So I've been in the ER since 5:30pm yesterday

[Black Octagon]

The whole thing is one giant mess. The Us spends so much more per capita for administration and drugs that theres nothing left for people to do actual work.

I don't have any real data on this, but I've also kinda assumed that the health insurance premiums that Americans pay are higher than they would normally be, due to the American culture of suing for damages. I think most doctors around the world now take out liability insurance to cover them in the event that they get sued for medical malpractice. However, in the US I imaging such policies cost a fortune, because the statistical likelihood of being sued is way higher than (I always assumed) anywhere else.

The US is the only country I've ever visited where you actually see TV ads from law firms, with snappy advertising like: "Did you take Drug X during the period 1984-1991. If so, you could be at an increased risk of cranial haemorrage and eligible for up to 90,000 dollars in combensation. Call 1800-SUE-SUE-SUE to learn more."

Pretty sure such advertising is illegal in most other countries.

 

[Hayabusa Rider]

LOL, during those 'recuperative' physiotherapy sessions down the line, perhaps. No, France's healthcare system is incredible, but it's still plain white hospitals. What the French enjoy is basically 100% 'free' healthcare, in that they never really see a bill, either at the hospital or in the doctor's rooms. I understand access to specialists and beds in the ER is pretty good too. The only downside is that the money has to come from somewhere, i.e., significant levels of income tax. Oh, that and every second French resident goes to the doctor as soon as he/she gets a runny nose, demanding blood tests, injections, morphine suppositories and God knows what else.

(That last part was a joke, by the way. The point is that it's easy to impose yourself on the system when you never see any bill at all).

I think our problem here is manyfold.

Above all is ignorance of the subject. When that happens today people bubble themselves and look at the internet for whatever conforms with their perspective. It's always been the case and that's even easier to do now. Then there's a pervasive sense that access to many words and sources leads to knowledge and informed opinion. That's quite untrue. When one has no basic understanding how does one go about being sure what one is reading is accurate and contextually relevant? What weight should be assigned to each point even if factually based? An example of the "poor quality" of our healthcare often cited is life expectancy compared to some other nations. Completely ignored is how dysfunctional aspects of our society influence both quality and length of life. We pay more so we demand longer life. Frankly that's as stupid an expectation as can be made. Going back to where we were before, transplanting LA to Belgium or any nation you can think of, you can adopt the same medical system, but everything else being equal not much will change. Gangs will still shoot others. That's a physician's fault? Insurance companies? Obamacare? No, move it to Switzerland and they will fail. What's wrong with them? 😉

I suppose that's failing in general, but having worked in health care for decades I get to see the good and bad. We have the potential for expanded and improved care, but fighting nonsense and ignorance will always be the chief problem.

 

[Hugo Drax]

I'm really sorry to hear this. Stories about the American healthcare system is a major reason why I rarely give serious thought to a potential career move there.

The problem in America is it costs like 250K to get a medical degree, 8 years of school + etc..

Cost of Malpractice insurance, dealing with insurance etc.. I can see why the US has a huge shortage.

 

[Subyman]

Thought I would pop in and give my experience at the ER. I've been a few times in my life. Like others have mentioned, the ER is really only for emergency issues. I went once for anaphylactic shock and they had me strapped to a gurney within 2 minutes, wires all over me, and I had an epi-shot and a huge shot of benadryl within 4-5mins. It was ridiculously fast and I felt instant relief. They went over everything I had done in the last few days and ended up attributing it to amoxicillin (penicillin allergy.) They kept me for another hour or so and I was released. Went to my doctor and got on a different antibiotic and haven't had any problem since.

The other time I went in because I had been vomiting the entire day. I believe it was a mild case of food poisoning. I couldn't see my normal doctor because it was Sunday. It took longer at the ER this time and it was probably 1-2hrs before they got me some medicine to calm my stomach. I wasn't critical and it wasn't life or death, so I had to wait a bit.

Both times were fine experiences. ERs are insanely quick if it is life or death. It is too bad the OP couldn't get admitted to the hospital through some other means.

 

[Subyman]

The problem in America is it costs like 250K to get a medical degree, 8 years of school + etc..

Cost of Malpractice insurance, dealing with insurance etc.. I can see why the US has a huge shortage.

Briefly I considered a career in radiology. I have a MS in nuclear, but the amount of time and money to get into that career would have put me into my 30's before I could start earning and I would have been strapped with enormous debt. It is hard to do without major backing from parents.

 

[Hugo Drax]

I thing what you will see in the future is a health care system just like the movie like the movie Elysium. Where only the 1% of the population in the US will get good health care, the rest will be SOL.

It is inevitable.

 

[Hayabusa Rider]

The problem in America is it costs like 250K to get a medical degree, 8 years of school + etc..

Cost of Malpractice insurance, dealing with insurance etc.. I can see why the US has a huge shortage.

Money is a major factor and you have to count loss of potential income while becoming a physician. The years of schooling are what's required, and that's how it is. The bottleneck in terms of numbers would be residencies and that is in fact due to government inaction.

Let's cut costs!

 

[RollWave]

Money is a major factor and you have to count loss of potential income while becoming a physician. The years of schooling are what's required, and that's how it is. The bottleneck in terms of numbers would be residencies and that is in fact due to government inaction.

Let's cut costs!

Loss of potential income is only the half of it. On top of that you have loss of life. During your medical school and then during residency you are at the mercy of your training with little to no time for anything else going on around you. Its a large sacrifice to make to have to miss family events, etc. Even having a child is near impossible until you're done training.

 

[Slew Foot]

Money is a major factor and you have to count loss of potential income while becoming a physician. The years of schooling are what's required, and that's how it is. The bottleneck in terms of numbers would be residencies and that is in fact due to government inaction.

Let's cut costs!

having more doctors isnt really going to cut your costs. if you look at your bill, the hospital charges you $20000, the doctor charges you $500. all those mbas in the hospital c suite dont come cheap.

 

[Hayabusa Rider]

Loss of potential income is only the half of it. On top of that you have loss of life. During your medical school and then during residency you are at the mercy of your training with little to no time for anything else going on around you. Its a large sacrifice to make to have to miss family events, etc. Even having a child is near impossible until you're done training.

That's true. A normal life isn't going to happen although I've known people who have worked around their education and training. It isn't easy.

I have to ask myself what kind of masochist would go into health care these days. Smart people can make money in other ways, and without the pressure and responsibilities involved. They don't have to be seen as people doing it just for money, that any common person can do it, or even all one needs to know can be learned on the internet. It takes intelligence, a certain emotional disposition and willingness to endure working conditions those who complain about them wouldn't begin to accept. Add demonization these days and I'd advise the overwhelming majority to consider graffiti removal first.

 

[Hayabusa Rider]

having more doctors isnt really going to cut your costs. if you look at your bill, the hospital charges you $20000, the doctor charges you $500. all those mbas in the hospital c suite dont come cheap.

How much out of the 3 trillion dollars spent go to them? I'd like to see a number.

 

[Grooveriding]

Briefly I considered a career in radiology. I have a MS in nuclear, but the amount of time and money to get into that career would have put me into my 30's before I could start earning and I would have been strapped with enormous debt. It is hard to do without major backing from parents.

How old were you when you first considered it ? From your initial two years of sciences to medical school and then your five year radiology PGY it will be a 9-10 year investment to complete a radiology residency. Two more years if you want to go for nuclear medicine.

It's not a cheap program by any stretch but you are earning an income with benefits in your PGY years, and that income ramps up through your residency. Once you're done job security is a non-issue and income potential is quite high in the US; $400K is not out of the ordinary and depending on where you work and years of experience you can see $600K+ by age 45.

 

[vi edit]

oss of potential income is only the half of it. On top of that you have loss of life. During your medical school and then during residency you are at the mercy of your training with little to no time for anything else going on around you. Its a large sacrifice to make to have to miss family events, etc. Even having a child is near impossible until you're done training.

I know A LOT of doctors. Almost every one of them that was married and wanted kids did it during their residency years. Their wives stayed home and took care of kids. You get paid during residency, but it's not a lot. $40,000-50k depending on location and specialty. It's not a lot, but it pays for basic rent and utilities. It's just what a lot of them did. It's not ideal, and takes the right kind of wife to basically single parent for 2-4 years. But it's what they did.

 

[Hayabusa Rider]

I know A LOT of doctors. Almost every one of them that was married and wanted kids did it during their residency years. Their wives stayed home and took care of kids. You get paid during residency, but it's not a lot. $40,000-50k depending on location and specialty. It's not a lot, but it pays for basic rent and utilities. It's just what a lot of them did. It's not ideal, and takes the right kind of wife to basically single parent for 2-4 years. But it's what they did.

But that's for men. What about women?

 

[vi edit]

But that's for men. What about women?

I only played basketball with the male docs 😛

I've known several female residents that did have kids during their residency. Overall, it is a male heavy industry (at least in the specialties that I normally work with).

 

[Slew Foot]

How much out of the 3 trillion dollars spent go to them? I'd like to see a number.

rough estimate

800000 doctors x 200000 avg salary= 160 billion or ~6% of 3 trillion

 

[Slew Foot]

I only played basketball with the male docs 😛

I've known several female residents that did have kids during their residency. Overall, it is a male heavy industry (at least in the specialties that I normally work with).

med schools nowadays are predominantly female, its not unusual to see a 60-40 split.

 

[vi edit]

med schools nowadays are predominantly female, its not unusual to see a 60-40 split.

I mostly work with radiology, cardiology, radiation medicine and emergency services. In those areas it's about 10:1 male to female in the hospitals I've worked.

OB/Pediatrics/Primary care I'm sure is much differently skewed. I just don't work with them near as much.

 

[Subyman]

How old were you when you first considered it ? From your initial two years of sciences to medical school and then your five year radiology PGY it will be a 9-10 year investment to complete a radiology residency. Two more years if you want to go for nuclear medicine.

It's not a cheap program by any stretch but you are earning an income with benefits in your PGY years, and that income ramps up through your residency. Once you're done job security is a non-issue and income potential is quite high in the US; $400K is not out of the ordinary and depending on where you work and years of experience you can see $600K+ by age 45.

I was 25 when I graduated with my MS. Frankly, another 4 years of school plus the debt plus me being in my mid thirties before I started earning decently was enough for me to not pursue that path. I'm now self employed in real estate investment and am really liking it and am making nice money. So much potential for earning in this field and have a plan to have many rental properties by the time I'm in my mid thirties.

 

[RollWave]

I know A LOT of doctors. Almost every one of them that was married and wanted kids did it during their residency years. Their wives stayed home and took care of kids. You get paid during residency, but it's not a lot. $40,000-50k depending on location and specialty. It's not a lot, but it pays for basic rent and utilities. It's just what a lot of them did. It's not ideal, and takes the right kind of wife to basically single parent for 2-4 years. But it's what they did.

Yeah you totally forgot the female side of this coin. If she's doing a surgical specialty its almost forbidden to take time away for having a child.

And if your spouse is also a physician at your school level, again impossible to proceed with normal life. All of that is frameshifted 5-10 years.

 

[vi edit]

Surgery is still heavily skewed towards men. 15%-30% depending on type.

 

[RollWave]

And I'll leave this here:
http://www.bestmedicaldegrees.com/salary-of-doctors/

 

[Subyman]

And I'll leave this here:
http://www.bestmedicaldegrees.com/salary-of-doctors/

What kills any professional field is the high tax rate. Our professionals such as doctors, professors, engineers, and such pay extremely high taxes because they bring in high salaries. On the other hand, businessmen can more easily hide their earnings. The tax burden on our most educated population is immense.

 

[preslove]

I take it you are a health care professional who deals with "red tape". You have been doing this long?

A health care professional is the best person to comment on this why? This is an issue of public policy and economics, and from your idiotic statements about health care policy, you clearly don't know shit about actual policy. Someone with a PhD in public policy with a focus on health economics is someone whose opinion I'd take over some random doctor who earns his living in our insane health care economy. Someone like my friend James, who just got his PhD from RAND in policy analysis with a focus on health care economics. I can send you his linked in profile, you want.

And his opinion is the same as anyone who actually studies comparative health care policy, and it is that our for-profit system is utterly inefficient because of simple market forces. People will pay as much as they can afford for care, so this has lead to consistently high health care inflation.

I dealt with tons of red tape while in HR at a major university whose health insurance provider provided extremely poor service for a gargantuan rate. I also dealt with insurance companies in another job involved in medical billing. My uncle worked for a GP getting claims filled for years. He made a salary of over $30k just to deal with the insurance companies. I know how how awful the service health insurance companies provide.

You talk like you don't know anything about health care policy and haven't even read a single book on it. Here's a great one to start with: http://www.amazon.com/Healing-Americ...ing+of+america

What you are suggesting would work if we could turn Ferguson into Brussels, but that's not going to happen. You would have to work with exactly what we have. Guns, knives, economic circumstances, education and job opportunities, culture, race issues, and our system of government. You get the whole thing as it is because what's what we will have to deal with.

None of those things in bold are what hinders reform. The insurance companies, AMA, idiotic hatred for "socialism" are stand in the way of implementing a coherent medical system. You blaming "race issues" is pretty revealing...

 

[phreaqe]

Keep in mind that its flu season and many hospitals are short staffed. My wife is a nurse and for about the last 2 weeks they have been short staffed to the point of having open beds that they cannot fill because there are not enough nurses and doctors to take care of the patients. Unless you are experiencing a life threatening issue, you need to have patience right now, cause the nurses and docs are working there butts off right now.