications, he was able to resolve his patients' ills through his hard work.

So the solution is to ramp up overbilling?

 

[X3pilot]

Maybe the solution is to federalize all graduating med students and doctors. You now work for the Public health Service. The Surgeon General likes to dress up like an admiral anyways.

All doctors are conscripted to 10 years public health service in exchange for forgiveness of student loans, much the same way they do teachers that go teach in inner cities. After your hitch, free to practice privately for those that can afford it.

 

[Toshi]

Maybe the solution is to federalize all graduating med students and doctors. You now work for the Public health Service. The Surgeon General likes to dress up like an admiral anyways.

All doctors are conscripted to 10 years public health service in exchange for forgiveness of student loans, much the same way they do teachers that go teach in inner cities. After your hitch, free to practice privately for those that can afford it.

we already have income based repayment. in return for monthly payments on your loans of a fixed amount whatever is left over at 20 years (iirc) is forgiven.

programs that exchange primary care service in rural areas for loan forgiveness already exist...

i knew about the payment issues above going into medicine yet i still did it... but also note that i'm far from doing primary care!