That’s the elephant in the room that no one talks about: How private insurance companies screw doctors as their way of reaping record profits.

Where is your argument? You are saying nothing.

I simply agreed with MedRes and added my reasons to why I agreed with him. You choose to throw that out as your argument? So my reasons are different from his, as my background gives me reason to be, but does that really matter when we are in agreement?

I have no problem with the Time article, it was flutterdoc’s interpretation that docs were going to be out of a job because NPs can do everything they can do, but for less cost. Perhaps I misread the sarcasm I thought he was implying…

And as far as your 3rd point, when I get a job, I’ll be sure to remember that. Very helpful, that information…

Yes, politics, they do suck don’t they. I worked in academia (neurology/neuropsychology) for 10 years and the biotech industry for 3. There are problems everywhere. But IN MY OPINION they are quite pathetic in medicine. You seem to have a problem with me pointing it out and commenting on how it would be nice to make attempts to change that for the future? I’m sorry, I guess I’m a bit more progressive in my desire to not follow status quo. I am not a follower. I have and will continue to demand equality in everything I do, but I will also prove that I deserve it. I chose my career so that I could contribute to the betterment of society, and if it means fighting a couple of peeps on FAIL blog, I’ll do it.

As a radiographer (x-ray tech) I frequently do orbital x-rays on patients to screen for metal in the eyes , if they have a history of metalworking or something similar.

If we were to simply abolish insurance, except when used as actual insurance (i.e. when you honestly need a life-saving procedure you cannot afford, ever), rather than health coverage, doctors/hospitals wouldn’t have to employ people like me, plus two more just to handle the paperwork. Doctors could largely charge what people pay now in co-pays, in terms of office visits, and make just as much money.

As it stands now, they have to employ at least three ti four people to handle it all, per doctor: a clinical medical assistant, an administrative medical assistant, and generally a biller/coder, as well as a transcriptionist. Sometimes they need a file clerk, for larger offices, as well. Each of these people makes, in general, anywhere from $10-$15/hr on the west coast, minimum.

Further, what the doctor charges, some paper-pusher at the insurance company looks at and decides, “Nah, you’re not actually worth that, so we’re going to pay you a tiny percentage of that, instead, and you’re going to like it. Oh, and since you’re a participating provider, you’re also not allowed to bill the patient for the difference. Further, if you don’t get all of this paperwork in to us and letter perfect, along with every other little thing we ask for, up to and including your first child on a silver platter, within 30 days, we don’t have to pay you. If you do, you still won’t see any money from us for 6 months. Have fun with the bill collectors in the meantime!”

And don’t even get me started on the huge costs HIPPA has incurred on the medical system, while being a completely self-defeating piece of legislation.

Do you agree with that statement?

You responded to MedRes by putting words in his mouth. Point #1: he never said the training and cost of MD education was “obnoxious” so you are not agreeing with him. He was making a point justifying MD salaries.

#2: his point was that increased reimbursement for primary care would attract more MDs. You seem to agree with the increased reimbursement but for a different reason since you think that MDs turn away from primary care because of their egos. Personally, I’d rather be seen by an egotistical MD with rude bedside manner (and over a decade of medical education) than an RN who has resentment over their wage and thinks they are as capable as the former.

#3:You’re concerned about if your wage will offset the cost of your education? How about examining the ratios instead? Divide your education cost by your wage. If the number you calculate is smaller than that which you calculate for MDs then you best reformulate your argument to serve your interests. Concerning gender inequality I can only suggest you study the teachings of Dick Masterson.

As for the analysis of your anger, you are describing politics. Do you honestly believe this is something specific to your field? Heck, it exists inside the White House, engineering firms, and fast-food restaurants!

To me it seems like your anger stemmed from flutterdoc’s quote of Time magazine. What’s the matter? Upset that you’re not a doctor?

That’s TWICE.

I wonder what they’re afraid of?!

True Failblog FAIL.

Sigh. I suppose we’ll just let the nurse practitioners rule the world, huh?

1. Perhaps MD training is in need of an overhaul? I agree that 12+ years of training, and hundreds of thousands of dollars in loans is obnoxious. And many of my MD friends sought out MPH and GMS degrees prior, just so that they could get into decent schools, so tack on a few more thousand there. I’m looking at 3 years of education and 150 grand in loans (for education at top school, I could have gone cheaper), and I walk out with a prescription pad and the ability to work independently in some states. Nursing has struggled for respect for years, perhaps they (and PA programs) are onto the future of medical training? Most of my colleagues were pre-med until they realized that NP was a much better route in terms of time and money. And as for your friends who make more money, I’m assuming that they are probably in the financial/corporate world? Well, they are getting theirs at the moment, as they have caused an economic crisis to tsunami the world…

2. You agree that few new MD grads seek out primary care and that this has created an opening for NPs to step in? It is not glamorous and doesn’t pay well, so few have the heart to do it. I know many MDs who chose their career path simply for the bragging right. They have rude bedside manner, and they treat anyone under them with contempt. They ruin it for those of you who care. You are obviously not one of those people, we need more like you! Thank you for doing what you do. Perhaps if the focus of health care was on good prevention and primary care, we would not have as much need for specialized care? Awesome that you brought up increased reimbursement for primary care! The public needs to support this!!!

3. As for my comment about making shit for money. Yes, pay is typically between 70k-130k, but this is still less than MDs and PAs, and male NPs are making 8% more than female NPs. I’m also concerned that this will not offset the cost of my education. I worry that NPs are being seen as cheap labor and are thus being paid as such, instead of being compensated for the true benefits that they bring to health care.

Part of the anger that came out in my initial post was at the lack of respect that seems to permeate medicine, not just at nurses, but towards everyone. I have friends in residency with horror stories of how they’ve been treated, I know NPs that are treated horribly by RNs, I know MDs who won’t discuss patient care with NPs simply because they aren’t MDs, I know NPs who are expected to act as the MDs secretary. It would be nice to see a more respectful collaborative practice with the understanding that everyone plays an important role in providing optimal health for the patients.

I couldn’t have said it any better.

Actually, I DID say it better, but FailBlog decided to not post it because I said a$$ one too many times.

If you need a job, give me a call.

-Flutter

2, “And don’t shit on nurse practitioners, we’re only stepping up to pick up your slack, sorry we’re doing a better job at it for and at a fraction of the cost, but someone needs to provide Primary Care, whilst you idiots go into specialized medicine so you can brag to your friends and quote stupid journal articles and drive that nice new BMW.”
OK. Not even sure how to begin here. Picking up our slack. Nice. How about the clinics are overwhelmed with patients who demand to be seen yesterday, flood the ED every time they get the sniffles because swine flu is in the news or cant be bothered to get an appt with a primary MD. We are understaffed and the time and requirements for documentation and billing are horrific. I could see at least 50% more patients if the gov would decrease the BS paperwork, phone calls needed to get prescribed care authorized, and insurance companies would stop changing practices and denying treatment for no valid reason. These reasons, among others, drive some MD’s into specialties because there is less hassle and more pay. If the gov would increase, yes increase, reimbursement for family and gen med types more MD’s would stay there and more people could be seen by an MD in a timely manner.

3. “NPs get paid shit, we take your shit, and we do it because we care about the patients.”
I do believe that NP’s care. However, get paid shit? The NP’s I know make at least $75-130K a year and work about half the hours I do. If that pay is shit to you I am not sure anything would make you happy. They also have about half the education and the MD’s have the ultimate responsibility in clinic for the patient care. That is not a bad deal for NP’s and most of the ones I see know it.
Don’t put MD’s down because they specialize, they have been driven to that by the government, insurance companies, and the legal system (which is a whole other topic).

But in a recent study of 135 patients subjected to a 3 Ts MRI with pacemaker, exactly zero of them suffered any PPM disability. In a similar retrospective study, 52 patients with ICDs who were exposed to 1.5 Ts and 3 Ts MRis, only one patient had an issue…an episoide of VF, secondary to the heating of the distal coil present on old Medtronic 6949 leads.

MRI Tech–you are right, no physician runs an MRI any more. But I was trying to illustrate a point. In less than 5 years, when you go into a hospital with an acute MI, you will more-than-likely be seen by a nurse practitioner only, as they, as Time magazine puts it (8/3/09) “Can diagnose and treat any disease that doctors do, at less than 20% of the cost.”

And good luck trying to be seen by a physician…we will have been run out of business by the new “health care overhaul.”

Don’t believe me? See what happens on January 1, 2010, when Medicare reduces payments to doctors 23%, combined with Obama’s plan to reduce reimbursement an additional 11%.

So many doctors will go out of business….America won’t know what hit them. But don’t take my word for it. It is happening. It WILL happen. I’m not trying to be an alarmist here.

But we are headed for that inevitable brick wall and the life-ending CRASH.

Masybe I should learned to play baseball or been an actor. Because what would we DO without throwing huge sums of $$ to watch these buffoons perform?

Good luck….in six months, we will all need it. Impending and catastrophic EPIC American medical system FAIL…in progress.

although i work with NMR instruments, and all the warning signs still say do not go near the magnet if you have a pacemaker. an MRI machine is the same thing only bigger, so /shrug.