Med students: We'll accept lower pay to get true health reform

My brother who's a doctor agrees with this

 

Well, Azadre, I think your thoughts would be welcome.

 

Good for them. Imagine. Health care that puts patients first.

 

It seems that you believe that withholding coverage for patients with complicated diseases will be more costly for our healthcare system than treating them and dealing with the deficit on the lower end of the spectrum, on endeavors your classmates have listed as "primary care, mental health services and preventive medicine". I am interested to know your reasoning behind this.

And as I understand it, there are quite a few primary care and internal medicine residency positions that do not go filled each and every year because no domestically trained doctor would want to subject themselves to such a life. More and more the positions that they are making available are going to foreign graduates, and this looks to continue as a trend until they make family medicine and geriatrics more palatable, or at the very least, fiscally viable career options. I could see how, as a student at Johns Hopkins, you would have a natural bent towards "innovation zones pertaining to all aspects of health care", but what concrete initiatives are there really that indicate to us that these solutions are on the horizon at all, and that they will arrive before the whole system crashes under the burden of an entire population stricken with obesity, hypertension, and diabetes?

It seems that what your classmates are calling for, namely "a health care system that values holistic patient care, improves patient outcomes and rewards evidence-based medicine" is not unreasonable, nor is it diametrically opposed to the idea that the US should remain the world leader in medical research. Of course, the system is too broken at this point for even evidence-based medicine alone to rescue, but it can't hurt can it?

 

Agreed. I just looked at my loans and it looks like I'm going to have to pay about $250k after I graduate. Clogged arteries? More like clogged full of yellow gold.

Slightly joking aside, Texas recently passed a loan repayment incentive for those who decide to go into primary care like me.
http://www.tafp.org/news/TFP/09No4/1.asp

 

This I think is one of the biggest problems with the system.

During the past fiscal year while most industries saw decline, the pharmaceutical industry continued to grow exponentially.

The focus on treatments, rather than preventive care and even R&D towards cures, is a huge problem in my opinion. To put it in business terms, the lifetime value of customer is maximized if patients keep returning for medications to "treat" their illnesses. There are no incentives (financial), other than maybe moral incentives, to research and invest heavily into cures; when once a patient is cured, there is no reason for them to come back.

Pharmaceutical companies have some of the biggest pockets, and are the major culprits to the problem, not the doctors. Their huge influence with lobbyist won't allow for any significant change to the current system/problem.

 

What a bunch of tools. I hardly doubt doctor pay is a large contributing factor, or even a factor at all, in the so called healthcare reform debates. These things happen all the time.

Sounds like more bull****.

 

Dude, it's a huge problem. Family docs are finding it more and more difficult to stay afloat because of the practices of reimbursement from Medicare and the nature of poor Americans being increasingly uninsured. We're not talking about spoiled upper crust brats here--lots of them are going bankrupt even after working 70-80hr work weeks that usually end in over an hour of arguing with insurance company telephone operators about why their patients should be covered for potential life-saving procedures.

The majority of medical students that have the power to avoid such a fate are doing so as a result, and who does that hurt? The poor people of course. The reality is that there's a growing shortage especially among impoverished communities of family docs, and the ones that do exist are getting harder and harder to see. Factor in some other issues and you have a whopping uninsured rate (Houston is the worst in the country at this in case you didn't know, see http://www.chron.com/disp/story.mpl/front/5968063.html ) and that only puts an even bigger strain on the public health system because they all show up at Ben Taub to get "free" care which of course is just America's implicit version of nationalized healthcare since they're forcing hospitals to treat without overtly earmarking funding for them, so hospitals react by charging anyone that DOES have insurance $3000+ for any routine visit. Furthermore, since EMTALA forbids treating people that don't pay UNTIL they have a life-threatening conditions, you've got a bunch of poor people essentially waiting until they're on the throes of death before getting things like therapy for diabetes which of course ends up costing 10x as much by the time their end-stage manifestations start to develop.

It's a vicious freaking cycle and certainly not the bull**** you claim it to be, since it ends up affecting everybody. And no matter who you are, poor and uninsured or tax-paying and being sapped to the bone in payments just to get coverage for healthcare, it affects you and it could be done better. Asking doctors to "bite the bullet" is tantamount to asking patients to wait until they're dying to receive care. No one benefits.