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Should The GOP be using Obamacare like this?


thorne
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I think the point is for that type of $50k dollars, it's not so much what YOU personally get paid Kirk, it's WTF happens to the rest of the money?

 

My mother (who you and I just discussed recently) had her knee replacement done. The initial bill from Cleveland Clinic just for the proceedure was $54k on her EOB. 42 pages later the final totals everything she was billed for after 3 months of surgery, care, PT, etc. was just under $93k.

 

Crazy shit.

 

i hear you, and agree. the implant itself can cost upwards of $10k!!! i've done replacements where we've replaced half of the femur and the whole knee joint. that device cost $27k. i know, because our hospital administrator let me hear about it. out of the whole hospital bill, the only thing that you're getting a deal on is the amount the surgeon gets paid. again, i have zero input on this. i replaced my surgical assistant's husband's hip---she gave me some of the breakdown on the individual costs and i was shocked. again, i didn't go into this job to set prices, and shit like that. its the part of the job i like the least is sitting in meetings and crap like that.

 

 

and to answer bill's question before, the total time i might have invested in the knee replacement might be 4+ hours, give or take. but keep in mind for every surgical patient in my office there are more patients that don't end up getting surgery, and i only operate twice a week, sometimes three times a week. the only reason my office does reasonable and turns a profit is because i end up doing a lot of injections---sometimes 30 a day, on a busy day. otherwise, the office simply sustains itself.

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Your 100% right I think hardcore right wing religious people are idiots. I also feel you should have to pass a test about things you vote on. If you can't answer enough questions accurately you can't vote.

 

Great. Before our next election I will give you a spelling and grammar test. When you fail, you will NOT BE ALLOWED TO VOTE.

 

One less idiot voting. :)

-Marc

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Great. Before our next election I will give you a spelling and grammar test. When you fail, you will NOT BE ALLOWED TO VOTE.

 

One less idiot voting. :)

-Marc

 

Dude just copy a pasta some of the best writing I have seen him post. Give the guy some props, ya dirty steelers fan.

 

-Shittsburg sucks

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Great. Before our next election I will give you a spelling and grammar test. When you fail, you will NOT BE ALLOWED TO VOTE.

 

One less idiot voting. :)

-Marc

 

If I'm an idiot the other 99.9% of the population must Peter.

http://i.imgur.com/BHh5N.jpg

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i hear you, and agree. the implant itself can cost upwards of $10k!!! i've done replacements where we've replaced half of the femur and the whole knee joint. that device cost $27k. i know, because our hospital administrator let me hear about it. out of the whole hospital bill, the only thing that you're getting a deal on is the amount the surgeon gets paid. again, i have zero input on this. i replaced my surgical assistant's husband's hip---she gave me some of the breakdown on the individual costs and i was shocked. again, i didn't go into this job to set prices, and shit like that. its the part of the job i like the least is sitting in meetings and crap like that.

 

 

and to answer bill's question before, the total time i might have invested in the knee replacement might be 4+ hours, give or take. but keep in mind for every surgical patient in my office there are more patients that don't end up getting surgery, and i only operate twice a week, sometimes three times a week. the only reason my office does reasonable and turns a profit is because i end up doing a lot of injections---sometimes 30 a day, on a busy day. otherwise, the office simply sustains itself.

 

 

Now my next question is are there cases where you have 16 hours in and make the same or less? In Tuning I call those 3000GTs

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If I'm an idiot the other 99.9% of the population must Peter.

http://i.imgur.com/BHh5N.jpg

 

You actually might be one of the worst members CR has ever had. Ever. Everytime I log in I wish Anthony would allow me to pay him to ban you. For real.

 

Now my next question is are there cases where you have 16 hours in and make the same or less? In Tuning I call those 3000GTs

 

Nope; once Kirk has 4 total hours into a patient he quits and leaves them to die. He is an evil, Republican MD earning in the top 1% by robbing all of us poor slobs. He should be better.

-Marc

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Typical CR. Someone busts their ass to make it, everyone who doesn't feel they made it to the same level tries to tear him apart. Kirk can probably buy and sell me on the black market if he wanted, but I give him mad props for busting his ass. I'll continue to do the same and hope I can achieve the same results so everyone on here can hate me too.
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Typical CR. Someone busts their ass to make it, everyone who doesn't feel they made it to the same level tries to tear him apart. Kirk can probably buy and sell me on the black market if he wanted, but I give him mad props for busting his ass. I'll continue to do the same and hope I can achieve the same results so everyone on here can hate me too.

 

Who is attacking Kirk?

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Now my next question is are there cases where you have 16 hours in and make the same or less? In Tuning I call those 3000GTs

 

some re-do hip or knee replacements take 4 hours to do the surgery, need to be seen much more often, and i get paid 130% over a standard procedure. the surgery is much more stressful, and the results are not as good. think of that as tuning someone else's 3000gt where the previous tuner fucked everything up, and the car has 100k+ miles on it. and you have to do all the repairs with the car still running. and you can't really stop in the middle of the job to take a lunch break.

 

if the surgery takes longer than normal, if the patient is much larger than normal, we don't get paid more. i can tell you its much harder to do a hip replacement on a 400lb guy compared to a 120lb female--you get paid the same. i don't see very many people who weigh 120lbs here in wisconsin. i don't even comment anymore when we see a 300 pounder.

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some re-do hip or knee replacements take 4 hours to do the surgery, need to be seen much more often, and i get paid 130% over a standard procedure. the surgery is much more stressful, and the results are not as good. think of that as tuning someone else's 3000gt where the previous tuner fucked everything up, and the car has 100k+ miles on it. and you have to do all the repairs with the car still running. and you can't really stop in the middle of the job to take a lunch break.

 

if the surgery takes longer than normal, if the patient is much larger than normal, we don't get paid more. i can tell you its much harder to do a hip replacement on a 400lb guy compared to a 120lb female--you get paid the same. i don't see very many people who weigh 120lbs here in wisconsin. i don't even comment anymore when we see a 300 pounder.

 

Fucking Packer fans....

 

:)

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Typical CR. Someone busts their ass to make it, everyone who doesn't feel they made it to the same level tries to tear him apart. Kirk can probably buy and sell me on the black market if he wanted, but I give him mad props for busting his ass. I'll continue to do the same and hope I can achieve the same results so everyone on here can hate me too.

 

i'm not complaining. i love the surgery i do. i do two of the most successful surgeries that can be done in all of medicine, and there's an endless supply of people who need knees and hips. i practice medicine in a state with great insurance reimbursement for now, and my med school loans are almost gone, house paid off, etc etc.. i'm pretty good at what i do, but people still have complications--that's why i don't sleep a ton, and have bad heartburn.

 

the income i earn is significantly more than 90% of other physicians because of the volume of surgery i do, the fact that i practice surgery (and not general medicine), and the location in which i practice. people look at the cars i own, and tell me i'm lucky. sure, some luck is important--plenty of things could have gone the other way in my life. but its not like i won the lottery, and i'm not ashamed to buy nice shit and enjoy spending money. most of what could be called 'complaining' on my part is for my colleagues who work their ass off and don't get paid shit, for the time they work, and the investment they've made to get them where they are.

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some re-do hip or knee replacements take 4 hours to do the surgery, need to be seen much more often, and i get paid 130% over a standard procedure. the surgery is much more stressful, and the results are not as good. think of that as tuning someone else's 3000gt where the previous tuner fucked everything up, and the car has 100k+ miles on it. and you have to do all the repairs with the car still running. and you can't really stop in the middle of the job to take a lunch break.

 

if the surgery takes longer than normal, if the patient is much larger than normal, we don't get paid more. i can tell you its much harder to do a hip replacement on a 400lb guy compared to a 120lb female--you get paid the same. i don't see very many people who weigh 120lbs here in wisconsin. i don't even comment anymore when we see a 300 pounder.

 

Insightful, Thank you for sharing. So your basically flate rate. Does that go on top of some base level salary?

 

Offtopic: If your in a 4 hour surgery and you have to take a leak can you or how about a drink?

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i'm not complaining. i love the surgery i do. i do two of the most successful surgeries that can be done in all of medicine, and there's an endless supply of people who need knees and hips. i practice medicine in a state with great insurance reimbursement for now, and my med school loans are almost gone, house paid off, etc etc.. i'm pretty good at what i do, but people still have complications--that's why i don't sleep a ton, and have bad heartburn.

 

the income i earn is significantly more than 90% of other physicians because of the volume of surgery i do, the fact that i practice surgery (and not general medicine), and the location in which i practice. people look at the cars i own, and tell me i'm lucky. sure, some luck is important--plenty of things could have gone the other way in my life. but its not like i won the lottery, and i'm not ashamed to buy nice shit and enjoy spending money. most of what could be called 'complaining' on my part is for my colleagues who work their ass off and don't get paid shit, for the time they work, and the investment they've made to get them where they are.

 

How is a General Medicine Dr paid? Just a salary? I only ask because you brought it up.

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Insightful, Thank you for sharing. So your basically flate rate. Does that go on top of some base level salary?

 

Offtopic: If your in a 4 hour surgery and you have to take a leak can you or how about a drink?

 

Everything is based off Medicare rates, which are set by the govt. so when obamacare says they will cut Medicare reimbursement by 5% over the next five years! that means we get paid 5% less. Private insurance companies pay a percentage of Medicare. Like I said I live in a good area to practice. Some private companies will pay 300% of Medicare (very few do this). That is obviously awesome. Most of my patients are over 65 and have Medicare. Most private insurance companies will pay just above Medicare rates, but this is HIGHLY variable based on location. When I was in Florida some of the insurance companies paid as low as 80% Medicare. It was eye-opening. After taxes, that knee would pay less than $400. Guys just didn't give a shit about quality---some days we did 15-16 joint replacements. It was nuts.

 

Docs will scrub out during long surgeries to piss. I've never had to do it as a surgeon but have when I was in training. Not to sound overly dramatic but I'm usually so focused during a surgery I just don't get hungry, don't have to piss or shit.

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How is a General Medicine Dr paid? Just a salary? I only ask because you brought it up.

 

Again, payment is highly variable on location and practice type. University docs are typically paid a flat salary per year. There's no incentive to work harder. I have a base salary, but can get much more than that once I cover that base salary. The more I produce, the less overhead I pay. That's why I bust ass, and take a modest amount of vacation. If I take a week off, I need to fight the urge to think of it as lost money.

 

Our family physicians earn roughly $150k. They have 8-4 office, no weekends, no call, etc. they can earn more by doing procedures like injections. In big cities a pediatrician might make $100k. That's sad considering most are $200k+ in debt right out of school.

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Everything is based off Medicare rates, which are set by the govt. so when obamacare says they will cut Medicare reimbursement by 5% over the next five years! that means we get paid 5% less. Private insurance companies pay a percentage of Medicare. Like I said I live in a good area to practice. Some private companies will pay 300% of Medicare (very few do this). That is obviously awesome. Most of my patients are over 65 and have Medicare. Most private insurance companies will pay just above Medicare rates, but this is HIGHLY variable based on location. When I was in Florida some of the insurance companies paid as low as 80% Medicare. It was eye-opening. After taxes, that knee would pay less than $400. Guys just didn't give a shit about quality---some days we did 15-16 joint replacements. It was nuts.

 

Docs will scrub out during long surgeries to piss. I've never had to do it as a surgeon but have when I was in training. Not to sound overly dramatic but I'm usually so focused during a surgery I just don't get hungry, don't have to piss or shit.

I hope all dr's get in the zone as you describe.

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Again, payment is highly variable on location and practice type. University docs are typically paid a flat salary per year. There's no incentive to work harder. I have a base salary, but can get much more than that once I cover that base salary. The more I produce, the less overhead I pay. That's why I bust ass, and take a modest amount of vacation. If I take a week off, I need to fight the urge to think of it as lost money.

 

Our family physicians earn roughly $150k. They have 8-4 office, no weekends, no call, etc. they can earn more by doing procedures like injections. In big cities a pediatrician might make $100k. That's sad considering most are $200k+ in debt right out of school.

 

That sucks, To spend that much on schooling and only make 100k. OUCH. High end IT guys make more than that, and many of those guys have little to no college.

 

I think they are quite underpaid.

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People can believe what ever magic space daddy they want. Just don't make my countries policies based on your mythologies. I will make bigoted comments about ANYONE who tries to make policies based on there Superstitions.

 

I have no reason to accept people who try to make policies like Prayer in school. Or for Idiots to try and force SCIENCE CLASSES to be taught creationism.

 

Your 100% right I think hardcore right wing religious people are idiots. I also feel you should have to pass a test about things you vote on. If you can't answer enough questions accurately you can't vote. Nothing upsets me more than seeing people who head up Science Committees and think our earth is 6000 years old.

 

Separation of Church and state. DONE

 

So you support Jim Crow laws, got it. Can't be letting those uneducated minorities have anyone to defend them.

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i'm not complaining. i love the surgery i do. i do two of the most successful surgeries that can be done in all of medicine, and there's an endless supply of people who need knees and hips. i practice medicine in a state with great insurance reimbursement for now, and my med school loans are almost gone, house paid off, etc etc.. i'm pretty good at what i do, but people still have complications--that's why i don't sleep a ton, and have bad heartburn.

 

the income i earn is significantly more than 90% of other physicians because of the volume of surgery i do, the fact that i practice surgery (and not general medicine), and the location in which i practice. people look at the cars i own, and tell me i'm lucky. sure, some luck is important--plenty of things could have gone the other way in my life. but its not like i won the lottery, and i'm not ashamed to buy nice shit and enjoy spending money. most of what could be called 'complaining' on my part is for my colleagues who work their ass off and don't get paid shit, for the time they work, and the investment they've made to get them where they are.

 

I don't make near what you do, and even I get grief for the money I spend. It's sad when I was going to buy a Vette or CTS-V for my own enjoyment but people around me started trashing me because I was "acting all baller" so I decided to get a fucking Jeep. Not that i'm complaining at all because I've always wanted a Jeep as well, but still. When they found out the Jeep was bought new, HOLY SHIT! They didn't realize I bought a 2012 that was in the back of the lot, the 2013's were out for some time and the 2014's were around the corner. Sure it wasn't exactly what I wanted but the price was one I couldn't refuse.

 

This country seems to punish those who work hard, keep their money by spending wisely and saving instead of living on credit to keep up with the Jones'. (Pun intended Joans!) I'm by no means rich but we are nearly debt free with the exception of our house which we under-spent on. It took us quite a few hard years of penny pinching to get where we are at and i'm fucking proud of it. It just pisses me off that the harder I try to get myself ahead, the more taxes they want to take and give to some asswipe who refuses to earn his own keep.

 

Fuck it, I'll get off my soap box and stop now before I really start ranting like a retard.

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Again, payment is highly variable on location and practice type. University docs are typically paid a flat salary per year. There's no incentive to work harder. I have a base salary, but can get much more than that once I cover that base salary. The more I produce, the less overhead I pay. That's why I bust ass, and take a modest amount of vacation. If I take a week off, I need to fight the urge to think of it as lost money.

 

Our family physicians earn roughly $150k. They have 8-4 office, no weekends, no call, etc. they can earn more by doing procedures like injections. In big cities a pediatrician might make $100k. That's sad considering most are $200k+ in debt right out of school.

 

 

When I found out how little the typical Doctor or Lawyer earns my mind was blown.

 

The sheer effort, time, skill, and investment required do not payoff for the vast majority in these fields in my opinion.

 

Yes liberals, I just said I believe most doctors and lawyers are UNDER paid.

 

 

 

When the doc I visit for routine checks (who technically should have the most breadth of medical knowledge) earns less than most of the pharmaceutical sales rep that push pills Mon-Fri 9-5... there is a fucking problem.

Edited by 2highpsi
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When I found out how little the typical Doctor or Lawyer earns my mind was blown.

 

The sheer effort, time, skill, and investment required do not payoff for the vast majority in these fields in my opinion.

 

 

Wait till I tell you about veterinarians. $200k in debt, average starting salary $40k. The average salary is listed at $80k right now, but that will decrease as the baby boomers retire and practices are bought by corporations like VCA because the vets with $200k on loans can't afford to buy their own practices

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