October 1st, 2010 by KevinMD in Better Health Network, Health Policy, News, Opinion
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The average medical school debt today, according to the Association of American Medical Colleges, is $156,456.
The United States is the only country in the world were future doctors have to bear such a financial burden of their education. That places significant strain on any relationship involving an American medical student.
Recently, there was an interesting piece in the New York Times discussing this very issue. The article profiled a female medical student who had amassed $250,000 of school debt:
Still, if she and [her boyfriend] Mr. Kogler are going to move in together and get engaged, she wants their financial arrangements to be clear and fair. But how do you define fair when you’re bringing a quarter of a million dollars in debt to a relationship?
Indeed. It’s an issue that’s rarely discussed, yet frequently encountered by medical students. With that degree of debt, there is little room for flexibility should one’s future plans change. You have to continue working to pay off the loan. Read more »
*This blog post was originally published at KevinMD.com*
September 10th, 2010 by John Mandrola, M.D. in Better Health Network, Health Policy, News, Opinion, True Stories
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“Ouch! That really hurts! You win, please stop torquing my arm behind my back. “Uncle! I said, Uncle!!”
Yes, the threshold has been reached. We docs no longer need a tennis court or a Mercedes, our kids are fine in public schools, and we will happily buy our own damn pens.
But, please, just give us some modicum of autonomy. Throw us a measly scrap and let us take care of our patients as we see best. Like Dr. Saul Greenfield so beautifully said today in the Wall Street Journal. The paragraph that stood out the most for me is as follows:
Physician autonomy is a major defense against those who comfortably sit in remote offices and make calculations based on concerns other than an individual patient’s welfare. Uniformity of practice is a nonsensical goal that fails to allow for differing expression of disease states.
Really, it isn’t hyperbole to surmise that the overwhelming majority of doctors would decide, if faced with a choice between less compensation and less autonomy, to choose less compensation.
As a teen my dad told me the best part of being a doctor would be the autonomy. He was right, and that’s what hurts the most these days.
JMM
*This blog post was originally published at Dr John M*
July 28th, 2010 by StevenWilkinsMPH in Better Health Network, Health Policy, Opinion, Research
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I often hear from physicians that they would do a better job communicating with patients if they were adequately reimbursed for the time it took to do so. Given that certain types of physician-patient communications (patient education, care planning, etc.) can have quantifiable, therapeutic benefits for patients, I can see their point.
I have no problem with physicians asking to be adequately reimbursed for services they provide, as long as they are high quality and add value. For example, teaching chronic disease patients how to care for themselves at home takes time and is critical to effective patient self care. In this role, physicians are called upon to be a provider of necessary information as well as a coach to encourage and support patients.
But as evidence suggests, many physicians don’t communicate effectively enough with patients, chronic or otherwise, to seem to merit additional reimbursement. Read more »
*This blog post was originally published at Mind The Gap*
June 2nd, 2010 by RyanDuBosar in Better Health Network, Health Policy, News, Opinion
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The American Medical Association will launch a multi-million-dollar ad campaign tomorrow to heighten pressure on Congress for a doc-fix bill. The American College of Physicians (ACP) reacted by calling for doctors to contact their member of Congress directly to let their voices be heard. Robert Centor, FACP, called for doctors to protest as well. (American Medical Association, American College of Physicians, DB’s Rants)
Meanwhile, a Florida medical society predicts a crisis in that senior-laden state. The society cited but did not name eight primary care doctors who’ve stopped accepting Medicare patients this year, and 12 cardiologists who left private practice for employment elsewhere because of already reduced payments. Unbelievably, business columnist Steven Pearlstein sorted through the issues around the doc fix, and concluded that it’s the docs that need fixing for paying themselves generous salaries. (Naples News, The Washington Post) Read more »
*This blog post was originally published at ACP Internist*
May 26th, 2010 by KevinMD in Better Health Network, Health Policy, Opinion
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Much has been recently made about the bureaucratic obstacles that primary care doctors face. With good reason. The impetus was a recent New England Journal of Medicine paper from Richard J. Baron that I mentioned recently.
The New York Times’ Pauline Chen interviewed Dr. Baron, who shared some interesting insights on what needs to be done. He contrasts the inertia in primary care to drug manufacturing.
If you took the resources that went into drug development, for instance, “and put them into a program like this that achieves meaningful levels of behavior change, a lot more patients could be better off.” In other words, research into new primary care models isn’t taking off because the money isn’t there.
But Dr. Baron also notes that money isn’t everything, since “primary care practitioners have been saying that we either already do or would do certain things if you paid us more. It’s true that you can’t do things consistently, reliably and across scales without additional payment. But payment is not enough. People have to change what they are thinking about when they go to work.” Read more »
*This blog post was originally published at KevinMD.com*
