On Educating Doctors

I’ve spent a lot of time recently with doctors. And I’m fed up with their babble about “socialism” taking over. My theory: Insurance and drug companies fill their heads with propaganda. I don’t argue. Why do that with someone whose skill you’re depending upon for health care. But maybe patients should argue. Liberals and Democrats ought to find a way to persuade these otherwise intelligent beings that government is not their enemy, that insurance and drug industry flaks filling their heads with nonsense are more to blame. So that they don’t pass on this bullshit to their patients.

Doctors Without Borders

82 thoughts on “On Educating Doctors”

  1. Craig… my doctor is a woman. When she opens the door to the exam room where I’m sitting, she always says “well, hello, hello, how are you Renee”.

    I was there about 5 weeks after the election for my regular diabetic checkup. I responded with “feeling great… I’m so happy the election went the way it did both nationally and statewide. She gave me this big grin and said, “me too”.

    I’ve heard many women doctors on NPR state that the system needs changing. So I guess the moral of this tale is… we need more women doctors…

  2. Doctors… they’re enough to make you want to take a turn for the nurse.

  3. CBob…
    I love Retired Physicist. I’ve been following his stuff too for a little while.

    Good on him for marching on DC.

    And I agree with the spitballing…. Craig is too talented to just waste his time sitting on the sidelines.

  4. Since Britain “nationalized” healthcare after WWII, doctors in the USA have been whining about “socialized medicine.” Why? Because it would result in poorer healthcare? No. Because it would reduce their very high incomes.

    Why do college students choose medicine as a career? While a few honestly want to help people, the majority of medical students are after the money. The average MD in the USA today makes about $300,000.

    Now the MDs are whining because the insurance corporations are taking over the healthcare system and, eventually, the corporations will turn the MDs into lower-salaried hired help.

    If you want to fix healthcare, start by not listening to MDs or insurance corporations. Their only motivation (regardless of what they say) is profit.

    THAT is why we have 50 million people in the USA today with no access to healthcare.

  5. Craig,
    A great subject matter.

    My good friend, Carol, says that a doctor is actually your ‘consultant’.

    I’ve just noticed that they are often in a hurry, because a general practitioner has to see a high quota of patients in a day just to make enough money.

    So, Nash… although some doctors (I think mostly specialists) are well paid, others are not. Blue Cross is worse than the government medical insurance for cutting their prices. The doctors have to take the discount price they offer in order to get their business.

    It’s the insurance companies that are getting rich…. IMO.

  6. They liked all that socialism stuff well enough when they were borrowing government money to pay for med school.

    Go figure?

  7. Why is it that dentists choose to have some of their most interesting conversations when both he and the hygienist have their hands in your mouth?

    My pithy replies always get lost in the ordinance. 😉

  8. socialism from the fire department is one thing….quite another when the poor folks get some government cheese.

    –bongo seville

  9. My fellow New Mexican states

    Doctors… they’re enough to make you want to take a turn for the nurse.

    My friend is a nurse practitioner as is CT. I have seen many a NP for medical care (doc in the box on the corner) and they are carrying a huge load in the health care attempt.

    The NP doesn’t have the same bad attitude as the docs!

  10. Doctors should make a lot of money. It’s paper-shufflers and middle-men that shouldn’t.

  11. And I read the other day that a retired couple spends over $220K in retirement for medical care. Most humans think Medicare is FREE like the can’ts tell us? I have had doctors accuse me of wanting everything for nothing. Yet, in reality, I have been buying health insurance since 1975. I have spent tens of thousands in the industry for basic care. So, when the doctor’s staff continues to charge for report that I have already paid for, it is ludicrous.

    My republican-lite doc thinks the new paperwork pushers at the office are the new ‘WPA.’ I have watched one eye doctor struggle with electronic records…still cranky after two years. I think he needs counseling or one of the fifty staff upfront can type his notes for him! I always ask for a copy of the notes…you should see what your doc says about you! It appears many doctors tire of humans.

    Universal, single payer would correct this mess, once and for all.

  12. By the year 2025, every American will work for healthcare insurers, to pay for their health insurance.

  13. “Berkshire Hathaway, 3G Capital to buy Heinz for $23 billion cash”

    Now, our Secretary of State can afford to take Vlad out for a nice dinner, and talk about some things.

  14. champ, nice Valentine’s Day song. we never know what to do for the occasion. this year we decided to pay off an old gnarly credit card bill today.

  15. Blondie, nurses are educated differently than physicians. We had a lot of education re: health, not just pathology. I think that we are more holistic. We also had education, how to teach, as part of curriculum. Not all nurse will become NPs. Even NPs didn’t always have the ability to write prescriptions. That was a good thing. Drugs aren’t always the answer but they are easier and faster. Now that we do have prescriptive authority, I see many NPs who are trying to mimic physicians. That makes me sad.

    I do want to point out one thing. It’s often the patient who encourages medical practitioners to practice bad medicine. Over the years, I’ve watched young docs start their practices with high ideals. They try to do things differently but if they want to stay in business, they have to please their patients. Patients want drugs, whether they are good for them or not. Even TV commercials tell you what to go in asking for.

    You ought to try to convince a patient that they don’t need an antibiotic, even patients who are intelligent and have a medical background. You are very likely to lose a patient. Medicine is a business. One reason that so many antibiotics have lost their efficacy is because of prescribing them when they aren’t needed. That has become a serious problem but patients demand it.

    I found one way to handle that problem. I tell the patient or the parents of a child who is my patient, that I don’t think that an antibiotic is needed. I tell them why. I take the time to educate but I tell them that I will put one on hold at the pharmacy. If the symptoms don’t resolve or get worse, they can get it filled. They won’t have to come back to pay for another visit and I cover my ass for liability. Medical malpractice is another thing that gets in the way of practicing good medicine.

  16. Yep…although my health care attempt throughout my life has been continuous, I must start over every year with an insurance company. What a racket. Can we get them on RICO? I am not born anew each year and I carry my flaw map and problems into each year. I believe in preventative health care, but we are human. We need maintenance. How offensive to pretend you are ‘new’ each year with ‘what’ the gambling casino calls health insurance? If the docs and the insurance companies would spend as much time on patients instead of billing and tiers of treatments, maybe we could join the rest of the world in providing health care…not stress to our patients.

  17. Wait, let me correct an earlier post of mine: Nurses should make a lot of money, they do all the work.

    Have a good day, glad you enjoyed the song, Mr. C.

  18. Thank you, CT. I think what you have done and do for humans is outstanding!

    I like working with a NP…they listen. They have knowledge that is invaluable to the system. Plus, many have years of experience.

    The medical community is becoming more specialized and an NP will always be there for the common ailments.

  19. CT, i get ear infections 1-2 times a year, usually in the summer (altho not last year) and all i want is cipro on a phone call, and my ear doctor’s aide obliges. never even considered alternatives, but now you’ve got me thinking

  20. Champ…I used to have a saying —

    Women run the world, but men take all the credit.

    With a little substitution —

    Nurses run the care, but the docs take all the credit and most of the money.

  21. Thank you for including the link to Doctors Without Borders. These men and women go to places where no one else will,to provide care and simple human decency to our fellow man. A number of these health care heroes end up paying the ultimate price for their actions.
    Before the holidays we mentioned our favorite causes & charities; I remember many were those that provided care and comfort to our brothers and sisters. I would like to mention my favorite again:
    The National Association of Free and Charitable Clinics. They can be contacted at http://www.nafcclinics.org ; or write to:
    1800 Diagonal Road
    Suite 600
    Alexandria, VA 22314

    Thanks to all for putting people ahead of money and social status.

  22. about doctor pay, i’ve been thinking about how automobiles are getting so complicated that mechanics will need PHDs in computer science and one day make more money than doctors

  23. Craig…IF wax is causing water problems and infection in your ears — check Amazon for an ear vacuum. And I have had an nurse put children’s liquid stool softener in my ears and used a syringe to extract wax. A lot cheaper and healthier than antibiotics.

  24. Doctors are like really bad consultants — only interested in their own opinions

    And more often wrong then right — as for patients asking for drugs — why not? That is now the role of the physician

    I’d also like to give a should out to Physicians Assistants

  25. If can’t advocate for yourself and don’t have someone to do it for you — your doctor will accidentally kill you

    When Mr. Cracker has a stroke last year,since he is a member of an HMO and was being cared for in the HMO facilities one would think there was immediate access to records. He was prescribed drugs he didn’t need which carried serious side effects.

    Although this was later straightened out, his own physician who was involved in clarifying which drugs were necessary had never bothered to update the records

    Not only are we paying a lot — but actual medical care is a crapshoot

    I am related to an md and she is different but then she is currently studying sandscript and aryuvedic medicine

  26. 3 Systems of Healthcare

    (1) British system: govt owns hospitals, all MDs are govt employees on salary. Also called “socialized” medicine.

    (2) Canadian system: govt pays all bills, but hospitals private non-profits. Also called the “single payer” system.

    (3) U.S. system: hospitals are non-profits or “for-profits,” most MDs are self-employed small business owners or members of for-profit partnerships, payments are made by private for-profit insurance companies, and by government for Medicare & Medicaid, military & govt employees. 50 million citizens have no health insurance, and limited access to care which equates to “3rd world” conditions. U.S. has the HIGHEST healthcare costs in the world, but the QUALITY of care is ranked #17.

    Why is the U.S. system so dysfunctional? Because it incorporates so many elements whose only motivation is “profit.” Most nations have abandoned the notion of a “market-based” healthcare system, but the USA clings to it, because the for-profit entities have many lobbyists and make huge campaign donations to both parties, effectively blocking change.

    Don’t expect anything to change soon. Obama is as much a part of the current system as any DC politician and his “reforms” are trivial.

  27. I’d have to know more about your ear infection, whether it is a middle ear or an ear canal infection.

  28. Prescription drugs and inappropriate or incorrect use of them are a serious cause of death and disability. Google that.

  29. In 2016 Hillary should run on “Medicare for all,” which would be essentially the Canadian single-payer system.

    If the USA is really turning to the left after 30 years of conservatism, this could be the centerpiece of a winning strategy.

  30. The doctor’s office does less these days and wants to charge more…need a vaccine? Take your script to the pharmacy. They are the new ‘shooting parlors’ in America.

    I really do blame insurance, drug companies…their reps have been giving wonderful gifts to doctors for years…trips, tv’s, free pills. Practicing medicine via the best gifts.

  31. “If can’t advocate for yourself and don’t have someone to do it for you — your doctor will accidentally kill you”

    Damn straight there KGC. Usually, not on purpose.

  32. Craig

    Have you ever considered having tubes put in your ears — this has been successful with some children (and pets) with chronic ear issues -it more or less straightens out the ear canal and avoids the pockets where the infections usually never quite get cleared up

  33. It’s very scary that many docs do get their main drug education from the drug reps. And you are correct about the other Blondi.

    Many physician’s offices have tons of food brought in every day by the drug reps.

    Since I worked for corrections, and was stuck with a strict formulary, that I actually created myself based on most efficacious and cost effective drugs, I wasn’t popular with the drug reps.

    The only time I had some popularity was when I was a diabetes educator. One company took me on a bass fishing trip. It was local. Best fishing I’ve even experienced but I had to catch and release, dang it. Those were to good old days. Didn’t influence me though. I didn’t even like that companies drugs. LOL. Didn’t tell the rep though.

    When I worked private practice for a while, before Medicare drug program, I had this poor old lady come in taking about a dozen drugs that totaled more than 1000 bucks a month. She had a 600 buck SS check. She was taking only a couple of those drugs each month and would rotate those. You would have thought that her last doc would have checked into that. Nope. I spent hours trying to find something she could afford that were similar. I called a local pharmacy to help me. The pharmacist didn’t have the time. Fortunately the money I lost with all the time I took to help her didn’t come out of my pocket. The NP I worked for was good. The docs in her town were trying to put her out of business because she had the nerve to try and open her own office. They finally did.

  34. tubes in my ears as a child probably damaged an ear drum, according to my current ear doctor. and several attempts at patches didn’t take. there is outpatient surgery for it but i don’t do surgeries i don’t absolutely need. in the past year and a half taking care to keep that ear dry has so far done the trick, no infections.

  35. of course i’ve always liked to joke that it was a hazard of punditry, sticking those ear pieces full of germs in there so much. my ear doctor didn’t rule that out, said i should get my own and not use that — but, like sunglasses, i keep losing them

    ok that’s enough, i didn’t mean for this to be Craig’s Ear Thread

  36. To the horror of my PCP, I use the internet for medical advice, definitions, etc.

    When I broke my foot, I had economy insurance and my out-of-pocket was $250. for cast, wraps and x-rays. When released, I was not given any physical therapy. I had that phat phoot pheeling around the toes…instead I went online and found a series of exercises, advice, etc. from other humans who also were ‘let loose’ without follow-up care as to how to walk again.

  37. And Chloe is right. Your doctors are your consultants. You hired them but don’t fire them just because they won’t do what you want when what you want may not be what you need. That’s what is hard to determine. The Internet can be a very good reference.

  38. this story looks like a big mess to me, but indicative of the frenzy over HRC — claims that Bill told a wealthy donor she is running, but then the donor’s spokesperson backs off, everybody runs for cover

  39. i get ear infections 1-2 times a year, usually in the summer (altho not last year

    craig, before anymore meds or tubes or going under the knife, don your sherlock hat call in dr. watson and investigate what happened differently this past summer. it may be an avoidable allergy. and avoidable doctor and pharmacy bills.

  40. I know one doc who bitches about socialized medicine. He’s a people butcher in Twin Falls, ID. He claims the County often calls him in to resect people, but he doesn’t complain about that.

    The rest of the docs I know work for the University of MN or for profit ‘HMOs’. These docs are just glad to be paid regularly, dependably, and at the agreed upon salary.

    The U of M has one of the most highly rated medical schools/hospitals on earth. Because it is owned by the state has to be considered socialist. I never heard a U of M doctor complain about the pay, the work load, or the working conditions.

    Doctors’ big gripe ought to be the insurance companies that often announce they decline to pay, but wait for 3 – 4 months after the event to do so. On the occasions when insurancce companies deign to pay for something, it’s six months down the road.

  41. Really have loved reading this thread.

    Nash, I learned a lot in reading your 10:47 post.

    … and, Craig…. thanks for letting us know about Hillary’s new website. Just the thought that there’s a possibility, a slight hope of her running in ’16 is almost too exciting to even think about.

  42. Re ear aches,

    A. In most cases wax can be melted and drained through the use of warmed mineral oil administered by an eye dropper.

    This failing, a warm water lavage, as from shower wand, can eventually melt and clear the waxy mass.

    B. The intake of milk, ice cream, and cheese dramatically increases the likelihood that the subject will get ear aches.

    When subject xrepublican quit drinking milk, and eating ice cream and cheese, to ease his nightly stomach distress he also stopped experiencing the annual, (or sometimes twice annual) earache. He is now in his 26th year of earache-free living, following 40 consecutive years of earaches.

  43. Interesting development concerning Secretary Clinton. I want her to be healthy and happy first, but will always hope she runs. I can’t think of a better person qualified to be President. Most importantly, her heart and priorities are in the right place. Being a Mom gives her a unique perspective on what really matters in life.

    ct, I wish healthcare professionals like you had taken care of my mother 30 yrs ago. You represent the kind of person who will always be needed to have the intelligence to figure out the problem and know when to administer the human touch when it is needed. Sometimes just caring is the best medicine of all. Kudos.

  44. Greetings from the desert. Medicare for all with docs as government employees at a good salary working in non-profit facilities. And, not just the 80% medicare pays for but the whole bill. One of the overlooked aspects of the health care debate was not addressing the 20% gap faced by those on medicare only allowing the insurance industry with advantage and supplement policies to make big bucks. Happy Valentine’s Day everyone!

  45. Getting tubes installed is an extreme remedy for a once or twice per year earache.

    You needn’t re-plumb your skull when ciproflaxin, abstention from milk solids, or ear lavage will easily remedy the problem.

  46. Making all docs government employees seems overboard to me.

    I’d go for a single payor (Canadian) style system instead of a wholly-owned (British) style system.

  47. Since we’re on medicine and medical procedures, did any of you watch the video from Dr. Eric Topol on NBC Rock Center I posted? The smart phone could unlock many medical procedures that then can be transmitted to your doctor in advance of any office visits. I see my GP on the 4th and the first question I’m going to ask him is are you familiar with Dr. Topol’s iPhone applications? I want to unlock the power of new technology to medical processes. If not, I’m going to show him and if he’s not interested I’ll look for another doctor. Google Dr. Eric Topol if you’re not familiar with him and his research into this exciting field of medicine.

  48. i talked to one doctor who doesn’t take medicare but does take medicare-advantage plans even though they pay the same rates. he said the difference is the insurance companies pay him within a few weeks, but that medicare takes 6-8 months to pay. i can understand how that would be a problem if that’s common, and one you’d think medicare could fix, so that more doctors would accept medicare-only patients

  49. and eprof, on using technology, how about a simple thing like portable medical history forms so that you don’t have to fill out a new one every time you see a specialist or whatever

  50. OK, now I’m settled into my warm chair at Owl camp, named by C-Bob. We can get to your ear infections Craig. From what you have said, it’s hard to tell if it’s a middle ear, otitis media, or a canal infection, otitis externa. Sounds like both have been an issue in the past. Also sounds like you have a permenantly perforated ear drum. That’s a problem because what you could do to help reduce canal infections would be contraindicated with a perforated ear drum. Yes, the best thing is to keep those canals dry but don’t keep plugs in them for long. That keeps them damp and a warm. A dark, warm and damp place is a perfect environment for shit to grow. Shit is not the technical term for what is growing but it works. Maybe I should use the term organisms. Remember, I worked in corrections for a long time and I had to adapt my vocabulary to what most of the residents there understood. Now, it’s kinda hard to change back.

  51. ct, your advice is spot on based on all that i’ve learned about it. like i say there’s a skin graft procedure to rebuild the drum but it doesn’t bother me enough to go through that. about a 10-15 percent loss of hearing in that ear but i kinda like that. when i don’t want to hear somebody i just turn that ear toward them. and if i sleep on the good ear i’m less likely to be awakened by the 6am dump trucks in my neighborhood

  52. Don’t put anything into a ear canal when you have a perforated ear drum unless it’s specially an antibiotic drop than can go behind the ear drum. Not all ear drops can.

  53. I just got back from Rick taking me to our favorite Italian restaurant. I had pumpkin mascarpone and honey filled raviolis with toasted pine nuts and golden raisins in a brown butter sage sauce. It was to die for! But now I’m stuffed…. burp.

  54. dex, and if not, there’s always the trail to help us make it thru the night


  55. My opinion of doctors and their billing ways fluctuated a lot over the years of Mom’s illness. Myself, I prefer NPs–

    Having said which, though, I’ve spent the PM writing about Al Capone– 😉

  56. As the resident Crawfordite living under the dreaded socialist medicine, this thread has had me remembering what it was like when our gov’t was planning/announcing/passing the Medicare for All legislation. Insurance companies bemoaned it (and still do), doctors went ON STRIKE, opposition (read Conservative) party said it’d all end in tears and death, and yet the gov’t held firm, continued through three readings of the bill and passed it in 1964. If you’re interested, I’ve linked to the wiki page all about health care in Canada. All in all, a fabulous system whereby if you need medical care, all you need to have is a specialized health card. http:en.wikipedia.org/wiki/Health_care_in_Canada

  57. My NPR is a woman and I get better care from her than I have gotten from a doctor in the past 40 years.

    And for those cuddling closely tonight:



  58. It’s always been my dream for NPs to take over primary care and leave specialty medicine for the physicians. Not likely to happen. And I don’t want NPs to turn into junior doctors. I want them to continue to keep what is special about nursing.

  59. I’m proud and pleased to see that many of you have experienced what is special about nurses. I hope we can all live up to your expectations.

  60. Note to Harry Reid.

    How’s that hand shake thingy working for you?

    Tip: Next time you get screwed, at least demand a kiss.

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