I made a point to set myself up so that I would never be held in a career position where I would have to make those choices, but in many other fields, doctors are forced to either advocate for their patient or be safe with their employer and its often very hard to do both because doctors have a lot less power than they used to compared to corporate health care systems.
I made a point to set myself up so that I would never be held in a career position where I would have to make those choices, but in many other fields, doctors are forced to either advocate for their patient or be safe with their employer and its often very hard to do both because doctors have a lot less power than they used to compared to corporate health care systems.
It's disappointing, although not in the least surprising, that doctors don't have an organization that has advocated for their ability to practice as so many would prefer. Instead, they've passively allowed the entire system to degrade and along with it their autonomy and ability to truly serve patients. If there is such an organization it's so ineffective as to be invisible. I will never forget when, as a young teen in the 60's I asked my mom why we weren't stopping by the cashier to pay as we left the clinic. When she explained "oh, nobody pays, everybody has insurance that pays" I knew instantly what that meant - the system would inevitably be taken over by the very worst individuals, and become a corrupt mess. Why most people can't understand how a system with every incentive to raise prices and no incentive toward efficiency must fail is beyond me. High prices benefit insurance companies, that should be obvious but apparently is not.
"Why most people can't understand how a system with every incentive to raise prices and no incentive toward efficiency must fail is beyond me. High prices benefit insurance companies, that should be obvious but apparently is not."
The fact that we're forced to buy health insurance is another clue that supports what you wrote there.
There are few incentives for delivering quality care either. In fact, it often works just the opposite as we can now clearly appreciate.
Also, the freedom from liability seems to encourage sloppy or harmful work and not only that, but government funding obviously encourages a race for the bucks and the short cuts that typically entails.
The object is to do just enough to get the handouts with little regard for the results. I have a brother, an engineer, who went to Bosnia after the war, with USAID. He was (naively )concerned about quality until a superior took him aside one day and told him that the object was just to spend money. Reminds me of the shocking scandals that took place when the railroads were being built in the USA 150 years ago. Apparently the situation regarding government favoritsm, spending, and graft has only worsened since.
If we cannot abolish monster government, then we should at least abolish corporations, but I doubt that'll ever happen.
Tragically, most doctors today function as little more than hired hands but that goes as well for anyone employed by large corporations. You are smart for seeing the trap and having the guts to avoid it.
It's really sad to think of how many years and how much effort docs have invested to secure their own slavery.
Just as the military seems to be finding it difficult to find good people, medicine will increasingly find that to be true as well. Part of the problem is that the quality of our journalists and politicians has been in a tailspin for decades too.
they get kick backs from pharma. Either in the form of vacations, parties or free fancy dinners. I know this.
So, if you are a doc in a "group", you might be able to decide how to treat your patients conservatively, or you might give in to the pressure of offering a new med that is horribly expensive but "we can give you a coupon". pharma needs people taking meds, Not old meds, new meds
I made a point to set myself up so that I would never be held in a career position where I would have to make those choices, but in many other fields, doctors are forced to either advocate for their patient or be safe with their employer and its often very hard to do both because doctors have a lot less power than they used to compared to corporate health care systems.
It's disappointing, although not in the least surprising, that doctors don't have an organization that has advocated for their ability to practice as so many would prefer. Instead, they've passively allowed the entire system to degrade and along with it their autonomy and ability to truly serve patients. If there is such an organization it's so ineffective as to be invisible. I will never forget when, as a young teen in the 60's I asked my mom why we weren't stopping by the cashier to pay as we left the clinic. When she explained "oh, nobody pays, everybody has insurance that pays" I knew instantly what that meant - the system would inevitably be taken over by the very worst individuals, and become a corrupt mess. Why most people can't understand how a system with every incentive to raise prices and no incentive toward efficiency must fail is beyond me. High prices benefit insurance companies, that should be obvious but apparently is not.
Great comment.
"Why most people can't understand how a system with every incentive to raise prices and no incentive toward efficiency must fail is beyond me. High prices benefit insurance companies, that should be obvious but apparently is not."
The fact that we're forced to buy health insurance is another clue that supports what you wrote there.
There are few incentives for delivering quality care either. In fact, it often works just the opposite as we can now clearly appreciate.
Also, the freedom from liability seems to encourage sloppy or harmful work and not only that, but government funding obviously encourages a race for the bucks and the short cuts that typically entails.
The object is to do just enough to get the handouts with little regard for the results. I have a brother, an engineer, who went to Bosnia after the war, with USAID. He was (naively )concerned about quality until a superior took him aside one day and told him that the object was just to spend money. Reminds me of the shocking scandals that took place when the railroads were being built in the USA 150 years ago. Apparently the situation regarding government favoritsm, spending, and graft has only worsened since.
If we cannot abolish monster government, then we should at least abolish corporations, but I doubt that'll ever happen.
Tragically, most doctors today function as little more than hired hands but that goes as well for anyone employed by large corporations. You are smart for seeing the trap and having the guts to avoid it.
It's really sad to think of how many years and how much effort docs have invested to secure their own slavery.
Just as the military seems to be finding it difficult to find good people, medicine will increasingly find that to be true as well. Part of the problem is that the quality of our journalists and politicians has been in a tailspin for decades too.
they get kick backs from pharma. Either in the form of vacations, parties or free fancy dinners. I know this.
So, if you are a doc in a "group", you might be able to decide how to treat your patients conservatively, or you might give in to the pressure of offering a new med that is horribly expensive but "we can give you a coupon". pharma needs people taking meds, Not old meds, new meds
By design. Saw it coming when managed care took hold.