Doctors Unionize to Resist the Medical Machine • Hacker News Board

Re: Doctors Unionize to Resist the Medical Machine

#11

Post by pragone » Sun, Jan 10, 2016, 8:51 PM UTC

c3534l wrote: post #9

Doctors are already paid absurd salaries in the US and the barriers to entry already high. As much as we all hate dealing with insurance companies, when I lost my insurance and had to pay for things out of pocket, the difference between what they charged me and what they would have charged an insurance company was obscene. Insurance companies actually do a pretty good job of reducing the costs of medical care, althou…

> Doctors are already paid absurd salaries in the US

To put it in context, when I finish all my training, I will owe over $600,000.

It's not the doctors being "paid absurd salaries" that makes medical care in this country expensive. It's lawyers - malpractice insurance can take upwards of 25+% of your income - and it's insurance companies, who have shareholders they are responsible to, and it's hospital administration, whose positions keep multiplying.

Re: Doctors Unionize to Resist the Medical Machine

#12

Post by merqurio » Sun, Jan 10, 2016, 8:51 PM UTC

sghodas wrote: post #8

jraines wrote: post #2

All of this rings true from what I've heard my dad, a GP, complain about for years. It's hard for him to watch other doctors game the system to increase their earnings -- not only seeing more patients with unaccountably short sessions, but also up-coding their maladies and ordering unnecessary tests. In addition to the pressure of seeing more patients per day, they have all this new administrative bullshit (ironicall…

Hell, I'm only in my second year of med school in the US, and I wouldn't recommend young people go into this profession.

I'm in the last year and I would totally do it again. It's true college it's abusive(http://www.kevinmd.com/blog/2016/01/physicians-arent-burned-...), but I find it amazing as a career.

Re: Doctors Unionize to Resist the Medical Machine

#13

Post by Dr_tldr » Sun, Jan 10, 2016, 8:53 PM UTC

pragone wrote: post #11

c3534l wrote: post #9

Doctors are already paid absurd salaries in the US and the barriers to entry already high. As much as we all hate dealing with insurance companies, when I lost my insurance and had to pay for things out of pocket, the difference between what they charged me and what they would have charged an insurance company was obscene. Insurance companies actually do a pretty good job of reducing the costs of medical care, althou…

> Doctors are already paid absurd salaries in the US To put it in context, when I finish all my training, I will owe over $600,000. It's not the doctors being "paid absurd salaries" that makes medical care in this country expensive. It's lawyers - malpractice insurance can take upwards of 25+% of your income - and it's insurance companies, who have shareholders they are responsible to, and it's hospital administratio…

And yet, when Texas put a cap on medical malpractice awards, the cost of medical care didn't go down at all. Surely you have a good explanation for that and you're not just repeating discredited talking points for personal gain.

Re: Doctors Unionize to Resist the Medical Machine

#14

Post by c3534l » Sun, Jan 10, 2016, 8:55 PM UTC

Dr_tldr wrote: post #13

pragone wrote: post #11

Earlier quoted context omitted.

> Doctors are already paid absurd salaries in the US To put it in context, when I finish all my training, I will owe over $600,000. It's not the doctors being "paid absurd salaries" that makes medical care in this country expensive. It's lawyers - malpractice insurance can take upwards of 25+% of your income - and it's insurance companies, who have shareholders they are responsible to, and it's hospital administratio…

And yet, when Texas put a cap on medical malpractice awards, the cost of medical care didn't go down at all. Surely you have a good explanation for that and you're not just repeating discredited talking points for personal gain.

Whoa, calm down now. No need to resort to an ad hominem and speculate on someone's personal motivations.

Re: Doctors Unionize to Resist the Medical Machine

#15

Post by Spooky23 » Sun, Jan 10, 2016, 8:59 PM UTC

nostromo wrote: post #3

For what it's worth, people have been calling the AMA a union by another name for several decades. http://www.forbes.com/sites/johngoodman/2014/09/03/the-docto... They lobby, they control the supply of doctors, they restrict competition, and they even engage in price fixing: https://www.washingtonpost.com/business/economy/how-a-secret... They shape a lot of medical legislation, for example killing the Affordable Care…

The dynamics of medical practice are changing substantially. Regional medical organizations are consolidating and creating vertically integrated medical behemoths.

As a result, MDs are losing their independence and becoming just another group of highly paid employees. Once big corporate entities take over, neutralizing noisy, highly paid employees is always part of the playbook.

Re: Doctors Unionize to Resist the Medical Machine

#16

Post by hardcandy » Sun, Jan 10, 2016, 9:01 PM UTC

c3534l wrote: post #9

Doctors are already paid absurd salaries in the US and the barriers to entry already high. As much as we all hate dealing with insurance companies, when I lost my insurance and had to pay for things out of pocket, the difference between what they charged me and what they would have charged an insurance company was obscene. Insurance companies actually do a pretty good job of reducing the costs of medical care, althou…

What do you consider to be ''absurd salaries''? A friend of mine is a hard working (50 hours/week) 35 year old GP in San Francisco and makes about $175k all-in, which is about the same as the average base + cash bonus (excluding options) of all our white collar friends (mostly software developers, but also some in finance and other fields). He left medical school with about $50k in student debt (very low relative to the average) and only started a ''real'' job at 30 (8 years after his peer group, who by then had accumuluated savings of several hundred thousand dollars each).

I also know a neurosurgeon who makes significantly more than this but given the sacrifices required to train into and hold that job, I'm not sure any amount of money would be fair compensation.

Medicine is unique in that you have to pay providers higher salaries to work in more remote, less desirable locations, which is the opposite of how most professions are structured. But without this, rural populations would have almost no access to specialist care.

Re: Doctors Unionize to Resist the Medical Machine

#17

Post by Spooky23 » Sun, Jan 10, 2016, 9:01 PM UTC

c3534l wrote: post #9

Doctors are already paid absurd salaries in the US and the barriers to entry already high. As much as we all hate dealing with insurance companies, when I lost my insurance and had to pay for things out of pocket, the difference between what they charged me and what they would have charged an insurance company was obscene. Insurance companies actually do a pretty good job of reducing the costs of medical care, althou…

Insurance creates all sorts of weird market abstractions. There's a phony "rack rate" that you pay as an individual. Everyone else negotiates discounts.

Medicare is the price floor, and gets the best price. Everyone else is in the middle.

Re: Doctors Unionize to Resist the Medical Machine

#18

Post by noja » Sun, Jan 10, 2016, 9:02 PM UTC

c3534l wrote: post #9

Doctors are already paid absurd salaries in the US and the barriers to entry already high. As much as we all hate dealing with insurance companies, when I lost my insurance and had to pay for things out of pocket, the difference between what they charged me and what they would have charged an insurance company was obscene. Insurance companies actually do a pretty good job of reducing the costs of medical care, althou…

So the US healthcare market doesn't work because... doctors??

Re: Doctors Unionize to Resist the Medical Machine

#19

Post by [deleted] » Sun, Jan 10, 2016, 9:06 PM UTC

pragone wrote: post #11

c3534l wrote: post #9

Doctors are already paid absurd salaries in the US and the barriers to entry already high. As much as we all hate dealing with insurance companies, when I lost my insurance and had to pay for things out of pocket, the difference between what they charged me and what they would have charged an insurance company was obscene. Insurance companies actually do a pretty good job of reducing the costs of medical care, althou…

> Doctors are already paid absurd salaries in the US To put it in context, when I finish all my training, I will owe over $600,000. It's not the doctors being "paid absurd salaries" that makes medical care in this country expensive. It's lawyers - malpractice insurance can take upwards of 25+% of your income - and it's insurance companies, who have shareholders they are responsible to, and it's hospital administratio…

[deleted]

Re: Doctors Unionize to Resist the Medical Machine

#20

Post by marshray » Sun, Jan 10, 2016, 9:07 PM UTC

merqurio wrote: post #10

marshray wrote: post #4

Earlier quoted context omitted.

My doctors usually spend less than 5 minutes talking to me and 10 minutes hunting and pecking at the computer. Some offices will have other staff do much of the data entry, but it doesn't seem to result in the doctor any spending more time with me.

Precisely we just created an start-up with a product that helps doctors making the EHR much faster and intuitively so they can focus on the patients.

I believe you, but when I worked in a medical office in 1993 vendors were saying that exact same thing.