Why primary care doctors are fed up

[Onkel Neal]

This is posted on CNN (http://www.cnn.com/2009/HEALTH/08/25/harris.primary.care.doctor/index.html)

It will only get worse, as people expect first rate service at cut rate prices.

How many diabetics do I struggle with, trying to get them to take better care of themselves? How many hours have I spent with teenage diabetics who will not check their blood sugar and forget half of their insulin doses?

[AVGWarhawk]

I agree with him 100%. My dad is a retired ER physician. Although the pay was great for him it was thankless none-the-less. This fella in the article talks of saving money by not ordering this or that procedure. Ordering MRI and imaging of all kinds is a result of the sue happy society. CYA is all that it is. So, yes, he is saving money in the system by not ordering further procedures but he is also hanging himself out to dry. Furthermore, I agree with him that pay will be reduced greatly for physicians. So, why bother to pay out the whazoo for med school and with deminishing returns? I certainly would not want to be paid minimum wage to hear b!tching and moaning all day long. What happens is doctors have a set base of patients then cut it off. I have had doctors say they are not accepting anymore new cases/patients. They have enough to handle.

Yes, it will only get worse however, good health starts with taking care of yourself. This I agree with whole heartedly.

[ReallyDedPoet]

You could add smokers, people who drink to much, and obesity to this list as well :yep:

Also another interesting stat is the cost of folks not showing up for scheduled medical appointments. It's in the hundreds of millions per year.
Sometimes we like to crap all over the health care system yet many times we only have ourselves to blame.

By the way I am a diabetic and could not agree more regarding being responsible for one's health.

[AVGWarhawk]

I still chuckle remembering Obama saying that people need to live healthier and eat correctly. This was right before he took his press corp entourage to Five Guys Burgers and Fries :har: Do as I say and not as I do. I believe he had a smoke after lunch:hmmm:


Let's see if I have this straight.

Obama's health care plan will be
written by a committee whose head says he doesn't understand it,
passed by a Congress that hasn't read it,
signed by a president who smokes,
funded by a treasury chief who did not pay his taxes,
overseen by a surgeon general who is obese, and
financed by a country that is broke.

What could possibly go wrong?

[SteamWake]

I still chuckle remembering Obama saying that people need to live healthier and eat correctly. This was right before he took his press corp entourage to Five Guys Burgers and Fries :har: Do as I say and not as I do. I believe he had a smoke after lunch:hmmm:


Let's see if I have this straight.

Obama's health care plan will be
written by a committee whose head says he doesn't understand it,
passed by a Congress that hasn't read it,
signed by a president who smokes,
funded by a treasury chief who did not pay his taxes,
overseen by a surgeon general who is obese, and
financed by a country that is broke.

What could possibly go wrong?

Almost right except the bill was not written by any committe or politican in fact it was written by the "Apollo Allience". But very few know this as the media doesent bother to mention it.

http://therealbarackobama.wordpress.com/2009/07/29/the-apollo-alliance/

But hey ... thats a diversion from the topic at hand.

I can fully understand the primary care doctors frustration as whenever I need to visit them I am stunned at the general state of health of the pepole in the waiting room.

[AVGWarhawk]

Mr. DINGELL (for himself, Mr. RANGEL, Mr. WAXMAN, Mr. GEORGE MILLER of California, Mr. STARK, Mr. PALLONE, and Mr. ANDREWS) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, Education and Labor, Oversight and Government Reform, and the Budget, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned"

http://frwebgate.access.gpo.gov/cgi-bin/… (http://frwebgate.access.gpo.gov/cgi-bin/…)

I do not see it as a diversion at all. It is part of the ever growing problem and it will get worse.

[SteamWake]

Mr. DINGELL (for himself, Mr. RANGEL, Mr. WAXMAN, Mr. GEORGE MILLER of California, Mr. STARK, Mr. PALLONE, and Mr. ANDREWS) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, Education and Labor, Oversight and Government Reform, and the Budget, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned"

http://frwebgate.access.gpo.gov/cgi-bin/… (http://frwebgate.access.gpo.gov/cgi-bin/…)

I do not see it as a diversion at all. It is part of the ever growing problem and it will get worse.

Link is 404 ;)

They 'introduced' the bill, they dident write it. These bozo's are not capable of writing a thousand plus page bill let alone read it.

[AVGWarhawk]

Link is 404 ;)

They 'introduced' the bill, they dident write it. These bozo's are not capable of writing a thousand plus page bill let alone read it.

The link was just the PDF of the bill. Of course they could not write it or read it. With that in mind what makes Congress capable of anything at this point?

[roman2440]

I don't agree with the doctor at all. When I read his commentary all I see is some whiney little b***h who thinks he's underpaid. Look at how he writes that his compensation is only in the hundreds, BS. This is some california doctor that is upset that he isn't making the same pay grade as some of big suit patients he has.

There is one aspect of his complaint that I do agree with, though. And thats those people who choose to ignore their doctor's advice and instead trust their fears and what they read online about their 'condition'. People are driven by fear, its a common staple through life if you want to sell something, you sell it by planting fear of not having it. When most people go online to read about their symptoms they are going to focus on the items that they fear the most, which are usually going to be those rather rare corner cases that they really shouldn't be worrying about. But they really need to realize they are going to the expert and if the expert calls it something, he's more than likely right.

[SteamWake]

The link was just the PDF of the bill. Of course they could not write it or read it. With that in mind what makes Congress capable of anything at this point?

Fully capable of expanding their own power and the nations addiction to dependency. In fact there doing quite well at that.

[AVGWarhawk]

Fully capable of expanding their own power and the nations addiction to dependency. In fact there doing quite well at that.

Yes, but that is coming to a grinding halt! Today the expected deficit is oh say, a few trillion over what was once thought! A nice clever out for Obama and his tanking health care plan.

[PeriscopeDepth]

I don't agree with the doctor at all. When I read his commentary all I see is some whiney little b***h who thinks he's underpaid. Look at how he writes that his compensation is only in the hundreds, BS. This is some california doctor that is upset that he isn't making the same pay grade as some of big suit patients he has.

He has a point though. Nobody is becoming a GP any more because you can make twice as much money with half as much of a workload in other specialities. It is kind of a problem if there are no GPs around.

PD

[Onkel Neal]

I don't agree with the doctor at all. When I read his commentary all I see is some whiney little b***h who thinks he's underpaid. Look at how he writes that his compensation is only in the hundreds, BS. This is some california doctor that is upset that he isn't making the same pay grade as some of big suit patients he has.



I disagree, I see no reason to label him whiney just because he feels he is underpaid. He's a doctor. They do not grow on trees, not everyone has the stuff to do it. Try letting your mechanic install a heart valve on you :)

Doctors should be highly paid.

[Aramike]

I disagree, I see no reason to label him whiney just because he feels he is underpaid. He's a doctor. They do not grow on trees, not everyone has the stuff to do it. Try letting your mechanic install a heart valve on you :)

Doctors should be highly paid.Not to mention the extraordinary cost of med school...

[Platapus]

Considering that if he is like my GP, he will only see each patient for about 15 minutes max. At $55.00 per patient, if he can keep the waiting room filled that is $220.00 per hour.

And that does not include the kickbacks he gets from tests, prescriptions, and the stuff they push to sell you.

Not exactly poverty wages.

Forgive me for not crying a river for this guy.

It is the PAs and the NPs that collect the data, document the information, and perform the treatment. The doctor pops his head in the examination room for a few moments and gives out with the highly educated, highly trained medical council -- "let's try this drug. See me in three weeks and we can try something else".

Gee 8 years of medical school and I get "let's try this drug'? :damn:

[PeriscopeDepth]

Considering that if he is like my GP, he will only see each patient for about 15 minutes max. At $55.00 per patient, if he can keep the waiting room filled that is $220.00 per hour.

And that does not include the kickbacks he gets from tests, prescriptions, and the stuff they push to sell you.

Not exactly poverty wages.

Forgive me for not crying a river for this guy.

It is the PAs and the NPs that collect the data, document the information, and perform the treatment. The doctor pops his head in the examination room for a few moments and gives out with the highly educated, highly trained medical council -- "let's try this drug. See me in three weeks and we can try something else".

Gee 8 years of medical school and I get "let's try this drug'? :damn:
YMMV I guess. I've always been very happy with my GP. Very consultative, makes an effort to make sure I understand what's happening. But the fact is that he invested just as much time, energy, and money into his medical career (and any medical career requires gobs and gobs of that stuff) as say an orthopaedic surgeon. And makes half as much money while working more hours. If he wanted to make more money, his incentive would be to get people in and out the door as fast as possible and prescribe tons of drugs from drug companies that have bribed him enough. But my GP clearly hasn't gone this route.

I don't think my GP should make more money, I just think other specialities should make less to make sure GP will always attract a good amount of young doctors.

PS: I actually listened to a radio program about this a month ago. Here it is if you have any interest in it:
http://www.opb.org/thinkoutloud/shows/no-doctor-in-the-house/

PD

[Task Force]

pfff.... for some of the crap doctors do they dont deserve the money... most of them are quacks anyway... just want to give everyone a pill to fix everything...:shifty:

(please note im not talking about all doctors...)

[roman2440]

I disagree, I see no reason to label him whiney just because he feels he is underpaid. He's a doctor. They do not grow on trees, not everyone has the stuff to do it. Try letting your mechanic install a heart valve on you :)

Doctors should be highly paid.

Even doctors have a ceiling for their value.

I've worked with a lot of guys that have been underpaid. I've seen a lot of different approaches to whining about pay. The language this doctor is using is deja vu. The kind of language he is using I've only ever seen used by guys that only think about money and who over value themselves. People who truely deserve a pay increase don't speak in the same manner.

[Task Force]

anyway... I thought doctors were surspose to be concerned about there paitents, not lineing there pockets...

[Tribesman]

Not to mention the extraordinary cost of med school...
Which taxpayers subsidise .
Both the medical students and the medical schools themselves get federal grants.
Don't ya just hate it when someone else is taking your money.

[Aramike]

Even doctors have a ceiling for their value.

I've worked with a lot of guys that have been underpaid. I've seen a lot of different approaches to whining about pay. The language this doctor is using is deja vu. The kind of language he is using I've only ever seen used by guys that only think about money and who over value themselves. People who truely deserve a pay increase don't speak in the same manner.Nothing should have a ceiling for its value.

[Onkel Neal]

Considering that if he is like my GP, he will only see each patient for about 15 minutes max. At $55.00 per patient, if he can keep the waiting room filled that is $220.00 per hour.

And that does not include the kickbacks he gets from tests, prescriptions, and the stuff they push to sell you.

Not exactly poverty wages.

Forgive me for not crying a river for this guy.

It is the PAs and the NPs that collect the data, document the information, and perform the treatment. The doctor pops his head in the examination room for a few moments and gives out with the highly educated, highly trained medical council -- "let's try this drug. See me in three weeks and we can try something else".

Gee 8 years of medical school and I get "let's try this drug'? :damn:

That's not my doctor :arrgh!:


anyway... I thought doctors were surspose to be concerned about there paitents, not lineing there pockets...

Oh sure, and you and me work at our jobs because we like to see the company succeed, not for our paycheck ;)

[Task Force]

That's not my doctor :arrgh!:

lol, you have a doc thats awnser to everything isnt PILLS!!!! PILLS!!!!:rotfl:

[Rockin Robbins]

The base problem here is the exact opposite of the problem that led to the founding of this country. Then the saying was "no taxation without representation." In the early US only taxpayers could vote. You had to have personal or real property taxed by the Federal Government in order to cast that vote. You owned part of the shop, you got a voice in how to run it.

Now we have something much more dangerous than taxation without representation. We have representation without taxation. 50% of the public pay no federal income taxes at all. The top 1% of wage earners, that approximately 1.6 million people who earn more than approximately $360,000 pay more dollars into the federal till than the bottom 95% of wage earners! Yes, you read that correctly. It's been true since 2006.

Now, does the majority, which pays little or no taxes, want more services, which they will pay nothing for? Do they have any problem with tax increases, which do not affect them? Do they have any incentive to vote in a way that a responsible citizen who owns a piece of the action should vote? Or are they inclined just to loot and plunder those evil rich people, that top 1%?

Doesn't matter. The problem is self correcting. That top 1%, a lousy 1.6 million people have plenty of assets. They employ 75% of the working people in the USA. Unlike us, they participate in the economy voluntarily. You see, they need not make an income at all. They can well afford to close the doors, fire their workers, buy a boat and take off for five years while we either just die or regain our senses.

Can you see the danger of putting all of our fates in the hands of less than 1% of the people? Can you see the awesome power they posess, even as they are not using it yet to defend themselves?

If you want to see this insanity corrected, there is a tool available that will fix it. It's called the Fair Tax, a national sales tax which would take the place of the federal income tax, social security deductions and FICA taxes. Through the use of a prebate, it would guarantee that the truly poor don't pay a penny in taxes. And EVERYBODY, except the truly needy who could not afford to pay, would be a taxpayer.

If they vote to raise taxes, they vote to raise taxes on themselves! Isn't that fair? If they vote to fund a national health care program, they do it in full realization that the buck stops with them. I bet they'd be darned sure to get their money's worth.

Folks, nothing is worth more than what you pay for it and the majority of Americans are freeloading off the feds and voting to seize more money from the achievers who are responsible for what little prosperity they enjoy. But it's fashionable to hate these achievers, and refer to them as the "more fortunate" who need to pay more and more.

How much more than 50% of the federal budget would be fair for them to pay? Should the top 1% be made to pay MORE than the bottom 95% of wage earners? How much more? And how do you propose to keep this profound injustice from destroying this land we love?

Democracy has been reduced to two cats and a mouse voting over what's for dinner. I think we know the ending to that scene.

THAT's the underlying problem, more important and more dangerous than terrorists, national health care, green industry, global warming, pollution and CIA interrogation practices combined. By the time we realize it's there, this will destroy all we have.

[Task Force]

Oh sure, and you and me work at our jobs because we like to see the company succeed, not for our paycheck ;)
yea.... but in the medical buisness id think the paitents should come first... if I was a doctor I would... Its only right...:yep:

[Platapus]

50% of the public pay no federal income taxes at all.

Sure about that number? Seems a bit high. Got a citation?

[Aramike]

Sure about that number? Seems a bit high. Got a citation?It's only slightly high. I think the number is 41%.

But still, RR's points are spot-on.

http://www.taxfoundation.org/news/show/1410.html

Although, I do admit that I fear a national sales tax would result in an out-of-control black market, required a bureacracy and enforcement agency rivaling the IRS...

I'm personally in favor of a flat tax.

[Rockin Robbins]

The number is correct and from the IRS. In 2006 the top 1% for the first time paid more federal taxes than the bottom 95% and it's gotten worse every year. The story was on national news just last week and I checked it out.

Why aren't we told the truth? Uploading now. It'll be a spreadsheet from the IRS with reference URL so everyone can check it out for themself. Now the 41% isn't unreasonable on the face of it.

Look at it this way, the top 1% pays slightly more than the bottom 95%. That means the rest is paid by the 96th through 98th percentile, a group paying cruelly disproportionate taxes themselves. If the 41% is correct that would mean the top 1% pays 41%, the bottom 95% pays 41% and that would leave 18% to be paid by the 96th through 98th percentile. Without doing any fancy math, I'd say that sounds about right.

But I'm going to provide all the numbers and the means to confirm that they are 100% unsensationalized truth. Just give me a couple of minutes to upload.

[Onkel Neal]

yea.... but in the medical buisness id think the paitents should come first... if I was a doctor I would... Its only right...:yep:


You definitely should become a doctor. You can start tomorrow, let us know which medical schools you are applying to. :shucks:

[Platapus]

It's only slightly high. I think the number is 41%.

But still, RR's points are spot-on.



That number includes people who pay federal tax during the year but get it all back. That is not quite the same as not paying any tax as the federal government had the use of the money interest free during the year.

It is important to differentiate between people who don't file and people who get a refund of the taxes they paid all year.

This total includes those who pay no tax, and those who pay some tax upfront and are later refunded the full amount of the tax paid or more.

If you use the numbers on that site, the percentage of people who pay no federal income tax at all is about 11% 15M/136M

11% may still be high to some people but it is not quite the same as saying the 40-50% of people don't pay income taxes.

[Rockin Robbins]

OK, here's your download link an Excel .xls file: the link (http://www.filefront.com/14397907/ff135data--all%20charts.xls), as downloaded from the IRS website. Let me take you for a tour of this thing.

This spreadsheet is divided into seven charts, not all of which will interest us here. The top chart is Number of Federal Individual Income Tax Returns Filed 1980-2006, a chart we're not too interested in, except that we can read that the top 1% was only 1,357,192 taxpayers out of a hundred times more filing! That is 135,719,160 total returns! See the danger if I'm right?

Down one is the Adjusted Gross Income of Taxpayers in Various Income Brackets, 1980-2006 ($ Millions). This is total income of all members of each group. Although there's compelling information hidden in this morass of numbers, we'll skip this one.

It's chart #3, Total Income Tax after Credits, 1980-2006 ($ Millions), where my apparently impossible claims lie. Even then we'll have to do some simple addition and subtraction to extract the truth. And we'll use the 2006 numbers. You can see the total dollars collected by the feds at 1,023,739 million dollars (yes that's a million million there). The top 1% paid 408,369 million of that, 39.8% of the total, so that 41% was a bit high for 2006. It's not high now as the situation has gotten worse!:-?

Now look at the top 5%, which paid 615,680 million dollars. Now to calculate what the bottom 95% paid, we'll start with the total dollars, $1,023,789 million and subtract that paid by the top 5%, 615,680 million. That shows that the bottom 95% of wage earners paid $408,059 million dollars. What's that amount for the top 1%? $408,369 million. That's more coming from the top 1% of wage earners than from the bottom 95%! It's worse now.

The next chart shows what percentage of income is earned by the various percentiles. You can see that the top 1%, which pays 39% of 2006 taxes only makes 22.06% of the income. Actually you can skip to the next chart down and see that I'm low on the percentage, which is 39.89% of federal tax receipts from 1% of the wage earners.

Finally, we'll look at the Dollar Cut-Off, 1980-2006 (Minimum AGI for tax return to fall into various percentiles). This is fancy talk for "how much do you have to make to fit into these various percentiles." In order to be in the top 1% of 2006 wage earners you would have to make $388,806 that year.

Don't forget to check out the citation in the box at the top of the spreadsheet. This is 100% unaltered fact from the horse's mouth, available to every citizen of this country who cares to find it. I found it myself and reproduce it here.

It's not a sustainable position. Like a free diver stuck on the bottom, how long can we hold our breath? Every one of you has just seen the end of our republic unless we do something to kill the "progressive" income tax and replace it with a means of fairly sharing the burden and giving each citizen a stake and a value to their vote.

What we're doing right now is the equivalent of letting all the Google stockholders crash a Microsoft stockholders meeting and vote. Do you think they would vote in the best interests of Microsoft? Or would they seek to weaken Microsoft in favor of the company they were invested in? Are voters who pay little or no taxes voting in favor of the best interests of our country or only to weaken those hated top earners to benefit themselves? But those top earners are responsible for 75% of our jobs. Hurting them hurts us worse.

The scary question: why am I the only one laying out these numbers and drawing the picture? Does the news media have some responsibility to the people? Does your representative or senator, Democrat or Republican have a responsibility to reveal this vital and threatening information? Republicans call themselves conservative (some of them) but they withhold this from us? Democrats scream that our "fortunate rich" are freeloading off the working classes, while they know or should know that the opposite is true! We are betrayed by both sides, and I'm the only one I've heard saying it. THAT's scary.

[Task Force]

You definitely should become a doctor. You can start tomorrow, let us know which medical schools you are applying to. :shucks:

http://img259.imageshack.us/img259/9426/tfs.jpg
well... see I already am sey up!!!:rotfl:

[Onkel Neal]

Heh heh! :har: :yeah:

[magic452]

Rockin Robbins is absolutely right! This trend is not sustainable in todays world economy. The higher you raise the so called safety net the more fish you will catch and the bigger the expense to all taxpayers.

Maybe the super rich can and will pay higher taxes but those on the margin will ask " Why am I doing this and not making any money?" It won't be long before you hit a point of diminishing returns.

The ones on the margin are mostly small business owners and the biggest employers, if they give it up what do you have left?

I ran a small business for 18 years and made decent money but the effort was great and i sacrificed much to do so. If you have never run a small business than you have no idea what it takes in time and effort. You deserve to make a decent amount of money and not have the government take it all away to support people who wont put out any effort.

If you really want a ball and chain around your neck just start a small business.

Those who don't pay taxes will always ask for more free stuff, there is no limit on asking if you don't have to pay.


@ task Force. We all may see things like this if Obamacare passes.:wah:

There is a real shortage of good doctors willing to take Medicare patients and I agree that there are too many Pill Pushers out there. The situation will only get worse if this so called Health Care Reform passes and all or most will be on a gov. run system.

I agree that the system needs a major overhaul but what the Dems are pushing is NOT it. With out tort reform health care reform will fail.

Free 100% insurance is not the answer, it is a persons responsibility to take care of themselves not mine. Those truly not able to afford insurance should be given some assistance but not free 100% insurance. Maybe assistance in buying a high deductible plan that makes them responsible for a fair part of the cost and protects them against a major illness.

Insurance portability is an absolute must and would relive the problem of preexisting conditions over time. One should not lose their insurance after short unemployment or changing jobs.

Wow where did all this come from, I don't often post in these kind of treads. Any way just my $0.02 worth

Magic