How money changes a doctor's thinking

No one goes to a doctor for "health care" we go for health crisis intervention.

My father had this system in his own general practice in Minnesota in the late 1930s and 1040s. He charged his "annual patients" $45 per year, a fee which covered their care with him. He practiced preventive medicine and personally met with groups of his patients at our house on weekends to explain how the different physiological systems worked. He made house calls and saw these patients in his office when needed. He told them he was practicing "Chinese medicine", ie., paying the doctor when well and not paying for care when sick. This was financial incentive for him to encourage prevention. The patients loved it--and him..

Ms. Cooney:

Please re-read the article, and report on its scientific merit without trying to make it into a drama. "Something like that" did NOT happen to the authors; they did not encounter physicians struggling with the dilemma of whether to help a colleague or not. The authors saw two doctors talking and thought, "what if . . ."

Also, doctors do not "bail out of practices in which they see patients very (sic) 15 minutes." It is hard work, but we all do that on a regular basis (every 10 minutes for orthopods). We signed up for hard work when we went to medical school, and almost all us make do. (And please don't buy into the idea that we are stuck in it and can't get out because we have to pay off our student loans. Not only are we, in general, bright enough people to succeed in professions outside of medicine, as many have done, but the vast majority of us don't get out because we get more than a monetary reward for our work: We get to help people in need, a value that is truly at the core of all physicians).

We get enough of this misplaced drama from prime time TV. Stick to the facts; we will still find it interesting.

Somebody should clue these bean-counter admins in: Sacrificing quality for volume isn't even considered "productivity" in the industrial world. One of these days, a lowly HMO patient is going to turn out to have a rich relative, and it's going to end up costing them right back, in a currency that even they can comprehend.

What a ridiculous argument their editorial makes. Using data from social science studies unrelated to the medical environment (social science is not real science by-the-way). Since when is moving a couch at all related to asking a colleague for medical advice. Pure bunk, especially at an academic center where discussing cases are normal and mandatory. Why would you even give this junk any press? Just because it is the guru Groopman published in the NEJM? In the real world, doctors help each other, and if they don't, they end up ostracized. It has nothing to do with money.

I go for health care. No crisis here

Elizabeth Cooney : "Once money enters the conversation, selfishness comes along with it, the theory goes."

MD's want 2 get paid. It's a job. Do u want 2 work for free? U make MD's look ugly and greedy. Why don't u write a piece how MD's work long hrs, work weekends, get paged all hrs of the night, do research and get published. How it works out 2 b for some MD's $13 per hr. Wait....u can write about the 20yr long road 2 become an MD?

Capitalism is killing our society on so many levels. Doctors should be ashamed of themselves for not protecting their profession. Health care has been infiltrated by business tycoons whose primary interest is in the profitability of medicine and not the care. Shame on everyone responsible for this grave path medicine has taken and God help America.

Since no one has a health care plan, here's mine: First, every health care professional (every doctor, nurse, specialist, unit secretary, etc) becomes a Federal government employee subject to the government pay schedule. Next, a 10% National Health Tax is imposed on EVERY item we buy including all food and other necessities. Everyone pays this tax. Everyone. Health insurers will cease to exist. The government takes over all of it and pays on a set salary pay scale. No more health insurance premiums, co-pays, deductibles, confusing fees and charges. Hospitals and nursing homes will no longer be private and the system ceases to be about profit and begins to be about wellness.

I have witnessed physician greed for a long time. No one wants to call it that. Physician incomes are extremely high and dedication is at an all time low. Being "on call" on weekends now means nothing more than telling your patients to go to the ER.

The problem isn't capitalism. It isn't the heatlhcare system. It's a belief that every doctor has to drive a new Mercedes and live behind the gates.

Physicians practice for MONEY! The average physician makes 3 to 6 times there collegues in other countries, yet we have worse outcomes. PS is right on the money but his plan won't work because the same lobby who protect impaired physicians and control the billing codes (the AMA) won't be happy until every American forks over most of their income (middle class is between $25,000 and $90,000 per household, the average physician makes $160,000) to these professional who apparently forgot why they became physicians in the first place!

to PS, My husband and I used to live in Canada. We were lucky to have caring doctors, and they would let us come back for the small fee the government paid them for each service. We did that for a while while living on the border later. The income taxes were confiscatory, they were not in it for the money though, but were independent health care people, not employees of the government. However, I did wonder why our US citizens paid for the exhorbitant drugs here while the Canadians had access to much cheaper identical drugs Why don't we have the same plan our genious members of congress have for all, trhen we would see some improvement here..

If you want a drug prescription or surgery go see a doctor. If you want healthcare go see a nurse.

PS,

I had government healhcare for five years while in the US Navy -- believe me, you don't want government healthcare! People are people -- in the private sector and in government -- not saints. The closer we get the decision making to physicians and their patients -- with no middle men in between -- the better.

-cc.