jonquiljo

No, just seem like they care "just a little" -- you know you guys do take care of people who really feel badly and are at their most vulnerable time. Perhaps I'm a bit old-fashioned, but healing arts used to be mostly concerned with healing. At least people were better at faking it.

So, no - you don't need to take an oath of poverty - but remember what you do and why you are supposedly doing it. I've seen too many people harmed by uncaring hands - and perhaps have been a bit jaded by it. I'm sure there are "good, caring" MD's on this board.

As for me, even though its irrelevant - I retired at 39 many years ago. I had been a biotechnology scientist. I certainly don't define myself by what I have - but rather who I have been to my friends and family. Everyone else will pick at the bones of my "things" long after I am dead.

As far as Porsches go - I've loved them since I was a kid admiring 356's. And I truly get a blast from my 911.

allegretto

Agreed!!!

He's young and full of himself, it will change...

OCBen

You know, Boo, I think you might have hit upon something there. That might not be a bad way to stop some of the malpractice we see. Just warn docs, "You kill it, you eat it." And they might just pay more attention.

Hauser_III

So we'll have a bunch of docs eating liver with fava beans and a nice chianti?

<for those that don't remember, it's a quote from "Silence of the Lambs.">

OCBen

Excellent, Hauser!

(But that's too famous of a quote for most of us not to know.)

ScottS

BTW "eat what you kill "is a term from lawyers- as in you get your billables without any split with your partner. Common short hand in practice arrangements to decribe the financials.

Overshare? So that's why we are here - to stare mutely at the screen and not connect with others. That sounds like a fun board.

Caring? My Pcar is 4 years old and has 12K miles. No time to drive it ( I work in the city and parking is dangerous at best) and too much caring at all hours of the day night and weekend. I enjoy what I do, it is demanding, fun and I get paid to help people. Mostly I get a lot of hugs from my patients families ( is that oversharing?).

How many of y'all paid for your Porsches by getting paid .30/1.00 USD and then giving away 20% of your work for 0.00/1.00 USD without the ability to write it off at all.

In terms of the retired- never underestimate the courage of the noncombatants. I don't do what I do for the money, I do it because it is my privelege, I help people, and I am damn good at it. I could not retire from my profession at 30 because there are many people to help before I stop.

Not complaining , just explaining.

allegretto

Hooboy, have you stepped into it here! I do agree that they were better at faking it (in more ways than you may care to think!), and perhaps as a percentage more guys cared back in the "Good Old Days". But in truth you are like many I speak to in your opinion about Medicine in general and physicians in specific. To say the least it is beyond the scope of this chat line to discuss this fully but your position is "selfish" in the true sense.

First of all, not many physicians need a lecture about patient suffering and how they feel about being sick. On the whole we are well aware of the circumstances and your leading with that point demonstrates your lack of depth on the subject. Further, you have no idea what it is like to fight the good fight every day (and often night) against the specter of sickness and dying. Sometimes guys will trivialize it with their language as a protective mechanism to better cope, but I know of no one who is as indifferent as you appear to believe.

Your position about physicians is like that "terracotta" guy. You want patients to be held up on a pedestal by caregivers (docs, nurses, administrators etc.) but you don’t want to give even consideration to the fact that most patients don’t feel the slightest qualm about making it a one-sided relationship. Patients will try like the devil himself to beat a hard-working practioner out of even a $10 co-pay. This is not because patients are evil or something, it’s because the healthcare system in the modern world (here and elsewhere) has systematically discouraged the mutual caring and respectful relationships of the past. Governments, insurance companies and regulators have made the old way a relic.

You’ve seen people hurt by uncaring hands. I’d suggest alternatively you’ve seen people hurt by incompetence. And if you think it’s bad, hang on, it’s going to get a lot worse. Society is so hell-bent on “free healthcare” (Economists here realize the folly of such concepts) that we turn out thousands of meta-competent “heath professionals” every year. Why? Cuz we want it CHEAP! And cheap my friends, is the enemy of GOOD.

What’s more important, a caring Heart Surgeon or a Porsche? Guess which one more people are willing to pay for?

I could go on…but it would go on and on and on. Suffice to say that unless you really understand, you don’t.

Did you make a lot of money and retire? Or was is non-voluntary due to health or some other reason? If it was because you made a lot of money, then you are specially non-qualified to make many value judgments about the little people in my experience. Easy to be critical of whatever catches ones fancy.

Nothing personal here, but unless you know both sides it is difficult to get a handle on it, even if you think you can.

S4to911

Wow...this is really getting off topic.

Let's just say, without naming names or academic institutions, that I am someone in a position to observe and participate at a fairly high level in the science, business, and service parts of medicine.

I like this board because it gives me an escape for 5-10 minutes every so often between the 30 sick cancer patients I see daily, the 20 clinical trials that I run, and the academic oncology division that I also manage.

In a sentence: you haven't got a clue about what medicine is like in 2006.

Like the post above, I wonder that you were able to retire at 39 as a "biomedical scientist." My guess (flame me if I'm wrong, but you do have a Porsche) is that you were able to retire after you cashed substantial stock options in a biotech company. Did the company produce an actual product that helped people? Or, as I have seen multiple times in my business, was it the medical equivalent of "vaporware," where the drug or technology looked good enough for an IPO, but the FDA canned it, leaving the patients and the investors holding the bag? Why aren't you still in the lab, helping out others through research for no or minimal pay? You know what post-docs make, don't you?

The bottom line is that all of us MDs, with very few exceptions, are in this business because we love people and want to make them better.

This is 2006, however, where there are a lot of $$$ at stake. A lot of people who have no clue about medicine (hedge funds, HMOs, etc) are trying to make money off of us, our relationship with our patients, and the hard work we put in (mainly because we love it). We know our responsibilities to those having a tough time of it--most of us take these responsibilities very seriously.

As distasteful as it is, we now have to understand business as well to beat these guys at their own game, which is being played on our field. If that means going to the payers ans hospital systems and asking for what we are worth, so be it.

Enough of this rant. I'm going out to drive my C2S cab through some twisties to relax...

jonquiljo

Whoa, don't over react! Its like I said ...


and I am sure there are. I was referring to what I perceive as noahark2's immature attitude - and all that it represents. Many of my best friends in college went on to become good and caring physicians. Luckily for them, medicine hadn't yet eaten their bottom lines away. These days good medicine isn't always good business, and I understand how both the patients and MD's lose. Given how much medicine has chaged in terms of a business in the last 20 years - my hats go off to you guys even more as I expect there will be more players and financial curve ***** in the future. This will probably happen when everything gets outsourced to China.

Hey I have all the sympathy in the world for you guys - most of you work very hard and get anything but rich from your labors. Thats especially true these days when the business climate has totally devalued human life.

Unfortunately it takes one silly and immature one to make everyone look bad. My displeasure was directed at a specific person and attitude. If I offended anyone else, I apologise.

As far as where and how I earn a living - let it suffice to say that I have lived both financial extremes in life and can understand the plight of people on both ends. I live now somewhere in between, which is where it should be.

And yes, Alegretto, I understand that most people want free healthcare. I couldn't agree more. Nothing in life is free and we should be prepared (as a society) to pay the ticket. My wife and I shell out about $150K a year in health care $$$ - a little extreme (sometimes people get chronically sick), but heathcare is anything but free. And yes, other people should be more reasonable about paying their share. And S4to911, it is unfortunate indeed as how business has made it difficult for both sides (MD's and patients) of the health care fence. I suspect we will get to the point where we will all die someday as a result of business decisions rather than disease. I am certainly getting resigned to that fact.

This is all the more reason to enjoy our Porsches - today may be our last. Which winds back to the topic of this thread - yes, pay as much as you can possibly live with to enjoy what you can in life.

allegretto

Well those of us who understand, already GOT IT.

As far as those who don't understand, I think if you read the posts here (a relatively sophisticated group) you will see that not only do they not get it, they think you don't.

So, would you rather be quiet and have people think you're a fool, or...

You are completely correct about non-combatants however. But that's the way it is. Everyone has their fantasies, reality often clashes with this, but it doesn't stop them since they know nothing of reality.

Oversharing simply means offering too much information for the audience to understand. Sadly it is rampant in Medicine. It causes much discomfort. Don't go off now, I KNOW, I KNOW, OK?

I also learned that expression from attorneys, but when you say it, it becomes an attribution to us. Attorneys are forgiven skulduggery with a nod and a wink because everyone hates them until they need them and when they do they want the meanest SOB they can find.

They NEVER want that from us.

Eat what you kill??? I know, you think you're being original. Sorry, very old. Fava beans? LAME! C'mon, that's from suspending reality way too often in two hours of lambent dullness. Anthony Hopkins hasn't a clue either.

Folks, there is way too much horror in Medicine. Good and loving people die for no reason at all. Disease takes no vacation and spares no suffering. Many young docs learn these methods of relating early in their career because if you don't develop an alternative way of looking at things you go home crying every day. It's like a combat soldier, you learn how to rationalize events that cannot be explained in rational terms.

Genug

icon

i got it and i didnt take offense.

i don't think you are giving us posters enough credit.

i'll agree maybe not the best choice of words, but again i didnt take it for anything other than a comment about the business side and was not offended and didnt think badly of physicians.

i hope you get a good nights sleep allegretto!

this is not oversharing?
i'm sure it can be very tough and at times unrewarding!
i hope you get fulfillment from your profession in the future allgretto!
i sounds like you are currently very disheartened!

my best to you!
jeff

allegretto

Sorry Jeff but your last paragraph proves my point.

I wouldn't like to do anything but what I do (except maybe a Porsche test driver )

CleanSlate

Can't we all just get along....

noahark2

In response to jonquiljo, It is rather offensive that you make any charaterization of me as a person. You do not know who I am or how I interact with people at my job. I simply anwsered a question that was asked of me. Just because you have high medical bills does not make me uncaring. There is an economic side of medicine. Since the topic was economics and how does one afford a car, this is a logical place for this. jonquiljo. Eat what you kill is a simple way to describe revenue sharing. What do you do jonquiljo? Were you perhaps a lawyer taking 30% of some car accident victims money? Perhaps charging 15 minutes worth of time to read a single piece of paper that takes really 45 seconds to read? Perhaps a contractor who builds poorly constructed houses in the south? Used car salesman selling salvaged cars from the floods in the south in New England? Maybe a "businessman" making money off stock grants and retiring early. I guess that money is always clean. Could never come from a bunch of investors in a stock offering who then lose their shirt when the company tanks. Yup, that is all impossible jonquiljo. Maybej onquiljo you didnt even earn your money. Perhaps you just inherited it. Your right I am the only uncaring person on this board.

OCBen

Every now and then we come across a thread where many of us invest (on topic!) our emotions in getting our points across, and inevitably it seems to devolve into name calling (your momma wears combat boots!) as feathers are ruffled and egos are bruised. .. Hey, I speak from experience.
It's often quite entertaining for the rest of us (where's Tim with his popcorn eating emoticon?) as we pull up a chair to watch the show.

And then someone comes in and flips on the lights and we blink and squint as we come to our senses.