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Doctors Unionize to Resist the Medical Machine

nytimes.com

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Re: Doctors Unionize to Resist the Medical Machine

#101

Post by vacri »

sayhar wrote: post #65
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…

> They lobby, they control the supply of doctors, they restrict competition, and they even engage in price fixing It saddens me that those are your go-to ideas of what a union is. > The AMA was key in killing Truman's universal healthcare proposal starting in 1945. Actual unions have been pushing for universal healthcare for much earlier than I was born. On this front AMA has been the enemy of real organized labor fo…

No True Scots Union...

Re: Doctors Unionize to Resist the Medical Machine

#102

Post by MaysonL »

CPLX wrote: post #96
digbyloftus wrote: post #72

Earlier quoted context omitted.

I mean, the difference between "resist management giving themselves millions while cutting pay for workers" and "price fixing/restrict competition" is just an arbitrary, subjective distinction based on your opinion on how much money people should make. Either way the goal is to get more money for members of the group. If you don't think doctors deserve the inflated value the AMA has captured for them but think that o…

Unions primarily engage in collective bargaining with the employers of their members. The AMA is not a union.

You're right, it isn't a union, it's a cartel!

Re: Doctors Unionize to Resist the Medical Machine

#103

Post by CPLX »

MaysonL wrote: post #102
CPLX wrote: post #96

Earlier quoted context omitted.

Unions primarily engage in collective bargaining with the employers of their members. The AMA is not a union.

You're right, it isn't a union, it's a cartel!

No, a cartel is a group of competing firms in the same industry that form an alliance.

The best analogy for the AMA would be something like a guild.

Re: Doctors Unionize to Resist the Medical Machine

#104

Post by kamaal »

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…

>>It's hard for him to watch other doctors game the system to increase their earnings

Make no mistakes this isn't just restricted to the US. This is quite common in India too.

>>not only seeing more patients with unaccountably short sessions, but also up-coding their maladies and ordering unnecessary tests.

In India there practices are almost in the fraud territory. Start from doctors having small testing labs in their clinics. Where they order unnecessary test for patients they don't need. Almost every clinic has a neighboring pharmacy, that sells medicines of brands only the doctor next to it prescribes. You won't be able to buy that medicine anywhere else, plus the doctor makes commission in the medicine sold in the pharmacy. Prolonging treatments to maximize per consultation fees is extremely common.

Its very common for hospitals to indulge in advising patients with either incorrect treatments or prolonging treatments. Pointless tests, doctors cooking up stories to scare patients to spend more at hospitals is all common.

>>It's just sad, and many older doctors don't even recommend the profession to young people at this point.

I talked to many doctors(friends, relatives and acquaintances) actually many feel cheated opting to chose a career in medicine. They are told they are very smart people, and all. Told they are super smart hence they deserve to go to medical college. Hence they expect to be paid proportionally. Most watch their friends in engineering, who they think have it(apparently, that's how they perceive it) a lot easier. While they spend a lot of studying, piling up a good deal of student debt, plus on a average making the same money at the end anyway. Except that every thing in life happens decades later.

They look at engineers, especially programmers as people who have a lot of opportunity to switch streams, learn and move on to new stuff, work at big companies, start companies. Especially programmers who are good investors come across as people who made far more sensible career decisions.

Doctos at the end of the day are humans, and are driven by peer financial pressures.

Re: Doctors Unionize to Resist the Medical Machine

#105

Post by Lordarminius »

merqurio wrote: post #12
sghodas wrote: post #8

Earlier quoted context omitted.

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.

(MD here...)

With all due respect, wait until you have been in the profession for at least one decade. Then, I'd like to hear your opinion again.

Re: Doctors Unionize to Resist the Medical Machine

#106

Post by [deleted] »

sayhar wrote: post #65
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…

> They lobby, they control the supply of doctors, they restrict competition, and they even engage in price fixing It saddens me that those are your go-to ideas of what a union is. > The AMA was key in killing Truman's universal healthcare proposal starting in 1945. Actual unions have been pushing for universal healthcare for much earlier than I was born. On this front AMA has been the enemy of real organized labor fo…

[deleted]

Re: Doctors Unionize to Resist the Medical Machine

#107

Post by ubernostrum »

hardcandy wrote: post #62
ubernostrum wrote: post #24

Earlier quoted context omitted.

I don't really see it as pure ad hominem; it's a demonstrable fact that malpractice insurance rates are not tied to malpractice award amounts, and that capping malpractice awards does not rein in the absurd ballooning of malpractice rates.

Malpractice insurance rates are not tied to malpractice award amounts? Unless rates were fixed by law and financially guaranteed by the Government, how on earth would that even be possible. Are you just a troll?

Malpractice awards tend to grow at a rate slightly higher than inflation. Malpractice insurance premiums, however, grow at a far higher -- sometimes double-digit -- rate, and do so even when malpractice judgments are capped by law.

If the premiums were simply rising because of the amount of money given in a malpractice judgment, we would not see that. Therefore, malpractice premiums are not -- in any meaningful sense -- tied to malpractice award amounts. Typically, the gigantic spikes in premiums seen over the past couple of decades are attributed to other factors in the insurance industry, including the need to make up for investment losses and for losses from other sectors of insurance (i.e., market crashes + 9/11 were not kind to insurers).

Re: Doctors Unionize to Resist the Medical Machine

#108

Post by Dr_tldr »

dang wrote: post #50
Dr_tldr wrote: post #13

Earlier quoted context omitted.

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.

Personal attacks are not allowed on HN. Your comment would be a fine one without the second sentence, which (apart from a personal attack) carries no information.

Suggesting that someone's material interests may interfere with their objectivity and cause them to pass on incorrect information uncritically is now a personal attack? This was my initial concern and it's been profoundly confirmed by subsequent dialogue.

If I'm a PHP dev and I say (without any good evidence) that all security problems come from not using PHP, contradicting me is not a personal attack. Or is it, in your world?

Re: Doctors Unionize to Resist the Medical Machine

#109

Post by dang »

Dr_tldr wrote: post #108
dang wrote: post #50

Earlier quoted context omitted.

Personal attacks are not allowed on HN. Your comment would be a fine one without the second sentence, which (apart from a personal attack) carries no information.

Suggesting that someone's material interests may interfere with their objectivity and cause them to pass on incorrect information uncritically is now a personal attack? This was my initial concern and it's been profoundly confirmed by subsequent dialogue. If I'm a PHP dev and I say (without any good evidence) that all security problems come from not using PHP, contradicting me is not a personal attack. Or is it, in y…

Talking about conflict of interest in general is fine, but making it be about one person is almost never fine. Egregious cases might be different, but to use it as a routine device in an argument is a personal attack and doesn't belong here. This is important because people on the internet are much too quick to jump to such conclusions about people they disagree with. See https://hn.algolia.com/?sort=byDate&prefix=true&page=0&dateR... if you want to read about our thinking on this; there's a lot of material there.

> contradicting me is not a personal attack.

You've moved the goalposts though. If I contradicted you by saying you were lying for personal gain, that would be.

Re: Doctors Unionize to Resist the Medical Machine

#110

Post by Dr_tldr »

dang wrote: post #109
Dr_tldr wrote: post #108

Earlier quoted context omitted.

Suggesting that someone's material interests may interfere with their objectivity and cause them to pass on incorrect information uncritically is now a personal attack? This was my initial concern and it's been profoundly confirmed by subsequent dialogue. If I'm a PHP dev and I say (without any good evidence) that all security problems come from not using PHP, contradicting me is not a personal attack. Or is it, in y…

Talking about conflict of interest in general is fine, but making it be about one person is almost never fine. Egregious cases might be different, but to use it as a routine device in an argument is a personal attack and doesn't belong here. This is important because people on the internet are much too quick to jump to such conclusions about people they disagree with. See https://hn.algolia.com/?sort=byDate&prefix=tr…

Argh, I see your point, and I'm wrong.

Even if I think that misleading-statement A stems from personal-interest/experience/bias B, bringing B into the discussion is a form of personal attack.

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