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“I miss being in private practice and being my own boss,” says Alexander, the Illinois cardiologist. “I would have said 30 years ago that I planned on dying wit

by nugget 14y ago

“I miss being in private practice and being my own boss,” says Alexander, the Illinois cardiologist. “I would have said 30 years ago that I planned on dying with my boots on and practicing until I couldn’t practice anymore. Now, do I look forward to retirement? Yes.” This will be the single greatest cause behind the looming physician shortage and subsequent decline in standard of care. How much harder do you work, for yourself, in a startup - versus for someone else, as an employee? It's NO DIFFERENT for doctors.

vacri 14y ago
If practicing is his love, then why doesn't he go back into private practice instead of retiring and take 'love of the job' as partial payment? It's not like he wouldn't be able to live very comfortably on the proceeds of his life's work to date, something that a great deal of other 'love of the job' workers couldn't do.
- chimeracoder 14y ago
  > It's not like he wouldn't be able to live very comfortably on the proceeds of his life's work to date That's quite an assumption you're making there. Aside from the fact that most doctors are not wealthy beyond belief (contrary to popular opinion), the insurance structure has changed so much in recent years that many literally cannot work any longer. Medicare reimbursements, for example, have been cut so much that doctors operate at a loss for certain procedures - for specialists, this may even cover the bulk of what you do, so the choice is whether to spend your savings to pay for your "hobby" or to retire.
  - vacri 14y ago
    "live very comfortably" != "wealthy beyond belief"
    - chimeracoder 14y ago
      Refuting a hyperbole != refuting the real point.
  - FireBeyond 14y ago
    "Aside from the fact that most doctors are not wealthy beyond belief (contrary to popular opinion)". Certainly true. Cardiologists, on the other hand? Median salary: $362,000 (with 10th% at $247,000, 90th% at $502,000). In terms of procedure costs, Medicare pays a hospital nearly $40 for an ECG (and if you're paying privately, you'll be paying a lot more) - for a procedure that takes an assistant an average of 60-90 seconds to apply 10 pads, acquire a 10-15 second graph of heart activity, and interpret (though any ECG machine in the last decade does rhythm analysis of its own accord). In the field, paramedics routinely run the ECG process in 3-5 minutes.
mikeash 14y ago
Most people aren't really natural entrepreneurs or businessmen, and do best when they're employed by someone else (which is why most people work for other people rather than owning their own businesses). I don't see why doctors would be any different in this respect, as there's no reason to think that medical ability and entrepreneurial ability are correlated. The same is true of programmers, of course. Although it can be hard to remember when reading startup-soaked HN stories, most programmers are happily employed by other people and aren't off founding startups.

by nugget 14y ago

vacri 14y ago

If practicing is his love, then why doesn't he go back into private practice instead of retiring and take 'love of the job' as partial payment? It's not like he wouldn't be able to live very comfortably on the proceeds of his life's work to date, something that a great deal of other 'love of the job' workers couldn't do.

chimeracoder 14y ago
> It's not like he wouldn't be able to live very comfortably on the proceeds of his life's work to date That's quite an assumption you're making there. Aside from the fact that most doctors are not wealthy beyond belief (contrary to popular opinion), the insurance structure has changed so much in recent years that many literally cannot work any longer. Medicare reimbursements, for example, have been cut so much that doctors operate at a loss for certain procedures - for specialists, this may even cover the bulk of what you do, so the choice is whether to spend your savings to pay for your "hobby" or to retire.
- vacri 14y ago
  "live very comfortably" != "wealthy beyond belief"
  - chimeracoder 14y ago
    Refuting a hyperbole != refuting the real point.
- FireBeyond 14y ago
  "Aside from the fact that most doctors are not wealthy beyond belief (contrary to popular opinion)". Certainly true. Cardiologists, on the other hand? Median salary: $362,000 (with 10th% at $247,000, 90th% at $502,000). In terms of procedure costs, Medicare pays a hospital nearly $40 for an ECG (and if you're paying privately, you'll be paying a lot more) - for a procedure that takes an assistant an average of 60-90 seconds to apply 10 pads, acquire a 10-15 second graph of heart activity, and interpret (though any ECG machine in the last decade does rhythm analysis of its own accord). In the field, paramedics routinely run the ECG process in 3-5 minutes.

mikeash 14y ago

Most people aren't really natural entrepreneurs or businessmen, and do best when they're employed by someone else (which is why most people work for other people rather than owning their own businesses). I don't see why doctors would be any different in this respect, as there's no reason to think that medical ability and entrepreneurial ability are correlated. The same is true of programmers, of course. Although it can be hard to remember when reading startup-soaked HN stories, most programmers are happily employed by other people and aren't off founding startups.