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Comment on Daily Docblock: EHR Style. by Should EMR’s Be Able To Talk to Each Other? |

Should EMR’s Be Able To Talk to Each Other? | — Sat, 25 May 2013 09:55:34 +0000

[...] Posts: Daily DocBlock (EHR Style); My EHR Tells me I’m a Bad Doctor; Snowbirds and the Unfulfilled Promise of [...]

Comment on I’m Tired Of. . . by GI czech

GI czech — Sat, 18 May 2013 01:56:00 +0000

you need to sit on the beach until you are tired of watching the same stupid crab make a hole in the sand to come up for air only for it to be washed away again with each wave

Comment on Be Nice To Nurses. . . Or Else! by Happy Nurses Week! |

Happy Nurses Week! | — Wed, 08 May 2013 15:59:07 +0000

[...] Posts: Be Nice to Nurses. . . Or Else! This entry was posted in The Truth About Health Care, Un-Sequitur and tagged medical [...]

Comment on Another Letter to Washington, from a Physician on the Front Lines. by North Carolina PA, MPH

North Carolina PA, MPH — Tue, 07 May 2013 23:33:00 +0000

I agree that Dr. Moeller, and the entire medical profession, have made tremendous personal and financial sacrifices to pursue the study of medicine and then to practice medicine.

Perhaps as a society, however, we should be looking at medical education from a different angle. This is the angle: How can the US best train the optimal mix of health care providers to meet the medical needs of our country?

Perhaps the US medical education system is creating too many Mercedes-Benz and Lamborghini’s when most consumers really just need a Ford Focus or Honda Accord.

Comment on Another Letter to Washington, from a Physician on the Front Lines. by Joyce N. DeWitt

Joyce N. DeWitt — Sat, 27 Apr 2013 21:41:00 +0000

I understand exactly what Dr. Moeller explains in both of his letters. I understand that when my orthopedic surgeon did a wonderful job fixing my torn rotator cuff, he did NOT get paid the $20,000 that was the total cost for the procedure. I’d be surprised if he made more than $1500. It’s easy to see where the rest of it goes…. charges for the use of the hospital “room” which was an outpatient pre-surgery room, the use of the operating room, the use of the recovery room, the medicines for my aenesthesia, antibiotics, and pain control, the charge for the aenesthesiologist, the charge for the pre surgery nurses, the operating room nurses, the post care nurses, the hospital office and staff charges for paperwork, and a lot of other things that I didn’t understand. Although I do think my surgeon makes good money, he should. In addition to all of his training and expertise, he spent many years as a flight surgeon in the Air Force, where I doubt his pay was nearly as good. I do understand a little about medical billing, just from reading articles, and from asking questions about my bill. It may on paper that the charges for a yearly physical are close to $1,000, but I know that most of that goes to all kinds of stuff besides payment to my wonderful doctor. It’s no wonder that they cram them into seeing between 2 and 4 patients an hour: fifteen minutes for an office visit, and thirty for a physical. And I can imagine his head spinning after an eight hour day of seeing that many people. As a former high school teacher, I know how people can misunderstand a job. Doctors are thought of as “making the big bucks,” when people have no clue as to the cost of their education, continuing education, fees for liability insurance, professional organizations, and the loss of those earning years between the ages of 22 and 30. With teachers, what we constantly hear is, “Oh, you have the best job. Don’t complain about your low pay! You get off of work every day at 2:30 or 3:00, and you get two weeks off at Christmas, a week in the spring and three months in the summer! Give me a break!” What they don’t know is that many teachers either come to school in the wee hours of the morning, or stay late in the evenings. Most days I did not leave until 6.p.m. and at least two nights a week, I’d have to stay until 7 or 8. My friends would ask me, “Why? Why do you have to stay so late? What do you do?” I would explain that our second work day begins when the kids walk out the door. That is when we plan for the next day or week, grade papers, get materials ready for the next day, tutor kids, attend meetings and workshops, serve on several different required committees (benevolence, site based management, school beautification, at risk students, school dances, festivals, etc), attend after school events such as Parent Teacher meetings, open houses, games, plays, band or choir performances, award ceremonies, etc. Many teachers work with extra curricular groups before and after school, such as Key Club, National Honor Society, Student Council, International Club, Science and Math club, etc. Some teach school all day and then coach after school. In addition we have to keep up our continuing education hours and often have coursework and tests to take, or presentations to make. We have to document all of the things that we do in our classrooms to line up with our school improvement plan, and we have to also fill in reports and forms about what we do to streamline and modify lesson plans for studens with individual education plans… kids with learning problems, and how we comply with federal laws regarding the education of these kids. Along with continuing education, we also keep up with all of the new technology making itself into the classroom. We might train on a grading and reporting system that we use for two years, only to have the district throw it out and purchase a complete new system to learn. And, we take all kinds of calls from parents before, during (on our “planning” period) and after school. Some of these calls can last as long as a parent wants to talk… or complain. Occasionally, instead of calls, we have individual parent conferences, and these, too can take a lot of time. We talk for an hour with a parent about how to address the kid’s unwillingness to pick up a book to study, we offer solutions, we offer tutoring hours, we come up with a plan, only to have the parent and the student to drop the plan and then complain about the low grade again the next six weeks. Teaching can be extremely stressful, and the only reason that most of us stay in it is because we love it. We are often, especially in middle or high school, greeted by students who disrespect us first, and we have to earn their respect and their attention. Christmas break is usually a mad scramble to finally get everything ready for our own families in a very short amount of time. December and May are the craziest months in the year for teachers: so many programs and activities at school, all while nearing the end of the semester and the final grades. And of course, increasingly, teachers’ salaries and even jobs are tied to test performances by their students… and some of those students don’t care about their grades. When you look at our summer breaks, they are often bogged down by attending a college class or two, or working with planning committees for the next school year. We may get a couple of months off in the summer (it is rarely three months anymore) but after the maddening school year, every teacher needs a long breather. People don’t understand what we do. And people do not understand how doctors are paid, or exactly what they do, either. They, too, also have a lot of extra things beyond just their regular jobs, such as continuing education, re-certification, new technology to learn, and committe or professional organization meetings and duties. Doctors have to deal with patients who don’t follow instructions, and turn up even sicker. A lot of their patients and their families are sometimes very demanding and difficult. There are so many similarities between doctors and teachers. I am extremely grateful for the good doctors that I’ve had over the years, and I hope that every one of them eventually enjoys a great lifestyle in compensation for the long years of training and the excellent care they give, and for the hours they put in every week. As for Dr. Moeller and his salary, I wish he would investigate relocation to the Carolinas, or to Texas, or other states where I believe the doctor compensation is better than what he is currently earning. I think that some medical communities are much better than others in terms of work-life load and pay. The Carolinas Medical Center located all over North and South Carolina is a fine institution with great places to work and live. The climate and beauty of the Carolinas make the area a wonderful place to live. The best doctors I’ve ever had have all been under the CMC group. They all seem happy with their work, and so do all the staff. Their blend of friendly professionalism and excellence really transcends to patients in confidence and ease of visits. I’ve seen internists, G.I. doctors, orthopedic doctors, aenesthesiologists, general surgeons, allergists, immunologists,dermatologists, physical therapists, and physician assistants, and in eight years, I have yet to meet a cranky tech, nurse, office staff person, or doctor. Pretty good performance, I’d say! I hope they do all earn a great salary. It’s annoying to hear people run the medical profession and their salaries down, because they all work very hard, and have come a long way to get where they are.

Comment on An Open Letter to Washington, D.C. From a Physician on the Front Lines. by AP

AP — Fri, 26 Apr 2013 21:35:00 +0000

I’m an incoming med student. Although there is the potential to do very well down the line, and I understand that, looking at raking in $350,000 to $400,000 in student loans at the age of 24 scares the living crap out of me!!!!

I’d like to note that perhaps we would all be less interested in subspecializing and lining our pockets if we would not have those loans in the back of our minds through the next four years of medical school. It frames how we think about the profession, doesn’t it? PCP, for example becomes very appealing when you have $0 debt. Perhaps not for everyone, but perhaps for enough that it may make a substantial difference in the way we see health care in the US.

Comment on An Open Letter to Washington, D.C. From a Physician on the Front Lines. by Josh Bucher

Josh Bucher — Thu, 25 Apr 2013 12:38:00 +0000

I think that most people here are missing the point of the article. The point is that he is graduating with over 200k in debt (like myself). Most other 1st world countries have education systems much more suited for encouraging people to go into primary care because they do not graduate with debt if they attend public medical schools.

As someone who just graduated last year with > 200k in debt, making 50,800 a year as a first year resident (you can look up UMDNJ PGY 1 salaries online), I sympathize with him.

The comment above that they know “so many people who bought $200k homes before residency” is totally irrelevant. I never worked, never had a full time job before residency and came straight from college. I borrowed money to rent apartments, and rent now. I drive a 10 year old Honda that I need to last me another 10 years. I am in NJ and pay some of the highest cost of living expenses. I make $500 a month loan payments. My assets are very low, and my loan principal keeps increasing due to compounding interest.

If we were anything like the rest of the 1st world, medical school debt would be a different story. I am going into academic emergency medicine. I will start at a salary on the east coast of approximately 180k. I am not getting a maserati, nor can I purchase a 700k house. I am also inheriting another 100k in debt from my fiance.

The point that I took away from this is that the system of debt needs to be changed. I am not complaining about my salary. I am not complaining I cannot afford a maserati. I am not complaining that I don’t make enough money. The point I will complain about is the education system has to change because there is a huge physician shortage, and students are discouraged from pursuing a career in medicine due to the way medical school and debt is funded in the US.

Comment on An Open Letter to Washington, D.C. From a Physician on the Front Lines. by guserson

guserson — Wed, 24 Apr 2013 06:28:00 +0000

What’s your salary now? you don’t mention it in the article.

Comment on Why Physicians Should Learn to Pronounce Patient Names Properly by hopeint

hopeint — Wed, 03 Apr 2013 19:40:00 +0000

very true!

Comment on An Open Letter to Washington, D.C. From a Physician on the Front Lines. by Smart technology and healthcare: why do we only hear about the incredible tech possibilities? | Bloguepost

Tue, 02 Apr 2013 13:09:47 +0000

[...] specialists perform their jobs. Two examples: in the US, costs for medical schooling can add up to $230.000,-. Will the traditional ‘business model’, of investing a lot of time and money to get a [...]