getting hyper

Friday, September 18, 2009

The more things change, the more things stay the same...
posted by Sigmund Friday, September 18, 2009

Sunday, September 13, 2009

I am so very, very glad that I never have to hear that coming out of my computer again
posted by Marianna Sunday, September 13, 2009

Welcome to's Dot Com!
posted by Sigmund Sunday, September 13, 2009

Tuesday, September 01, 2009

From the other side, a haunting perspective.

Having decided over the last few months on family medicine as a career choice, most of the opinions I have heard in response to health care reform have been strongly slanted toward excitement over it's promises to improve primary care and primary care compensation. While I do think this is the correct persective, especially when one considers that the countries with most success in health care delivery are primary care based, apparently it is a threatening position to specialist. In particular, this week on the start of my two week stint in Anesthesiology I have come in contact with strong hostility toward Obama and his plan for health care reform. Ironically, there is no clear plan so much of it is speculation and by no means just Obama's objective. In any sense, the attending anesthesiologist I was working with today apparently wanted to talk about this issue at great depth with me today after learning that I was applying to family medicine. I wish I could say that he had a particularly good argument for fearing that specialist would be "screwed" by Obama's plan, but honestly I can't. His major argument was that since primary care docs will likely see salary increases, specialist are looking at a pay cut. His gripe therefore was about money. While I understand that many fields of medicine require more training than family medicine and thus might deserve higher compensation, I think his perspective is very narrow minded. True, specialist will likely see a pay cut, but even if it is substantial they will be adequately paid for their services.

At present the spending on the end of specialist is out of proportion. Much of the this overpricing isn't so much because salaries are too high (though some of it is) but rather because specialist are being utilized at an unnecessary rate. With a very week primary care system in the US at present, many patients do not recieve the primary care they need to prevent speciality consult. Hence the number of patients seeing specialist is above and beyond what would ever be needed in a sound health system. Hence, health care reform likely will reduce demand for specialist in addition to reducing their pay somewhat. However, this is indeed a compromise this country must make to ensure that it may rise to become a health care leader. Indeed, American greed shows its terribly teeth in our health care system which is currently ranked below many third world nations.
posted by Marianna Tuesday, September 01, 2009

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