Caduceusblog - Latest Comments

Re: I’m Tired Of. . .

GI czech — Fri, 17 May 2013 21:56:00 -0000

you need to sit on the beach until you are tired of watching the same stupid crab make a hole in the sand to come up for air only for it to be washed away again with each wave :)

Re: Another Letter to Washington, from a Physician on the Front Lines.

North Carolina PA, MPH — Tue, 07 May 2013 19:33:53 -0000

I agree that Dr. Moeller, and the entire medical profession, have made tremendous personal and financial sacrifices to pursue the study of medicine and then to practice medicine.

Perhaps as a society, however, we should be looking at medical education from a different angle. This is the angle: How can the US best train the optimal mix of health care providers to meet the medical needs of our country?

Perhaps the US medical education system is creating too many Mercedes-Benz and Lamborghini's when most consumers really just need a Ford Focus or Honda Accord.

Re: Another Letter to Washington, from a Physician on the Front Lines.

Joyce N. DeWitt — Sat, 27 Apr 2013 17:41:36 -0000

I understand exactly what Dr. Moeller explains in both of his letters. I understand that when my orthopedic surgeon did a wonderful job fixing my torn rotator cuff, he did NOT get paid the $20,000 that was the total cost for the procedure. I'd be surprised if he made more than $1500. It's easy to see where the rest of it goes.... charges for the use of the hospital "room" which was an outpatient pre-surgery room, the use of the operating room, the use of the recovery room, the medicines for my aenesthesia, antibiotics, and pain control, the charge for the aenesthesiologist, the charge for the pre surgery nurses, the operating room nurses, the post care nurses, the hospital office and staff charges for paperwork, and a lot of other things that I didn't understand. Although I do think my surgeon makes good money, he should. In addition to all of his training and expertise, he spent many years as a flight surgeon in the Air Force, where I doubt his pay was nearly as good. I do understand a little about medical billing, just from reading articles, and from asking questions about my bill. It may on paper that the charges for a yearly physical are close to $1,000, but I know that most of that goes to all kinds of stuff besides payment to my wonderful doctor. It's no wonder that they cram them into seeing between 2 and 4 patients an hour: fifteen minutes for an office visit, and thirty for a physical. And I can imagine his head spinning after an eight hour day of seeing that many people. As a former high school teacher, I know how people can misunderstand a job. Doctors are thought of as "making the big bucks," when people have no clue as to the cost of their education, continuing education, fees for liability insurance, professional organizations, and the loss of those earning years between the ages of 22 and 30. With teachers, what we constantly hear is, "Oh, you have the best job. Don't complain about your low pay! You get off of work every day at 2:30 or 3:00, and you get two weeks off at Christmas, a week in the spring and three months in the summer! Give me a break!" What they don't know is that many teachers either come to school in the wee hours of the morning, or stay late in the evenings. Most days I did not leave until 6.p.m. and at least two nights a week, I'd have to stay until 7 or 8. My friends would ask me, "Why? Why do you have to stay so late? What do you do?" I would explain that our second work day begins when the kids walk out the door. That is when we plan for the next day or week, grade papers, get materials ready for the next day, tutor kids, attend meetings and workshops, serve on several different required committees (benevolence, site based management, school beautification, at risk students, school dances, festivals, etc), attend after school events such as Parent Teacher meetings, open houses, games, plays, band or choir performances, award ceremonies, etc. Many teachers work with extra curricular groups before and after school, such as Key Club, National Honor Society, Student Council, International Club, Science and Math club, etc. Some teach school all day and then coach after school. In addition we have to keep up our continuing education hours and often have coursework and tests to take, or presentations to make. We have to document all of the things that we do in our classrooms to line up with our school improvement plan, and we have to also fill in reports and forms about what we do to streamline and modify lesson plans for studens with individual education plans... kids with learning problems, and how we comply with federal laws regarding the education of these kids. Along with continuing education, we also keep up with all of the new technology making itself into the classroom. We might train on a grading and reporting system that we use for two years, only to have the district throw it out and purchase a complete new system to learn. And, we take all kinds of calls from parents before, during (on our "planning" period) and after school. Some of these calls can last as long as a parent wants to talk... or complain. Occasionally, instead of calls, we have individual parent conferences, and these, too can take a lot of time. We talk for an hour with a parent about how to address the kid's unwillingness to pick up a book to study, we offer solutions, we offer tutoring hours, we come up with a plan, only to have the parent and the student to drop the plan and then complain about the low grade again the next six weeks. Teaching can be extremely stressful, and the only reason that most of us stay in it is because we love it. We are often, especially in middle or high school, greeted by students who disrespect us first, and we have to earn their respect and their attention. Christmas break is usually a mad scramble to finally get everything ready for our own families in a very short amount of time. December and May are the craziest months in the year for teachers: so many programs and activities at school, all while nearing the end of the semester and the final grades. And of course, increasingly, teachers' salaries and even jobs are tied to test performances by their students... and some of those students don't care about their grades. When you look at our summer breaks, they are often bogged down by attending a college class or two, or working with planning committees for the next school year. We may get a couple of months off in the summer (it is rarely three months anymore) but after the maddening school year, every teacher needs a long breather. People don't understand what we do. And people do not understand how doctors are paid, or exactly what they do, either. They, too, also have a lot of extra things beyond just their regular jobs, such as continuing education, re-certification, new technology to learn, and committe or professional organization meetings and duties. Doctors have to deal with patients who don't follow instructions, and turn up even sicker. A lot of their patients and their families are sometimes very demanding and difficult. There are so many similarities between doctors and teachers. I am extremely grateful for the good doctors that I've had over the years, and I hope that every one of them eventually enjoys a great lifestyle in compensation for the long years of training and the excellent care they give, and for the hours they put in every week. As for Dr. Moeller and his salary, I wish he would investigate relocation to the Carolinas, or to Texas, or other states where I believe the doctor compensation is better than what he is currently earning. I think that some medical communities are much better than others in terms of work-life load and pay. The Carolinas Medical Center located all over North and South Carolina is a fine institution with great places to work and live. The climate and beauty of the Carolinas make the area a wonderful place to live. The best doctors I've ever had have all been under the CMC group. They all seem happy with their work, and so do all the staff. Their blend of friendly professionalism and excellence really transcends to patients in confidence and ease of visits. I've seen internists, G.I. doctors, orthopedic doctors, aenesthesiologists, general surgeons, allergists, immunologists,dermatologists, physical therapists, and physician assistants, and in eight years, I have yet to meet a cranky tech, nurse, office staff person, or doctor. Pretty good performance, I'd say! I hope they do all earn a great salary. It's annoying to hear people run the medical profession and their salaries down, because they all work very hard, and have come a long way to get where they are.

Re: An Open Letter to Washington, D.C. From a Physician on the Front Lines.

AP — Fri, 26 Apr 2013 17:35:42 -0000

I'm an incoming med student. Although there is the potential to do very well down the line, and I understand that, looking at raking in $350,000 to $400,000 in student loans at the age of 24 scares the living crap out of me!!!!

I'd like to note that perhaps we would all be less interested in subspecializing and lining our pockets if we would not have those loans in the back of our minds through the next four years of medical school. It frames how we think about the profession, doesn't it? PCP, for example becomes very appealing when you have $0 debt. Perhaps not for everyone, but perhaps for enough that it may make a substantial difference in the way we see health care in the US.

Re: An Open Letter to Washington, D.C. From a Physician on the Front Lines.

Josh Bucher — Thu, 25 Apr 2013 08:38:42 -0000

I think that most people here are missing the point of the article. The point is that he is graduating with over 200k in debt (like myself). Most other 1st world countries have education systems much more suited for encouraging people to go into primary care because they do not graduate with debt if they attend public medical schools.

As someone who just graduated last year with > 200k in debt, making 50,800 a year as a first year resident (you can look up UMDNJ PGY 1 salaries online), I sympathize with him.

The comment above that they know "so many people who bought $200k homes before residency" is totally irrelevant. I never worked, never had a full time job before residency and came straight from college. I borrowed money to rent apartments, and rent now. I drive a 10 year old Honda that I need to last me another 10 years. I am in NJ and pay some of the highest cost of living expenses. I make $500 a month loan payments. My assets are very low, and my loan principal keeps increasing due to compounding interest.

If we were anything like the rest of the 1st world, medical school debt would be a different story. I am going into academic emergency medicine. I will start at a salary on the east coast of approximately 180k. I am not getting a maserati, nor can I purchase a 700k house. I am also inheriting another 100k in debt from my fiance.

The point that I took away from this is that the system of debt needs to be changed. I am not complaining about my salary. I am not complaining I cannot afford a maserati. I am not complaining that I don't make enough money. The point I will complain about is the education system has to change because there is a huge physician shortage, and students are discouraged from pursuing a career in medicine due to the way medical school and debt is funded in the US.

Re: An Open Letter to Washington, D.C. From a Physician on the Front Lines.

guserson — Wed, 24 Apr 2013 02:28:51 -0000

What's your salary now? you don't mention it in the article.

Re: Why Physicians Should Learn to Pronounce Patient Names Properly

hopeint — Wed, 03 Apr 2013 15:40:36 -0000

very true!

Re: Another Letter to Washington, from a Physician on the Front Lines.

Edward Volpintesta MD — Mon, 01 Apr 2013 07:07:52 -0000

March
30, 2013

Caduceuslog.com

I
appreciate the comments made by Matthew Moeller MD posted on the March 28
Caduceus.blog. His willingness to speak openly and freely is admirable and I
wish more physicians could muster the courage to do the same. For many if not
most physicians suffer silently and to borrow a famous phrase of Thoreau’s lead
lives of quiet desperation.

My
response to his blog however is directed not to the time and the financial
burden but to the medical curriculum itself.

I
have been practicing primary care for almost 40 years. And as I look back on my
years of education I realize how much of it was either redundant or
inappropriate.

For
example, as I look back on courses like organic chemistry, physics,
biochemistry, biology of vertebrates, and physical chemistry which I labored
thorough because I was told medical schools favored students who took those
subjects—and the time and worry I spent on them I am overcome with a sense of
regret. For the time invested in them has contributed very little if anything
to my capability as a general practitioner. Ironically a great deal of time is
also spent on the so-called basic sciences in medical school as well.

The
basic sciences have their place in medical education of course. But, studying
them with the intellectual exactness that is more appropriate for a career in
medical research doesn’t makes sense.
Some of these subjects I suppose are intended to weed out those students
who do not have a superior aptitude for science. Unfortunately many students
who could have made good general practitioners were either turned off from a
career in medicine or refused admission to medical school because they were
daunted by organic chemistry or biochemistry.

My
point is that perhaps the medical education experience doesn’t have to be so
long and arduous. Certainly surgeons need their operating room experience to
develop their skills but even their pre-residency education could be modified
to be more practical. This would save time, money, and energy for those
pursuing medical careers.

Many
believe that the Flexner Report of 1910 which set new standards for medical
school is greatly responsible. Abraham Flexner undertook a study of American
medical schools, identified their deficiencies and with the power of the
Carnegie Institute and the Rockefeller Foundation supporting him set in place a
new set of standards. They were inspired by the German medical schools whose
main focus was on medical research. That focus has remained in place and has
been the foundation of American medicine ever since.

Clearly
the medical schools of the time needed the improvements in standards that
Flexner promulgated and no one would doubt the benefits that have accrued
because of medical research.

But
the overriding attention to research encouraged the training of specialists and
did all but ignore the training of general practitioners.

This
unintended effect of Flexner’s report is responsible to a great extent for the
primary care shortage that is constantly reported in the media. Perhaps if
Flexner were a physician his approach might have been different. He was an
educator not a doctor.

One
of his contemporaries, Sir William Osler MD a celebrated physician, teacher,
and author of a highly regarded medical textbook disagreed with Flexner’s
ideas. He preferred that medical research be done in institutes and not in
medical schools attached to teaching hospitals. He was also against full-time
teachers in the hospitals because he thought that not being directly involved
in private practice in the community did not give them the exposure to the
practical needs and problems of patients outside of the hospital environment.

Be
this as it may, some leaders in medicine are seriously taking a second look at
the changes that followed in the wake of Flexner’s report with plans to correct
any unintended consequences.

If
they do a good job future physicians may be spared some of the stresses and
adversities that Dr. Moellers described.

Edward
Volpintesta MD

Re: An Open Letter to Washington, D.C. From a Physician on the Front Lines.

Edward Volpintesta MD — Sat, 30 Mar 2013 13:06:44 -0000

March
30, 3013

Caduceuslog.com

I appreciate the comments made by Matthew Moeller MD posted on the March 28
Caduceus.blog. His willingness to speak openly and freely is admirable and I
wish more physicians could muster the courage to do the same. For many if not
most physicians suffer silently and to borrow a famous phrase of Thoreau’s lead
lives of quiet desperation.

My response to his blog however is directed not to the time and the financial
burden but to the medical curriculum itself.

I have been practicing primary care for almost 40 years. And as I look back on my
years of education I realize how much of it was either redundant or
inappropriate.

For example, as I look back on courses like organic chemistry, physics,
biochemistry, biology of vertebrates, and physical chemistry which I labored
thorough because I was told medical schools favored students who took those subjects—and the time and worry I spent on them I am overcome with a sense of regret. For the
time invested in them has contributed very little if anything to my capability
as a general practitioner. Ironically a great deal of time is also spent on the
so-called basic sciences in medical school as well.

The basic sciences have their place in medical education of course. But, studying
them with the intellectual exactness that is more appropriate for a career in
medical research doesn’t makes sense. Some
of these subjects I suppose are intended to weed out those students who do not
have a superior aptitude for science. Unfortunately many students who could
have made good general practitioners were either turned off from a career in
medicine or refused admission to medical school because they were daunted by
organic chemistry or biochemistry.

My point is that perhaps the medical education experience doesn’t have to be so
long and arduous. Certainly surgeons need their operating room experience to
develop their skills but even their pre-residency education could be modified
to be more practical. This would save time, money, and energy for those
pursuing medical careers.

Many believe that the Flexner Report of 1910 which set new standards for medical
school is greatly responsible. Abraham Flexner undertook a study of American
medical schools, identified their deficiencies and with the power of the
Carnegie Institute and the Rockefeller Foundation supporting him set in place a
new set of standards. They were inspired by the German medical schools whose
main focus was on medical research. That focus has remained in place and has been
the foundation of American medicine ever since.

Clearly the medical schools of the time needed the improvements in standards that
Flexner promulgated and no one would doubt the benefits that have accrued
because of medical research.

But the overriding attention to research encouraged the training of specialists and
did all but ignore the training of general practitioners.

This unintended effect of Flexner’s report is responsible to a great extent for the
primary care shortage that is constantly reported in the media. Perhaps if
Flexner were a physician his approach might have been different. He was an
educator not a doctor.

One of his contemporaries, Sir William Osler MD a celebrated physician, teacher, and
author of a highly regarded medical textbook disagreed with Flexner’s ideas. He
preferred that medical research be done in institutes and not in medical
schools attached to teaching hospitals. He was also against full-time teachers
in the hospitals because he thought that not being directly involved in private
practice in the community did not give them the exposure to the practical needs
and problems of patients outside of the hospital environment.

Be this as it may, some leaders in medicine are seriously taking a second look at
the changes that followed in the wake of Flexner’s report with plans to correct
any unintended consequences.

If they do a good job future physicians may be spared some of the stresses and
adversities that Dr. Moellers aptly described.

Edward Volpintesta MD

Re: An Open Letter to Washington, D.C. From a Physician on the Front Lines.

Deep Ramachandran — Sat, 30 Mar 2013 10:59:05 -0000

Followup to this article now posted at caduceusblog.com. Due to the
tremendous popularity of this article as well as the controversy and
questions it generated, Dr. Moeller has written a followup addressing
many of these issues.

Re: An Open Letter to Washington, D.C. From a Physician on the Front Lines.

steve — Wed, 27 Mar 2013 08:49:29 -0000

CRY ME A RIVER dude. Doctors aren't in it to help anyone. IF they were, you really think they'd be okay with their profession charging prices that wind up being the number 1 cause of bankruptcy in america??

Simply put, physicians are in it for the money. You said you spent 3 years in internal medicine. At that point you could have become a primary care doctor and actually worked to help reverse and prevent disease in people before it became something worse. But no, you specialized. They all specialize because that's where all the money is at. That's why you specialized in gastroenterology and now make on average $350,000.

In case we are still not understanding this, consider the most competitive fields in medicine (meaning the most difficult to get into with the smartest physicians applying) are: 1. Plastic Surgery. 2. Dermatology...LAST PLACE: Family Medicine

Meaning: you want to see a smart doctor, go find your local dermatologist.

Re: An Open Letter to Washington, D.C. From a Physician on the Front Lines.

Guest — Wed, 27 Mar 2013 08:21:53 -0000

I'm sorry but CRY ME A RIVER. I'm a pharmacist and have a similar amount of school debt. Granted, unlike your profession, we do not need nearly as much post graduate training and so begin earning a large salary earlier. But let's keep it in perspective here. The average salary for a gastroenterologist is $350,000 in the United States. No one forced you go to medical school or have two kids, or even pursue another 3 years of post-graduate training after internal medicine. In fact, you can argue that the reason you specialized was more for the money than anything else. Go on and admit it. Every other physician I've ever spoken with does. It's the reason there are primary care doctor shortages.

I see a lot of young attending's who first start working, with their massive school debts, who pay them off very quickly and then proceed to buy maserati's (true), BMW M3's (true), $700,000 homes (triple true), etc etc. Go on and do a survey on every attending physician out there: Hey, if the money wasn't so good, would you be in medicine? MOST of them would say no. People who go into health care should NOT have that much school debt. In fact, NO ONE should. But in exchange for providing a service and "caring" for people around you, you cannot gripe about not collecting an oversized salary. But physicians do collect oversized salaries. And the fact that while this continues while the biggest cause of bankruptcy in America right now is healthcare related costs should lead you to question how ALL of us are compensated and educated. The current model isn't working. After all, if you were really into "helping" people, does that help involve causing them bankruptcy as well? I know as a pharmacist, and my fiance knows as a physician in training, that we wouldn't feel very good about ourselves. And we are directly responsible whether we know it or not.

Re: An Open Letter to Washington, D.C. From a Physician on the Front Lines.

nick — Tue, 26 Mar 2013 11:25:54 -0000

I agree with the fact that doctors are not being paid enough but in this case I kind of disagree with my gastroenterology colleague as they are among high earners ( above 350K ) and actually under current system are being paid pretty well for what they do. Unfortunately doctors payment system in US is not fair at all. In current US health system you are not being paid for the time, energy, quality or level of stress you are dealing with and simply being paid for the number of procedures you do. For example in early 80s gastroenterologist were among least paid doctors no matter how much time they spent with their patients and Nobody wanted to do it. Suddenly after medicare started to pay for screening colonoscopy GI became a hot field and every medical students started thinking about it. Same story happened for Anesthesiology or some other fields. Procedural payment was the reason that many medical students decide to choose so called luxurious and less stressful fields ( such as Dermatology, GI,...) in recent years for the simple fact of work less and get paid more. I am not against the GI doctor who wrote this blog is wrong but I dont think he is the first one who should cry. Our primary care doctors, Hospitalists, surgeons, neurologist and even non procedural cardiologist have to tolerate far more and more pressure despite less and less pay everyday. I think Congress should come up with a system that guarantee a fair and sustainable pay for doctors and we as medical community should come up with fair and practical demands and work together to reach that goal otherwise our procedurists get paid less and less and our thinkers will suffer more and more everyday and nobody even patients will benefit from current situation.

Re: An Open Letter to Washington, D.C. From a Physician on the Front Lines.

Paul J Coppola — Tue, 26 Mar 2013 11:10:41 -0000

I just read your letter on Sermo and wanted to comment directly to you and say thanks.

Here was my response on Sermo

Great letter, I can easily relate as most all in our profession. I initially wanted to share with everyone I know who as ever said "you rich doctors have it made" and thought every lawmaker, insurance executive, and even patients so that they would understand what it is like getting to be a physician. I am nearing the end of my career and still love what I do and would not have changed if given another chance. I have great concerns for what the future generation of physicians will be like with computers, electronic health records, multilple layers of answering machines and staff before the patient gets to talk with the doctor and worst of all set hours as employees of hosptals or health care organizations. The real problem is that medicine has evolved to such a high level of technology that the cost is overwhelming and simply unaffordable. Noone, but the individual patient sitting with their doctor really listening, values the simple doctor-patient relationship, which in the long run is the most cost effective. However, that most important aspect cannot be maintained and is being sacrificed because of the technology costing so much. I am so thankful that I still have the privelage of spending time with the patients who have for so many years put their trust in me and in the end that is what makes getting there all worth it. Still great letter because it made me think about those years back in college, med school and residency training with all the struggles and yet they were good times. Thanks.

paul.coppola@snet.net

Re: Daily Docblock: EHR Style.

Deep Ramachandran MD — Tue, 26 Mar 2013 10:29:07 -0000

Ya, I like your point, there's a time and a place to determine whether a patient needs a vaccine. When your admitting an acutely ill patient is definitely not that time!

Re: Daily Docblock: EHR Style.

john buford — Tue, 26 Mar 2013 10:07:03 -0000

This criticism of the EHR points out the time wastage involved, and time is our least fungible resource. For example I could write admission orders in 5 minutes with a pen and paper, but now it takes 15-25 minutes on the computer, and I have to begin by stating whether or not this patient should have a flu shot. And patients complain to me that some of the doctors they see never make eye contact because they only look at the computer screen.

Re: An Open Letter to Washington, D.C. From a Physician on the Front Lines.

Jared Jameson — Sun, 24 Mar 2013 12:49:38 -0000

You and I both know that a doctor with a mortgage, and kids (his FB profile shows 3 kids), presumably daycare costs, and other tax-deductible factors is NOT paying that full rate of income tax. Hell, me and my wife were in the 25 percent tax rate this year, but after those deductions/credits mentioned above, our freakin' ETR was a mere 3 percent! We made six figures combined. Considering the letter offers nothing in terms of wishes from gov't, it is a letter of sour grapes, nothing more, nothing less.

Re: An Open Letter to Washington, D.C. From a Physician on the Front Lines.

Jared Jameson — Sun, 24 Mar 2013 12:46:43 -0000

your opinion also is disingenous, for one simple reason: everything is relative. I'd expect a law student's debt to be less than a doctor's, and a journalism student's debt to be less than a lawyer's, etc, etc, etc. It's all relative, and it rings of sour grapes by the doctor, if you ask me.

Re: An Open Letter to Washington, D.C. From a Physician on the Front Lines.

Jared Jameson — Sun, 24 Mar 2013 12:42:53 -0000

Furthermore, he flat out lied in his letter. A quick, easy public search of his residency years reveals that, while perhaps he made $39,000 in that year, he actually was paid at a rate of $41,500 his first year, with a 9 percent increase his second year, and then an 8.8 percent increase his final year. Furthermore, Henry Ford, where he now works, is considered a top-rated payer for gastro; his region rates at a yearly average salary of $397,000. He might not be at that rate yet, but I bet he's close, and I bet his starting salary was $250,000-$300,000 based on my interactions with my UM doctor friends, all of whom bought $200,000-plus houses in my sub BEFORE STARTING their residencies at Michigan. I suspect he needed to exclude some of the truths of his cirumstances in order to frame his 'point' in the perspective he intended. It's disingenuous, if you ask me.

Re: An Open Letter to Washington, D.C. From a Physician on the Front Lines.

21stCentMD — Sat, 23 Mar 2013 17:44:41 -0000

To all of you who are not doctors and disagree with this view, go become one and survive the process then talk to us. While we voluntarily chose to enter this profession, what if we voluntarily decide not to offer you care even if you or your family needed it? Don't hold doctors to a double standard just because of moral obligation (if such a thing even exists nowadays). We provide a billable service just like everyone else, but only difference it is your health and body. Imagine what would happen if physicians decide to simply see you as a client needing a deliverable rather than a human being in need of care and tender support? Just think how much happier we would be actually. ..

Re: An Open Letter to Washington, D.C. From a Physician on the Front Lines.

Dustin Pitts — Sat, 23 Mar 2013 11:49:39 -0000

This show should support your sad case. http://www.bravotv.com/married...

Re: An Open Letter to Washington, D.C. From a Physician on the Front Lines.

Matthew S — Fri, 22 Mar 2013 14:24:19 -0000

No one doubts that doctors are well-educated, hard-working, and caring people. The problem with health care is not the high salaries of doctors, but the massively inflated prices charged by hospitals and insurance companies - the burden of which is carried by consumers. If the author of this article were truly humanitarian, he would not simply bewail the public perception that he's an overpaid parasite, but offer some concrete suggestions about how to lower the overall costs of healthcare so that everyone in the system is paying, and earning, what they deserve. When a system is unequal, people naturally resent its relative beneficiaries.

And he might gain some credibility by addressing some of the abuses perpetrated by less-altruistic doctors than himself (e.g. ordering expensive but unnecessary diagnostic tests to avoid malpractice, placate hypochondriacs, or get kick-backs).

Re: An Open Letter to Washington, D.C. From a Physician on the Front Lines.

Tana Benner — Fri, 22 Mar 2013 13:10:45 -0000

I am an attorney from a modest Midwestern background. I have pride in what I do. I truly care for the well-being of the human race. Although I may "clock" the number of minutes that I talk with my clients, I do not hang up the phone on any of my clients ever, even when I am not getting paid. In fact, there are numerous cases where I end up writing off my bill. I listen to my clients and answer their questions, however long it may take, even if I am at home eating dinner with my family. I also have six figures of student loan debt and no retirement savings, but I will be lucky to ever make the kind of money that a physician earns. That's that.

Re: An Open Letter to Washington, D.C. From a Physician on the Front Lines.

Neuro MD — Fri, 22 Mar 2013 11:03:40 -0000

Give me a break, The story is a tired and boring harangue that so many of my colleagues have spewed out so often. The ideals underlying such stories reveal a self-inflated ego, but what would you expect from a profession where everyone has (viz: demands, expects) the same first name as 'Doctor'? Being a physician is not the most demanding, most under-payed profession. The bottom line: doctors made the choice to become doctors. Diatribes such as this have little credibility with me as a physician, and much less with someone who may be out of a job or less fortunate.

Re: An Open Letter to Washington, D.C. From a Physician on the Front Lines.

Will — Fri, 22 Mar 2013 10:39:54 -0000

Why try to counter a bunch of mistaken notions about doctors by spewing a bunch about lawyers? Makes you sound immature and ignorant, which is the opposite of what I think you wanted to portray.