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shrinkwrap, perhaps office management is different in different parts of the country. Every office I have visited in many years has numerous exam rooms in operation at the same time. PA's or nurses perform the basics: height/weight, history, vitals. An initial office visit might involve as much as 10-15 minutes of physician time. Followups are usually much shorter. Blink twice and they are gone.
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<p>That I can agree with ;-). </p>
<p>In one case I was actually given two tetanus shots by accident because, to increase throughput and keep costs low, the doc had his 'nurse', which was actually his receptionist, give most simple shots but because of lack of communication she gave me one and then he later gave me one too (I was getting several different shots that day). They quickly realized the mix up and the doc then had to come back and apologize much to his embarrassment. My arm was REALLY sore and out of commission for a few days but I was nice and didn't sue (although I'm sure these days some wouldn't have passed up the opportunity for a quick in-n-out malpractice case settled for a few thousand on the side).</p>
<p>edad, what you have been saying about average physician's salaries and the number of patients they see a day are way off base. Unless you can cite a credible source, I will have to tell you that it is simply not true.</p>
<p>The busy ER in the only hospital in my town with a population of around 100,00 may see about 75-100 patients per day, and that is in a 24 hour period with at least 5 docs, numerous PAs and nurses on duty on any given day.</p>
<p>Isn't this really more a question of managing expectations for the HS student about possible careers? I know that my high school and college (and even grad school!) view of what my chosen career would be like was, uhm, incomplete. The skills that would be required and rewarded, the things that mattered in addition to raw smarts, the types of careers that people in my grad program would actually end up in rather than what we expected we'd end up in, the locales that one would have to consider in order to get a certain type of job, all very, very different than my idealized view. </p>
<p>I'd guess that for some students, hearing the nitty-gritty might be enough to convince them that no, the field isn't right for them. Others might say that they can live with the downsides. Others will be just like me when I was a student :) and think that they'll be the exception, and they'll get the career they want without any of those inconvenient downsides.</p>
<p>"high deductible plan covers annual check ups at 80% "</p>
<p>Are you paying the deductible up front, or does the plan waive the deductible and go to co-insurance? Did you have other choices in plan design? ;) As I said most plans have provisions for preventative that are better than their major med requirements. Now if you're doing a HSA, well.. there's a drawback to that plan....</p>
<p>Exactly, ST. the OP was interested in hearing different experiences and opinions, and these are what s/he's getting. It can only be helpful.</p>
<p>For my H, the amount of time and stress was not worth the return (which was much, much less than the numbers being thrown around here.) Others may have had different opinions.</p>
<p>I will say, though, that if you meet a doc who's seeing 75-100 patients a day, run like the wind. that is a bad doctor.</p>
<p>I am sure practices vary, and I am ntimately aware of the practice patterns where I live, as it is the subject of "pillow talk". I am also familiar with the "MGMA" numbers as this is regularly discussed too. Both my H and I have been department chiefs, and H is currently vice president of his group. For the purposes of this thread, the op should know if their kids world have a practice seeing 75-100 patients a day, and what that's like.</p>
<p>Opie, if It m reading you correctly , there is no reason to defend your or your kids choice. If they want it great! Few of us are saying we would discourage our kids (I'm curious, would you encourage or discourage yours re: "securities"?), but I'm saying I would be hardpressed to encourage them (and they are going to need it). Personally I don't think it's for me to "let" or "have" my kids do anything.</p>
<p>Did you read the details of the post about bankruptcy you posted. "IRA assests over a million are not sheltered from bankruptcy?" ;) </p>
<p>The grist of that article was if you self insure your malpractice coverage, unless you have "trusted" away your assets, you bear a great risk.... </p>
<p>When ever you self insure, you assume the risk. It why people's paid for homes burn down and you find out they carry no insurance? why? A few thousand dollars a year protects possibily millions. </p>
<p>unfortunately, I did not take away the same seniment from your link that you might have. </p>
<p>I read the post but can't say I really "got it". Didn't seem to something that had anything to do with me.. I don't really have an agenda. Some body asked about bankruptcy so I posted what I found. Again, I would not stop doing what I do as long as I can practice in a way that is consistant with my values. It's the latter that I worry about.</p>
<p>@norcalguy: I believe that Derm is probably the toughest residency to match into. Plastic surgery is generally a fellowship not a primary residency (I could be wrong). Usually people do a fellowship in plastics after finishing their residencies in surgery, ENT or Derm. So the comparison of the % of applicants that go unmatched between Derm and plastics is apple to orange.</p>
<p>Anyways, medicine is very difficult today. There are doctors (minority) still doing well, but majority are under tremendous pressure. I took my HS senior (medicine is her second career choice) to a local meeting hosted by local medical society with aids from two senators office in our state, regarding additional 15% cut in Medicare reimbursement. Several presentations were quite interesting. One presentation was from an ex-GYN/OB, who came to our state from a northern state, opened his solo-practice office, dragged his wife to his office as his volunteer to help with the office, and simply could not make ends meet (the figures he presented was $28/hour that he was making combine him and his wife after paying office staffs and other costs). After 4-years, he closed down his practice and since then has been working as a PA to a hospital surgeon (physician assistant). Another presentation was from a family practice physician, who has been practicing for about 20 years, never made more than 110K during that time. Finally, she dropped Medicare (become a non Medicare provider) and only take cash for service. She also switched her direction of practice from sick patients to healthy younger patients by doing weight control, excise, healthy eating and thing in that nature. Apparently, she is doing better now.</p>
<p>As someone else asked me, "well what do you think your kids will tell your grandkids?" I guess my response would be the same I told them.. "find a career where you will be challenged, you'll earn a decent living, you'll have the respect of your community and you can pay your bills."
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<p>Perhaps the reason the only complaints come from kids who "already have family in it" is that *those **families are the ones who *really know the situation! I know my kids' pediatrician absolutely told his kids not to enter the profession because of the changes in how he has to practice. </p>
<p>As for the advice to give kids abut careers, I also feel it may be a good idea to make kids aware of the tradeoffs and issues associated with various choices. Regarding "the respect of your community," I respect anyone who does quality honest work, whatever the job.</p>
<p>susan4, the matchlists I've been given at my interviews have always included plastic surgery, but not something like cardiology or CT surgery (which would be fellowships). I do think you can match directly into plastic surgery.</p>
<p>"I read the post but can't say I really "got it". " </p>
<p>No worries.. It's hard sometimes writing on this site to set the emotion or attitude of the words. Sometimes the written words do not reflect the feeling behind them. </p>
<p>I too, don't have an agenda. However, sometimes folks just got to realize while they have problems, their problems are after they've satisfied the needs for food, clothing, shelter that right now, alot of other people can't cover.... </p>
<p>in general,</p>
<p>I blame my mom for this attitude.. she a child of the deppression lived a much different life then we do today... she was taught as she taught me was before you complain about your life....look around at how some other folks have to live.. don't like potato and cabbage soup? Your neighbor's going to bed hungry tonight..</p>
<p>"Perhaps the reason the only complaints come from kids who "already have family in it" is that those families are the ones who really know the situation! I know my kids' pediatrician absolutely told his kids not to enter the profession because of the changes in how he has to practice. "</p>
<p>Did you miss the word compensation in my post? Changes in how one works their practice is not the same as itching about pay... you should actually have to have experienced working in a practice and been compensated for your work before you start complaining about the wage... no? ;) </p>
<p>One really shouldn't be 4-5 years away and complaining about pay before getting their first dime for that work? no? ;)</p>
<p>Well, this is a depressing thread. I have a closte relative who is an orthopedic surgeon who is also discouraged and rather bitter about medicine after 23 years in solo practice. He makes much less money than he used to and does not take Medicare patients as he loses money on those surgeries. </p>
<p>to the OP: one aspect that has not been discussed here is how hard it is to get INTO med school. Your S will have huge, huge hoops to jump through in many areas. It is MUCH more difficult and stressful than undergrad applications and less than 50 % of applicants are accepted anywhere. My D is in the midst of this. It is a awful thing to go through unless you are in the very top layer of applicants.</p>
<p>If your S does decide to pursue this, be sure to tell him to keep his grades up from the beginning. It is very important, especially in the pre-req classes.</p>
<p>Why is dermatology so selective (i.e. top 5% quoted in this thread)? Is it because it pays more? And who makes the selection - existing derm practices? Just wondering.</p>
<p>No, Opie, I did not miss the word "compensation." The issue of compensation is a major one for those in private practice today, and a major part (although not the entirety) of the "changes" in how doctors have to practice. There is more pressure to rush patients in and out, largely because of a lower level of compensation, etc. , etc. and so forth. </p>
<p>I have no ax to grind here, other than I feel bad for the many physicians with whom I deal as a consumer and whom I know as friends. They deserve better IMO. I appreciate their hard work and their challenges, and wish they were not having the rug pulled out from under them as so many are. They are put in some real binds, especially if they insist on providing quality care, despite the level of compensation. </p>
<p>Stories such as those of garland's husband are not rare today.</p>
<p>As for
[quote=Opie]
"you should actually have to have experienced working in a practice and been compensated for your work before you start complaining about the wage... no?"
Actually, I do say "No" to that. The issue of compensation of physicians (as well as the cost of educating them) should be addressed throughout our society if we wish to have enough medical providers to care for the needs of the population. I certainly would not eliminate those who are in med school (or considering it) from participating in the debate.</p>
<p>Again, I am not employed in the medical field -- although I did spend over a decade working for an insurance company in group health insurance. This simply is an issue about which I care. I see it as a good thing that your son and others are going into medicine. But I am concerned about how it will work out for them -- as well as for the rest of us -- unless significant changes are made.</p>
<p>@norcalguy, I believe you, especially you sound like a current 4th year medical student. I do know as a fact that people can specialize in plastic surgery through fellowship training. It looks like you can be a plastic surgeon through direct residency, too. If you have choices of either, I personally would prefer dermatology. Good luck with your matching. </p>
<p>@ucsd<em>ucla</em>dad, dermatology has been a prestigious specialty for long time. Dermatologists are not the highest paid, but they are doing well. The nature of the practice and the intellectually interesting contents in this specialty, combining with extensive Latin words (which are fun) could be some of the reasons (I am not a dermatologist but I do interact with dermatologists and plastic surgeons).</p>