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[SoulPlaya]

hold up...I thought docs in rural areas usually made more due a shortage of physicians willing to live away from cities. I've heard stories of FPs and internists making bank in places like South Dakota. Plus, supposedly you sometimes get your loans taken of as well. Is that untrue?

No, it's not, but it depends where. Although, to be honest, I think his wife probably practiced some years ago, and things are different now, as many of those programs were recently implemented.

 

[Draff]

Dedicated to making $$

Honestly, I'm almost done med school and I can say that for someone to finish all of their training and put up with the countless hours of work, the $$:work ratio just isn't worth it for most people.

$150-$250 for a bag of saline. you know how much a bag of saline costs the hospital? less than a penny/bag. it only gets worse from there.

To be honest, knowing the cost of some hospital supplies, I highly doubt it costs <1 cent/bag considering that the solution has to be sterile with greater quality control checks. Plus, the cost likely doesn't include all of the additional IV-related supplies, not that this justifies $150. I'm in Canada so I never know how much these things cost the hospitals.

 

[Aruarian Reflection]

I will be the first to admit that many docs are crooks, but even I'm worried about how I'm going to make enough money to live decently when I'm staring 200-300K in student debt from med school.

In conclusion, the entire US health system is screwed up. Patients blame insurance, insurance blames hospitals, hospitals blame docs, docs blame med schools, med schools blame faculty, costs, and rotation costs. The whole thing needs an overhaul.

I can buy a Ferrari with how much I owe from my med school loans =/

And yeah, if you want to make money, there's far easier ways than becoming a doctor.

 

[dojokun]

This is why mandating people into buying insurance is not the answer. I support all the other major parts of our new healthcare bill, but not the mandate. I understand people say that without the mandate, the insurance companies would need to raise rates. Well I say: Let them try it. The public will get behind a public option even more than before.

 

[JB1981]

OMG can't believe they named Magdy Wahba I work for a competitor and I recognized that guys name! These guys should lose their licenses. Good on Aetna for having the balls to do this!!!

 

[SouthernDragon]

A single-payer healthcare system or a public option would force doctor bills to a standardized amount, avoiding these ridiculous bills. I can't believe the amount of money we pay as consumers for these procedures.

And with that, I'm bailing out.

 

[epmode]

Horrific.

America, your healthcare system chills me to the bone.

Get that Communist bullshit out of this thread.

But yeah, I agree. To this day, I'm astounded by how easily corporate interests manipulate our citizens and government into sticking with a system that allows for something like this. I mean, just about everyone I know has some kind of health insurance horror story or we know someone that got cleaned out due to an uncovered illness or whatever...

A single-payer healthcare system or a public option would force doctor bills to a standardized amount, avoiding these ridiculous bills. I can't believe the amount of money we pay as consumers for these procedures.

Remember that recent health care debate? And how the first thing Obama did was to promise the industry that we wouldn't even consider a single-payer system? And then the industry still fought the terrible compromise bill tooth and nail? God bless America.

 

[Unknown Soldier]

But but but socialized medicine is evil!

Spoiler

Some of the biggest opponents of Obama's healthcare reform were certain doctors. But not GPs and family doctors. Nope, the biggest opponents were highly paid specialists. Coincidence?

 

[dojokun]

Get that Communist bullshit out of this thread.

But yeah, I agree. To this day, I'm astounded by how easily corporate interests manipulate our citizens and government into sticking with a system that allows for something like this. I mean, just about everyone I know has some kind of health insurance horror story or we know someone that got cleaned out due to an uncovered illness or whatever...Remember that recent health care debate? And how the first thing Obama did was to promise the industry that we wouldn't even consider a single-payer system? And then the industry still fought the terrible compromise bill tooth and nail? God bless America.

PARTS of the industry fought the bill tooth and nail. Other parts supported the bill. Remember Scott Brown versus Martha Coakley in MA? The insurance companies were backing the Democrat in that race. The bill guarantees 30 million new customers to the industry. The only insurance companies that aren't benefitting from that would be the ones not into group health. So those companies fought it. Others supported it.

 

[epmode]

PARTS of the industry fought the bill tooth and nail. Other parts supported the bill. Remember Scott Brown versus Martha Coakley in MA? The insurance companies were backing the Democrat in that race.

That's true. The real point there is that the fight was over before it even began.

 

[Deku]

The in-network/out of network business is such bullshit.

 

[bill0527]

hold up...I thought docs in rural areas usually made more due a shortage of physicians willing to live away from cities. I've heard stories of FPs and internists making bank in places like South Dakota. Plus, supposedly you sometimes get your loans taken of as well. Is that untrue?

She got 35k out of 150k paid off by the hospital she worked for. I think they have incentives now for rural docs, but not when she was doing it back in the late 1990s. I really have no idea how these incentives are funded though because rural areas are all Medicare, Medicaid, and the uninsured. And medicare and Medicaid don't reimburse for shit. Very little commercial insurance to be had in rural areas.

 

[Sharp]

Heh... people don't realize how much work it takes to become a doctor. But doctors-to-be... y'all don't realize how much you are about to get paid. After ten years the loans will be ancient history. Thirty years after that you'll be multimillionaires.

 

[Xeke]

She got 35k out of 150k paid off by the hospital she worked for. I think they have incentives now for rural docs, but not when she was doing it back in the late 1990s. I really have no idea how these incentives are funded though because rural areas are all Medicare, Medicaid, and the uninsured. And medicare and Medicaid don't reimburse for shit. Very little commercial insurance to be had in rural areas.

Unless there is something like a University. State College is pretty rural and I bet most people there have damn good insurance.

 

[Dr.Guru of Peru]

Heh... people don't realize how much work it takes to become a doctor. But doctors-to-be... y'all don't realize how much you are about to get paid. After ten years the loans will be ancient history. Thirty years after that you'll be multimillionaires.

So will most people with a half-decent career.

 

[Sharp]

So will most people with a half-decent career.

No, not at all, even factoring in inflation. I'm not sure what standards you're using for "half-decent" but they aren't realistic.

 

[Al-ibn Kermit]

One defendant billed $30,000 for a Caesarean birth,

My mother had a c-section a few years ago and the bill was around $30,000. Their health insurance provider is also Aetna.

 

[hockeypuck]

I like using the analogy of a college athlete transitioning to pro sports when talking about doctor pay. The American medical resident gets paid a relatively nominal salary for the extraordinary amount of work put in for a set amount of years, and then all of a sudden their annual income can balloon to six times that amount once they finish residency. I know residents getting paid ~$50,000 this year for working like a slave and they've signed a contract paying them ~$350,000 the following year once they're out in private practice. This has been going on for decades. So of course physicians are going to feel some sense of entitlement as they finish their training because hey, this profession has one of the highest skill to pay ratios during residency.

Some sports writers advocate for colleges to pay their sports stars a salary for playing. I sort of feel the same way for medical residents, who in today's work environment are seriously underpaid, abused, and overworked. Way more than schoolteachers, nurses and other more vocal professions. Residents don't unionize because they anticipate that future payday. If medical residents were paid more during training, then hopefully that sense of entitlement would be diminished and as a group they would be more receptive to healthcare reform. If you take away that huge payday at the backend without doing anything to buffer the front end that is medical school costs and resident salary, then I guarantee that more jerks are going to be popping up in the news and overall quality of care will go down.

In the past up to this moment the amount of abuse medical residents go through to then earn a very good living is worth it. Take away that good living and the frontlines of American medicine will fall. Who do you think is actively writing orders for your loved one at Boston Childrens, Johns Hopkins, Mayo Clinic, UCLA, Harborview hospitals, all top quality hospitals? Residents.

I think physicians in America also have more autonomy than those in socialized healthcare countries, and that has both its benefits and liabilities. I'm not going to go into the details here but it's going to be very difficult to convince a profession full of bright people to relinquish some freedom.

I personally think a salary-based model like academic hospitals, Kaiser Permanente's or the Mayo Clinic's, does to a degree help separate a physician's clinical work with financial conflicts. It would be the ideal national model.

tl;dr True healthcare reform will never come to America until Medicare is run dry and there is another economic depression with the collapse of insurance companies and subsequent bailout, followed by blood, tears, and the gnashing of teeth. Yeah, I'm a cynic.

Heh... people don't realize how much work it takes to become a doctor. But doctors-to-be... y'all don't realize how much you are about to get paid. After ten years the loans will be ancient history. Thirty years after that you'll be multimillionaires.

Trust me, we know how much we are about to get paid. We're not idiots.

 

[JABEE]

So will most people with a half-decent career.

No they won't. That's very far from reality. Most people won't get to a million.

 

[Dai Kaiju]

Honestly, I'm almost done med school and I can say that for someone to finish all of their training and put up with the countless hours of work, the $$:work ratio just isn't worth it for most people.



To be honest, knowing the cost of some hospital supplies, I highly doubt it costs <1 cent/bag considering that the solution has to be sterile with greater quality control checks. Plus, the cost likely doesn't include all of the additional IV-related supplies, not that this justifies $150. I'm in Canada so I never know how much these things cost the hospitals.

Dude, saline solution is a fancy name for a fuckin bag of salt water. I doubt that guys estimate is too far off.

 

[Dreams-Visions]

To be honest, knowing the cost of some hospital supplies, I highly doubt it costs <1 cent/bag considering that the solution has to be sterile with greater quality control checks. Plus, the cost likely doesn't include all of the additional IV-related supplies, not that this justifies $150. I'm in Canada so I never know how much these things cost the hospitals.

I know because my father ran an ER for a a few years and he talks the shit to death even today.

He's in private practice right now and orders saline bags in small amounts. Maybe 50-100/case.

it costs him $1.20/bag.

Now take that reality and apply it to a hospital, who orders saline bags by the thousands. Super bulk ordering = much less per item.

If we want to be bold, I'll go ahead and up my number to $0.05/bag.

And they'll charge $150-$250 for it on the patient end.

 

[m0dus]

Dedicated to making $$

As someone who suffers through 80 hour workweeks, a ridiculous patient census, and making due with seeing my friends and family only a few hours a week, I'd say you're perspective is, at best, fallacious. If I wanted to make money, there's a whole lot of other, far easier careers to slog through. But you wouldn't know it, seein as how I'm big pimpin' in my '06 accord and my 2 bedroom apartment.

 

[hockeypuck]

Holy shit, we have a resident moonlighting as a GAF mod? That's awesome.

 

[gdt]

I can't fucking imagine working 80 hours a week. That's insane.

 

[m0dus]

Holy shit, we have a resident moonlighting as a GAF mod? That's awesome.

I'm actually an attending ...

But I'm a hospitalist. Which is essentially a better-paid resident.

 

[Deleted member 8095]

You should see the shit chiropractors try to get away with. Fucking scumbags.

 

[hockeypuck]

I'm actually an attending ...

But I'm a hospitalist. Which is essentially a better-paid resident.

Oh. I was wondering how you can be modding a large forum when you should've been reading, writing case reports and preparing M&M presentations, lol.

If I wanted to make money, there's a whole lot of other, far easier careers to slog through.

I'm going to play devil's advocate here. The real hard part is getting into medical school in the first place. Job security with decent wages is pretty much 100%, which I think no other career in America can say, especially in this economy. Health insurance is relatively cheap, too. And then there's the added benefit of curbsiding your friends in other specialties for free health advice when the time's convenient for you, if you wish.

I can't think of another career that has less risk and yet offers pretty much a six-figure income guaranteed a few years out of school for every. single. graduate.

 

[RobertM]

As someone who suffers through 80 hour workweeks, a ridiculous patient census, and making due with seeing my friends and family only a few hours a week, I'd say you're perspective is, at best, fallacious. If I wanted to make money, there's a whole lot of other, far easier careers to slog through. But you wouldn't know it, seein as how I'm big pimpin' in my '06 accord and my 2 bedroom apartment.

Heh, I though you were doing graphic design as a full time thing.

 

[Freshmaker]

Because they are out of network and they're jacking up the prices in the hopes that the insurance companies will settle to pay them for as much as possible.

Sounds more like they're using the patient as a hostage by waving a crippling bill over their heads if the insurance companies don't pay the claims. The insurance companies are in this case are paying the claims rather than allowing the doctor to ruin the patient's life.

 

[Tabris]

I love living in Canada!

 

[Phoenix]

“These doctors can charge whatever they want,” Leibowitz said. “The challenge for the carriers is to come up with an agreeable, acceptable, unbiased judgment as to what a reasonable and customary reimbursement rate is.”

Therein is the problem. Since there is no schedule of fees for these out of network doctors either the insurance company is going to pay those fees or YOU will - one or the other. The most deplorable act in all of the medical "reform" proposed by Congress is that there isn't anything known as a Medical Quote Right such that I will know how much a service is going to cost me BEFORE that service is performed. By law a mechanic is required to give me an estimate and must deliver the service at that price or within some constraint near it, but for anything related to people they can charge literally whatever they want - EVEN IF they have an insurance agreement for a particular price. It just means that those with the copays end up getting bent over more.

Its quite disgusting actually.

 

[Four_Chamber]

I'm actually an attending ...

But I'm a hospitalist. Which is essentially a better-paid resident.

I'm jelly

I'm super excited to finally be done with intern year and become a PGY-2 though the pansy intern rules for next year make it easy. Freakin baby rules for the incoming class, I detest the ACGME right now. These interns are gonna be shit residents when they have to do their first 28 hour (lol) call.

On topic, holy crap. These guys should definitely be sued. 50,000 for a cath and 5 grand for an echo? That's ridiculous- I hate insurance companies as much as the next guy but these clowns need to be disciplined somehow.

 

[bangai-o]

i got charged 900 dollars 2 months ago, for speaking with the doctor about my hearing in one ear. No lies. It was a whole 5 minute conversation.

I put up an argument with the paperwork lady about the ludicrous bill and left.

 

[Drkirby]

Both sides trying to take advantage of each other. IMO, Health Care Reform should be aiming at finding why Health Care costs so much, and then lowering it.

I've always been curious what things costs cause it seems I pay an arm and a leg every time I go.

Mother works in a Dental office, most of the stuff costs little to nothing (The equipments costs a lot though). You are paying for labor.

 

[hockeypuck]

I'm jelly

I'm super excited to finally be done with intern year and become a PGY-2 though the pansy intern rules for next year make it easy. Freakin baby rules for the incoming class, I detest the ACGME right now. These interns are gonna be shit residents when they have to do their first 28 hour (lol) call.

...says the resident who is technically limited to 80-hr workweeks, 36-hr straight call. I no longer hate, since the generation above us feel exactly the same way about us. Ask any attending who was an intern before 2003 how they feel about the ACGME and whether you're weaksauce

 

[Four_Chamber]

...says the resident who is technically limited to 80-hr workweeks, 36-hr straight call. I no longer hate, since the generation above us feel exactly the same way about us. Ask any attending who was an intern before 2003 how they feel about the ACGME and whether you're weaksauce

Inevitably each generation will feel this about succeeding generations as resident rules continue to be dumbed down. They talked to us about next year's schedules and implementing these rules will be a nightmare. It's gonna be an ugly first couple of months next year!

 

[Dreams-Visions]

It was $500 for me to...um...wait in a room for an hour, talk to the doctor for five minutes, have a subscription written, and leave.

And insurance paid half of it. Out 250 fucking dollars to be told to take some pills for ten days. Assholes.

you guys gotta stop going to the Emergency Room. :-/

 

[Freshmaker]

It was $500 for me to...um...wait in a room for an hour, talk to the doctor for five minutes, have a subscription written, and leave.

What did you get subscribed to? In Ya Ear Magazine?

 

[NeoUltima]

Healthcare and education costs would be a lot less if there weren't artificial limiting factors on the number of doctors.

I don't necessarily blame individual doctors for all of this shit(medical costs in general, not just OP situation). I blame the AMA, and the government for letting it get out of control. It costs shit loads to get a medical degree/license and doctors-in-training have to put in so much effort as well, so the American inside them feels they deserve big bucks in return.

Maybe part of the problem is just the way doctors are presented to our society. They're not seen as social servants helping people live longer. Instead we are raised on the notion that 'if you want to be rich, be a doctor!'


(I had started to type out a detailed 'rant', but then realized its not worth the effort, especially at this time of night.)

 

[WolfofMebu]

My wife slipped in the bathroom about a month ago, dislocated her toe and got a pretty bad gash. Took her to an urgent care center where they took several x-rays to make sure it wasn't broken, relocated it, and sutured it back up.

Cost us around $400 total. I was actually surprised that it cost more or less what I was expecting it to. Thankful too that it wasn't outrageous since we don't have insurance.

Know everyone experiences are different, but the several times we've had to go to the urgent care/doctor they have been reasonable as far as cost goes and it really make me wonder why we should get insurance(besides something like a Catastrophic Care Plan) and just pay out of pocket when we do go to the doctor.

 

[Freshmaker]

It wasn't ER it was... what do you call it... urgent care. Does that make a difference?

Scheduling a visit reduces costs by a lot.

I do have a similar urgent care story though. It ended with a $700 bill that the insurance didn't really want to touch tho.

(CT scans apparently aren't needed for strep. Huh.)

prescription hurr hurr ur funny

I was thrilled to learn that In Ya Ear is an actual publication at least.

 

[williamsan]

Super glue.

This man knows. But really, fuck stitches. Not for me.

 

[Jamesfrom818]

These doctors are the reason why I have a job. Keep these fuckers in check. AETNA isn't one of our clients though.

 

[reptilescorpio]

Sooooo glad to live somewhere that doesn't ream me in the ass for health care. When my son was born we paid $120 for a double appointment for the ultrasound. That was about it. Been to the ER a few times and even the local clinic has bulk-billed everything for our Son so far.

 

[speculawyer]

Good.

Insurance companies get a bad rap . . . and very deserved. But many doctors are raping the system as well. The rest of the economy has taken a big hit . . . doctors, you too need to take a step back.

 

[eastmen]

Thats why before the goverment takes health care over they need to define how much each item and procedure costs . If they don't do that then the country as a whole will get raped.

 

[beat]

OP, why didn't you bold this paragraph?

In 2009, Aetna, UnitedHealth Group Inc. (UNH), Cigna Corp. (CI) and WellPoint Inc. (WLP) were accused by the New York attorney general of underpaying out-of-network physicians by manipulating a database used to calculate payments. They paid a total of $90 million in settlements without admitting wrongdoing. UnitedHealthcare agreed that year to pay $350 million to settle a lawsuit by the American Medical Association over the same issues. Similar AMA lawsuits against Aetna, Cigna and Wellpoint are pending.

 

[thetechkid]

Thats why before the goverment takes health care over they need to define how much each item and procedure costs . If they don't do that then the country as a whole will get raped.

I watched video in one of my classes about how Japan dose(did? was an old video) that, anyone know how that is going over there?

 

[roll456]

I watched video in one of my classes about how Japan dose(did? was an old video) that, anyone know how that is going over there?

From what I have heard other people say (with their own anecdotal evidence), it is not as good as the American system. Those aren't facts though.

And capitalist health care is a sin. It's time to move on from it.

 

[Sofo]

So glad of living where I live! wtf seriously, outrageous sums right there (and in some of your stories).