4 ms·

Finally, someone said this. It's very rare to see putting some blame on doctors for such exorbitant medical prices in the US. I have made several comments about

Finally, someone said this. It's very rare to see putting some blame on doctors for such exorbitant medical prices in the US. I have made several comments about that on HN describing similar observation that I found. A recent example was when I went to see a doctor for ear infection. She put a otoscope in my ear, looked at it for one minute, prescribed me some anti-bacterial, and wrote up $250 for the service. The first time I came to the US, the same thing happened (I have had ear infection occasionally). I went to a hospital in NJ because my host family at the time drove me there. I didn't have insurance and they sent me to the ER department. I was charged $500. In the US, the journey to become a doctor is made unnecessarily complicated and once people become doctors, they do gatekeeping and make sure it's equally as hard for others to become one. But the reality is that the physicians who treat garden-variety diseases can be trained much less expensively. No wonder physicians make loads of money while complaining about their massive student loan. My gf is a medical resident; my host parents in the US are both doctors; I have so many doctors as acquaintances; and I know that what they do is NOT even remotely difficult in terms of intellectual demand (only physically tiring and emotionally draining sometimes when you have to deal with difficult patients). I, as a programmer, would switch my salary with them in a heartbeat (regret leaving medical school in after second year in my home country, though I hated it at that time because of the sheer amount of rote memorization one had to do) and I do believe what I do everyday requires at least equally tasking mental load than what doctors do.

caraffle 7y ago
There's a lot wrong with the medical field, but this is a ridiculous argument. Programming is hard, medicine is hard. But it's in different ways - it's definitely not transposable (obviously- you switched the other way). I say that as someone who worked in FAANG software and is now in medicine. Equating salary to mental load is also factitious. Manual laborers work harder than all of us, maybe we should switch salaries with them. I 100% agree with the difficulty of becoming a doctor. I disagree with the gatekeeping however. Ultimately it comes down to residency positions available, and funding is government limited. We're seeing tons of new medical schools opening, acceptance of the DO crowd, and still the system is getting more competitive.
- epmaybe 7y ago
  I discussed the funding in my comment above, in that medicare funding is only part of the problem. Nothing would stop a hospital from paying for resident training so long as the ACGME gave their blessing.
JudgeWapner 7y ago
> the physicians who treat garden-variety diseases can be trained much less expensively. So, how do you make sure that only garden variety patients see the medical assistant, while seriously sick ones or those who have only telltale signs of a 1-10k illness see the real doctor? If those rare ones don't get to the doc they die.
- greedo 7y ago
  Seeing a GP isn't necessarily a guarantee that you will get diagnosed properly. Most PAs know their limits and will consult with a doctor if they're not comfortable. Doctors complain about malpractice insurance, but the rates are high for a reason. I was misdiagnosed when I had cancer, my wife was mis-prescribed when doing fertility treatments. Hell, being rich doesn't help; look at Bill Paxton and Neil Armstrong.
  - JudgeWapner 7y ago
    > Seeing a GP isn't necessarily a guarantee that you will get diagnosed properly. so, because even the best make mistakes, that's a good reason to let under-trained (relative to an MD) people with even less skill make mistakes? Not following your logic here.
    - greedo 7y ago
      Seeing a PA for relatively normal issues frees up doctors for more serious cases. A triage system if you will. Doctors don't like this because it will hurt them financially. They want people to think of PAs as second rate, and that doctors are infallible. In my case, my doctor felt that because colorectal cancer (at the time) was relatively unusual for my age demo, that he didn't really need to consider it. Instead of doing an actual DRE, or a fecal occult blood test, he simply dismissed it out of hand (pun intended) as internal hemorrhoids. A year later, I was having a full resection, chemo, radiation treatment, and a permanent colostomy. Thanks!
- austhrow743 7y ago
  You accept that a greater number of people with a 1-10k illness die than whatever the current rate is.

caraffle 7y ago

There's a lot wrong with the medical field, but this is a ridiculous argument. Programming is hard, medicine is hard. But it's in different ways - it's definitely not transposable (obviously- you switched the other way). I say that as someone who worked in FAANG software and is now in medicine. Equating salary to mental load is also factitious. Manual laborers work harder than all of us, maybe we should switch salaries with them. I 100% agree with the difficulty of becoming a doctor. I disagree with the gatekeeping however. Ultimately it comes down to residency positions available, and funding is government limited. We're seeing tons of new medical schools opening, acceptance of the DO crowd, and still the system is getting more competitive.

epmaybe 7y ago
I discussed the funding in my comment above, in that medicare funding is only part of the problem. Nothing would stop a hospital from paying for resident training so long as the ACGME gave their blessing.

JudgeWapner 7y ago

> the physicians who treat garden-variety diseases can be trained much less expensively. So, how do you make sure that only garden variety patients see the medical assistant, while seriously sick ones or those who have only telltale signs of a 1-10k illness see the real doctor? If those rare ones don't get to the doc they die.

greedo 7y ago
Seeing a GP isn't necessarily a guarantee that you will get diagnosed properly. Most PAs know their limits and will consult with a doctor if they're not comfortable. Doctors complain about malpractice insurance, but the rates are high for a reason. I was misdiagnosed when I had cancer, my wife was mis-prescribed when doing fertility treatments. Hell, being rich doesn't help; look at Bill Paxton and Neil Armstrong.
- JudgeWapner 7y ago
  > Seeing a GP isn't necessarily a guarantee that you will get diagnosed properly. so, because even the best make mistakes, that's a good reason to let under-trained (relative to an MD) people with even less skill make mistakes? Not following your logic here.
  - greedo 7y ago
    Seeing a PA for relatively normal issues frees up doctors for more serious cases. A triage system if you will. Doctors don't like this because it will hurt them financially. They want people to think of PAs as second rate, and that doctors are infallible. In my case, my doctor felt that because colorectal cancer (at the time) was relatively unusual for my age demo, that he didn't really need to consider it. Instead of doing an actual DRE, or a fecal occult blood test, he simply dismissed it out of hand (pun intended) as internal hemorrhoids. A year later, I was having a full resection, chemo, radiation treatment, and a permanent colostomy. Thanks!
austhrow743 7y ago
You accept that a greater number of people with a 1-10k illness die than whatever the current rate is.