“I’m a Medicare Doc- Here’s What I Make”

March 4, 2010 5 comments

  

      Every year, physicans across the United States tremble at the thought of having their medicare/medicaid reimbursements slashed.  However for the first time, the guillotine began to fall on  March 1st.    This deadline came and went without reversing these cuts (there has now been another temporary extension till the end of the month from what I undersand).  If we have come this close to getting the axe, it is only a matter of time before these devastating cuts go through for good.  Check out this must read article from today’s CNNMoney and you will easily see how damaging this situation will be.   Because fixed costs (office rent, payroll, malpractice insurance, medical supplies, etc.) do not decrease in tandem with medicare reimbursement, a 21% drop in Medicare pay means the physician will be losing A LOT MORE.   For example, say a practice nets 500K a year but pays out 350K for overhead costs. That leaves 150K net pay. But with a 21% drop in reimbursement from Medicare (and I am making the valid assumption that private HMO’s will similarly follow these cuts), the gross revenue from your practice is now down to 400K leaving you with a whopping 50K a year in pay!  Good luck paying back your 250K student loan debt on that while working like a racehorse 60 hrs a week not being able to take a vacation!  As you can clearly see, one must magnify every percentage drop in reimbursement many times over to see the damaging end result.

        My advice to any high school student that happens to come across this blog is to THINK TWICE BEFORE GOING DOWN THE LONG ROAD TO BECOMING A PHYSICIAN!  Unless your conviction is as strong as that of Mother Theresa’s and you are willing to take on a vow of poverty, you really should consider doing anything else that you may have the slightest thread of interest in.  If you love art, become an artist.   If you enjoy children, teach kindergarten.  If you like cars, become a mechanic.   Besides, you will probably wind up making the same or even more in these careers down the road without any of the debt.  Medicine has gotten worse for sure but I am outright frightened to see what the landscape will be like in another 10 years.  You see the arrow at the top of this posting?  That is exactly where we continue to be heading with NO RELIEF in sight.  Ask yourself this.  Will tuitions ever decrease?   Will medicare and HMO’s ever increase their reimbursements?   Does the US govt get anything done nowadays to better the lives of their citizens aside from endless quarreling?  No, no, and no….point made, case closed.

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Bronx Woman Gets $60 MILLION for VAGINA Injury

February 17, 2010 8 comments

        Actually, the labia to be more precise.  According to this article 60,000,000 US Dollars (Yes, MILLION) were awarded by a Bronx jury to Ms. Alison Hugh this week after she sustained an injury to the involved private after going for a cosmetic thigh lift procedure. 

        If this particlar case does not scream TORT REFORM, quite frankly I don’t know what does.  You would think for 60 million that she lost 2 arms, 2 legs, an ear, and an eyeball.  This is even above and beyond brain damaged baby territory.  Here we have a clear cut example of how runaway juries can dole out valuable healthcare dollars like monopoly money and why ambulance chasing lawyers are so eager to play the healthcare lotto.  What I find even more shocking than the jury award is the fact that I would never have known about this case if it weren’t for the above lone article.  Apparently, exorbitant malpractice awards have become so matter of fact that they rarely even make the headlines anymore.  Meanwhile, healthcare costs continue to rally upwards as physicians pay ever mounting malpractice premiums and order more needless tests to rule out that needle in a haystack.   In the end, we all wind up paying for this woman’s almighty precious labia.

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Millionaire Gives Away ALL His Money

February 10, 2010 5 comments

        Check out this story of Austrian millionaire, Karl Rabeder, who is giving away every penny he ever earned in his lifetime. Mr. Rabeder states that “My idea is to have nothing left. Absolutely nothing.” He plans on raffling off his £1.4 million villa in the Alps and £613,000 farmhouse in Provence and giving all the proceeds to charities in Latin America. He will then downgrade to a simpler existence by moving into a “small wooden hut in the mountains” or a “small bedsit in Innsbruck”. I was particularly struck by his following comment, “More and more I heard the words: ‘Stop what you are doing now – all this luxury and consumerism – and start your real life. I had the feeling I was working as a slave for things that I did not wish for or need.” I have the feeling that there are lot of people doing the same thing.”
        I must say that this story really hit home with me. Like so many other Americans, I confess to being bound to the gravely mistaken belief that by working oneself to the bone one is able to accumulate wealth and happiness will ensue. However, after toiling away in a career that continues to shred me apart from the inside out, I realize more and more how trading one’s valuable time in exchange for money to buy STUFF is one BUM deal. This becomes even more apparent when you find yourself working 60-70 stressful hrs a week in a job that you don’t particularly enjoy. Part of the reason why I have become so tight with money is because I realize how painful it is to make. Is that Mocha Frappuccino really worth the one hour of torture I had to endure in the hospital? Let’s take it up a notch. Can I make do with a perfectly reliable Honda Accord versus BMW saving me 20K which will spare me 10 hours of hospital waterboard torture per week for a whole year? Let’s go even further. If I am willing to embrace simple living, could I possibly transition from a highly toxic career to one with less hours that is infinitely more enjoyable? Or perhaps even, if I can keep my expenses low enough could I even retire for good? Not possible you say? Well here’s one guy who has done it at the early age of 31 www.earlyretirementextreme.com
        I often wonder why it is that we lust after things made by man while what God has given us is not fully appreciated. No amount of money can buy a walk along the beach on a cool crisp September morning while the sun begins to peak over the horizon or the experience of trying to find the Big Dipper with your kids as you lay on the grass in the backyard gazing in awe at the darkness of the night sky. However, you would be too busy at work to even take notice of such things. Happiness is right before you but you don’t have time or the clarity of mind to see it. Society commends us for working like slavehorses so we can buy “things” to show off to others or to give us a quick fix to feel better about ourselves. I, on the other hand, now see this way of living as outright asinine. Instead, I’ll take having the freedom to do whatever I please with my time.  Now that’s priceless!

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Pic of the Year!

February 7, 2010 9 comments

CRNA SMILING WHILE PATIENT CIRCLES THE TOILET

I nominate Coastie, from the SDN forums, a Pulitzer Prize for this find! The CRNA smiling without a care in the world while the patient’s blood pressure reads 76/35 is ……well……uh…..(can anyone think of a word that encompasses the thoughts of shocking, hilarious, outrageous and disbelief all rolled in one?!)

CRNA Retires After 40 Years

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If Air Travel Worked Like Health Care

February 4, 2010 Leave a comment

IF AIR TRAVEL WORKED LIKE HEALTH CARE

there would be 757’s falling out of the sky like dead flies (assuming they even made it off the ground). The crushing bureaucratic BS that medicine has morphed into this nation is enough to make oneself buy a one way ticket to the insane asylum. If you took all the paperwork that I wrote during my internship alone, I am sure it would easily top the 560,000 words in Leo Tolstoy’s War and Peace. Makes going to work everyday just that much more pleasurable.

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ER Resident Posts Cadaver on Facebook

February 2, 2010 4 comments

and is now in SERIOUS hot water (now being investigated by state health dept and her ER residency at Stony Brook University Hospital on Long Island where she is a PGY2 is now on the line). The above photo which was taken by this resident of a fellow medical student (who could also find himself on the chopping block …Thanks for the tag!) is apparently now going viral and can easily be found online with a simple google search. Now whenever this particular resident googles her name, hundreds of hits involving this incident will pop up for posterity! You know future employers are going to love that! I wouldn’t be surprised if this story winds up on the front page of yahoo real soon. To those on the outside of medicine, this pic of a medical student giving two thumbs up in the presence of a cadaver could be erroneously seen as being as sensational as those involving the prison wardens of Abu Ghraib.

You can read more of the lurid details here 

Looks like one of her facebook “frenemies” turned her in. Reminds me of the story I posted sometime back about the chief surgical resident in Arizona who got expelled from residency after taking a pic of his patient’s hot rod penis on his phone cam and was allegedly snitched out by one of the OR nurses (according to a source). In the cut throat world of medicine this does not surprise me in the least.

Why is photography even permitted in the gross anatomy lab in the first place with cadavers all over the place??? This is 2010 and we now live in the digital age. I’m sorry but this resident is so screwed. She would have been better off having a secret sex tape leaked involving her than this. Don’t laugh. I am sure if given the choice she would agree with me and you would too!

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MD Underground

January 20, 2010 2 comments

Thanks to www.jdunderground.com and the suggestion of others in the medical community, I have been inspired to start the medical version- www.qfora.com/mdunderground/ .  Since medicine is going to hell in a handbasket, I strongly feel we need a forum of our own. The starting of this forum is even more imperative since SDN (Student Doctor Network) has been undergoing a recent Chinese crackdown where more vocal members have been threatened and outright banned for speaking the truth on the harsh realities of pursuing a career in medicine. Numerous threads have also been moved, locked, and outright shut down. I welcome you to the break away republic of  mdunderground where the truth shall finally prevail over censorship.  Please please please contribute to ensure it’s success so we can get it off the ground!  Registering takes two seconds and you can be posting right away.

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Thoughts on Sicko

January 17, 2010 2 comments

        Thanks to www.tiphero.com, I learned of a website where you can watch some of your favorite documentaries for free at freedocumentaries.org. Much to my pleasant surprise, Michael Moore’s Sicko was one of the featured films on the front page. Being that I never got the chance to watch Sicko and had a dreary Sunday afternoon to kill some time, I thought this was the perfect opportunity to view this film. Let’s just say that all my feelings of angst regarding our broken healthcare system have been reaffirmed.
        The gripping stories of typical Americans are real and their wrenching testimonies can not be discounted. Juxtaposing our system to those of Canada, the UK, France, and gasp …Cuba, only accentuates the needless absurdity that ours has become. Only in America would a for profit model like this be ever be introduced in the first place. The HMO’s are no different from the big banks in this country who have bought out Congress to further their own domination. They are an unnecessary parasite who have siphoned off billions of healthcare dollars that should’ve gone to the sick. Think of the number of cancer treatments, organ transplants, or preventive healthcare checkups that could be payed for by just one HMO CEO’s salary? Before this whole health reform got underway, I could’ve told you that not in a million years would we have one govt run system. Seriously, what would happen to the HMO’s? Did we honestly think that they would just disappear overnight without a fight? Instead, they are fighting tooth over nail to rid the govt option which is on it’s death bed right now.
        There are many doctors who despise Obama’s quest to reform healthcare. They feel that their salaries will plunge only further. Medicare and medicaid is run by government and their reimbursements are ABYSMAL. I fully understand this opposition. Some also don’t trust our government since they have a history of bungling everything up. One only need to be reminded of the Katrina disaster to see this. So what is the solution??? Since American medicine has turned into one really bad game of Jenga, I believe that the whole system needs to be bulldozed and restarted from the ground up. Medical school tuitions need to be reset to zero and those with current student loan balances should have them forgiven. HMO’s would be rid off the face of the earth for eternity. Salaries should be set at a level appropriate and commensurate for the level of training required to become a doctor  (meaning NO medicare pittance rates).  Tort reform would be mandated. 99 year olds would be allowed to die with dignity instead of languishing in ICU’s at 10K a day because daughter Sally demands it. Taxes would obviously have to be raised (sorry millionaires, but you will just have to cut back a mansion or two so your fellow human beings can access the healthcare system) but this would benefit the country many times over.  Unfortunately, “healthcare reform” has turned into a ridiculous folly and is only spiraling further out of control into an ever worsening bureaucratic mess.
        There is no excuse for the wealthiest country on the planet to not be able to provide healthcare to it’s own citizens. I am embarassed as an American and a physician to live in a country where greed trumps generosity like this. There is a heated debate whether having access to healthcare is a basic human right. I don’t get this. It is simply the RIGHT thing as a society to do.

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Defining Success

January 9, 2010 3 comments

 

“What’s money? A man is a success if he gets up and goes to bed and does everything he wants to in between” -Bob Dylan

 

     How do you measure success? By the amount of money in your bank account? the town you live in? the type of car you drive? the schools you attended? the places you’ve been? the title of your job? I would say no unequivocally to all of the above. Here’s a story of one person that I crossed paths with in my life that illustrates why.
     Dr. Slaughter was a highly “successful” orthopedic surgeon on staff. He would crank through patients in the OR as if it was some Michigan automotive factory back in it’s heydey. Time was money and money consumed his life more than he could ever bargain for. He thought very highly of himself for training at one of the premier surgery residency programs in the country (which he “name dropped” whenever the opportunity would (forcibly) arise) and made it well known that he lived in a million dollar house in a gated community. He also had two children and was already on trophy wife number two.
     However, Dr. Slaughter was a miserable pathetic man. He would yell at the nurses, curse out his residents, belittle the medical students, and always be complaining to the administration about something. He was an absolute nightmare to work with on so many levels. He was also having an affair with one of the scrub nurses which was widely known. His wife would call him on his cell phone and the conversations were always heated. His one son was in and out of drug rehab while the other was reportedly doing very well in prep school but their relationship was distant and strained.
     I just wanted to take a moment and personally thank Dr. Slaughter. If you ever happen to come across this post, thank you for being such an asshole and showing me everything NOT to do in my life. Thank you for proving that money truly does not bring happiness and success. Thank you for making me better realize that the quest for money and success can rob you blind of your soul and divert your attention from what REALLY matters in this world. Thank you Dr. Slaughter for giving my life more meaning.
     I will end with the following poem by Edwin Arlington Robinson that I read in the eighth grade. Though I would not classify Dr. Slaughter as “a gentleman from sole to crown”, I still think it is most befitting on how success can only be measured from within.

Richard Cory

Whenever Richard Cory went down town,
We people on the pavement looked at him:
He was a gentleman from sole to crown,
Clean-favoured and imperially slim.

And he was always quietly arrayed,
And he was always human when he talked;
But still he fluttered pulses when he said,
“Good Morning!” and he glittered when he walked.

And he was rich, yes, richer than a king,
And admirably schooled in every grace:
In fine — we thought that he was everything
To make us wish that we were in his place.

So on we worked and waited for the light,
And went without the meat and cursed the bread,
And Richard Cory, one calm summer night,
Went home and put a bullet in his head.

-Edwin Arlington Robinson

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The Joys of Working in a Pain Clinic

January 2, 2010 1 comment

Pain Medicine Anyone?

Medicinesux, of all the specialties in medicine which one do you dislike the most? PAIN MEDICINE – Hands down by a mile…..actually, make that a lightyear! Could you even imagine medicinesux in the above scenario??? I would’ve spontaneously combusted before she rattled off her third allergy. (video made by youtuber “crickethk”)

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