151–160 of 170 posts
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There’s a bag of almonds in my pantry that literally says “Contains almonds” on it in the fine print.
And cooking spray sometimes says "Fat free!" because an average 'serving' contains < 10 calories of fat. Yet its 100% fat. A spray can of fat.
It sounds to me that what is being monetized is the authority of doctors. There's a lot of medical conditions where you rely on the doctor to tell you what to do. After all, you don't have a degree in that. Now I can buy a clinic and pressure all the doctors through an incentive scheme that they are not used to, and get them all to nudge the borderline cases into must-act cases. And chances are each individual case i…
Are socialized medicine systems less evil?
A socialized healthcare system is actually truer to a functioning free market than what we currently have. By negotiating prices and treatment ahead of time (albeit collectively), both sides of the transaction have the ability to make informed decisions. Whereas in our current system prices are (at best!) negotiated by a sick person while they're over a barrel, and in most cases not even negotiated just let ride on the roulette wheel of health "insurance".
An open market (transparent, competitive, and payer-indifferent prices) could be even better, especially for more elective less time sensitive procedures like dermatology. But that's a long ways away from how things currently are, and in the opposite direction of how they're moving.
The proposed changes to Medicare reimbursement - which essentially pays the same for an office visit regardless of complexity - seems to be also pushing that way.
Speaking only from personal perspective, helping complex patients is incredibly rewarding and I would absolutely hate for the system to steer the specialty away from that.
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I am a general surgeon employed by a hospital system in the southeast. PE / VC don't add anything other than trying to skim a profit off the top of medicine, like any other capitalist. Dermatology is a lucrative practice. They don't have to work in hospitals, so they set their own hours. VC/PE's are doing the long game - purchase a practice (dermatology / anesthesiology, orthopedics ) and reward the current partners…
So is it usually the case that whenever you see a group run medical practice, in comparison to a solo practice, that the facilities are managed by some sort of larger VC/PE group, assuming they are a private,for-profit organization rather than a hospital owned by the city or local university? The business side of healthcare is fascinating and somewhat terrifying once you follow the money and see how this correlates t…
Basically, it's a bunch of business people making maneuvers to try and extract as much money from the system as possible, which is why it's >$30k / year to insure a family in the USA. This makes small businesses unable to compete against companies located in socialized medicine countries, in my opinion. It also makes it impossible to compete against a business that does not offer insurance to their employees.
Eventually, we'll go single payer, bc it cannot continue at this rate.
PS - Any non profit organization has to publish their tax returns. Search Form 990 and the non profit name to pull it up. All non profits have to publish the top 20 earners - some will be administrators and others will be physicians.
I have no proof they are involved, but my wife and I both had a visit to a dermatologist last year. Both of us were then recommended for excisions. She was 29, I was 28. Everything came back pretty much normal. We were sent to this fern after a friend went there. He also had an excision. Also under 30. Now, we feel pretty much like we were played. Maybe this is relevant to this issue.
No physician wants to be the one who says - don't worry about that -
having said that, if a dr recommends excision, and you're hesitant, get a second opinion.
but I also think that dermatologists see and biopsy so many lesions, that after a while, they should be able to be very selective in what they biopsy.
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In Sweden you cannot fire people on permanent contracts (that you need to give after 2 years) if you still require their work, i.e., you cannot fire someone without cause and then hire someone else to their exact job. In the Netherlands it is also extremely difficult to get rid of an employee with a permanent contract that you need to eventually give to them. In all cases I personally know of, permanent contract empl…
Does this not create an incentive for companies to rotate through short term workers rather than keep anyone on for more than 2 years?
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In many other countries you can not fire someone by default (it's illegal) so calling it a powerful tool sounds wrong.
Let’s not engage in Whataboutism. We’re talking about the US, specifically. In the US, specifically, being tenured and having protection against being fired is a powerful tool. It's still a powerful tool in any country regardless if it's the default or not.
People often wonder what the point of tenure is. Well this is it. Those authors need to not back down, and call attention to this. If they're tenured researchers or professors, they should be able to make publications like this without fear or retaliation from the school or industry.
Very few physicians are tenured professors today. Many stay at the associate or assistant level.
We have been and should continue pushing for better alternatives. ACOs [2] and integrated managed care [3] are promising possibilities and there are assuredly others.
[1]: https://en.wikipedia.org/wiki/Fee-for-service
[2]: https://en.wikipedia.org/wiki/Accountable_care_organization
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Users don't read. We have warnings in my state next to elevators that read "Ensure elevator is at this floor before entering". This is literally accurate but practically ludicrous. The solution to problems of this nature is almost always redesign.
But users sue.