We must fire bad doctors

[proud2BlibKansan]

This is not a new piece but I just found it today and loved it. Written by a teacher from Lawrence, KS.

All the talk lately about health care warrants stepping out of topic briefly to discuss a national public health epidemic: obesity.

According to the Center for Disease Control, one third of American’s are obese. Furthermore, obesity is not an equal-opportunity affliction. Obesity is 21% more prevalent among Hispanics, and 51% more prevalent among Blacks. The surgeon general’s office indicates that people living in poverty are 50% more likely to be obese.

Obesity is a major risk factor for cardiovascular disease, certain types of cancers, and type 2 diabetes. Obesity is unquestionably a life-threatening condition.

And obesity is expensive. Obesity-related medical expenses in the United States total nearly $100 billion annually, including about $50 billion in Medicare/Medicaid spending. In Kansas, we spend about $200 million each year on obesity-related medical costs.

How do we accept that one out of every three Americans suffers a life-threatening condition, and that minorities and economically-disadvantaged people are disproportionately afflicted? Why must society spend nearly $100 billion annually on what should be a preventable problem? Who is at fault?

Obesity is a medical problem, and medical professionals are supposed to prevent, treat, and cure medical problems. We spend $100 billion every year, but clearly we aren’t getting our money’s worth. It must be that our doctors are too incompetent and lazy to provide adequate medical care. The solution is simple:

We must fire bad doctors.

more . . . http://www.examiner.com/k-12-in-topeka/we-must-fire-bad-doctors

[Angry Dragon]

1. The same should hold true for politicians

[LWolf]

2. She needs to be careful.

This administration might not recognize sarcasm, and think she's got a good idea.

Who will they replace licensed doctors with, when they "turn around" the medical profession?

[progressoid]

8. They'll start a "race to the scalpel" program

[LWolf]

9. And doctors who agree to address obesity through surgery will

get more funding. Those that try to address it through diet and exercise will be fired.

[progressoid]

10. Yep. And no experience required!

Just figure it out along the way.

[LWolf]

11. So much more cost effective. nt

[FBaggins]

3. We DO fire bad doctors

and others have to spend a significant percentage of their income on insurance because their customers sue them whenever they aren't happy with their results.

But it's still a decent point.

[SharonAnn]

5. We don't fire nearly enough bad doctors. The 5% that cause most of the malpractice

claims have not all been terminated.

We don't fire nearly enough bad doctors.

[Hello_Kitty]

6. Are you seriously pushing that ridiculous RW talking point?

Do you have any idea how hard it is to even bring a malpractice suit, let alone win one?

[proud2BlibKansan]

12. They still get to practice medicine

Sure patients can fire their doctor but that doctor isn't out of a job.

[FBaggins]

15. And teachers still get to teach...

...if the "firing" is just a few parents moving to a different school.

I'm talking about actual firing, not losing customers. And yes, they are often out of a job if it happens.

My point was that the analogy can only be taken so far. The underlying meme is "teachers are professionals and should be treated (and compensated) as such" and that's absolutely true. It just doesn't mean that we can then extend the analogy to any other profession and assume that it's accurate.

Doctors (as with most white-collar professionals) have no union protection or collective bargaining/contract. They can be fired at almost any time for almost any reason (which is not to repeat the common error that teachers are "impossible to fire"). What doctors do have is a skill set that is in significant (and growing) demand that the vast majority of people cannot attain (and which is almost entirely immune to economic cycles). This insulates them from many issues that teachers face.

Another difference (that may change depending on how far HCR is taken) is that the taxpayer is essentially in the teacher's "chain of command" while the doctor has only a customer relationship with the patient.

[proud2BlibKansan]

16. Doctors don't need a union; they have a trades association

It's called the AMA.

And no, they don't get fired. They just find new patients.

[FBaggins]

17. Like a fired teacher can just find kids to tutor?

Come on. Most doctors work for a hospital system or other group. Of course the ones who have their own individual practice can't be "fired", but few fit that description these days. Ever were we to accept that spin, it's really no different than saying that a teacher can just open a tutoring company or go work for a private school. If a hospital fires a doctor, she certainly can have trouble getting hired by another hospital... particularly if the firing is related to malpractice claims (that would drive up the hospital's insurance).

And the AMA in no way substitutes for a union. They really don't not enter the labor/management arena. If you were to list the top five things that a union does for its members, you might find that the AMA does only one or two of them.

[proud2BlibKansan]

18. Doctors don't need a union cause they have the AMA

Ever wonder why doctors are paid as well as they are? Read the history of the AMA.

If teachers had a trade association instead of a labor union, their pay would be higher as well.

[FBaggins]

19. Only a small fraction of doctors even belong to the AMA

so that doesn't hold much water.

Ever wonder why doctors are paid as well as they are?

Nope. It would seem pretty obvious. They have skills that you need but don't have (and can't get in a reasonable period of time). The demand for physicians is high, but the supply side of the equation isn't very flexible (you can't just make 100,000 additional doctors in a factory - or even within a few years). The price is therefore high.


If teachers had a trade association instead of a labor union, their pay would be higher as well.

An interesting point for discussion. How many teachers do you think would be willing to give up the union? It's a dangerous line to cross... but it certainly is something that distinguishes teachers from roles that most people consider "professionals"

[Recursion]

24. You missed where the AMA comes in

The demand for physicians is high, but the supply side of the equation isn't very flexible (you can't just make 100,000 additional doctors in a factory - or even within a few years).

The AMA also pressures med schools to only have X slots per year. The competitiveness of getting into med school is partly just how hard it is, but partly an artificial scarcity the AMA pushes for.

[FBaggins]

25. So the AMA is to blame for the "insourcing" of foreign doctors?

:-)

And new schools are opening up all the time.

Regardless, it's still primarily "how hard it is"... which is just shorthand for my prior comment. The vast majority of doctors in this country could have easily entered a school of education and graduated with honors (which, don't misunderstand me, is a very different thing from having the talent or calling to succeed in the field), Most (but certainly not all) teachers could not have entered medical school, let alone graduated. That's why one makes more than the other.

It's not a knock... some jobs are simply harder than others and some jobs have much smaller tallent pools to draw from.

[sandnsea]

4. Doctors who prescribe medicine instead of diet

Should be held accountable. They are part of the problem. If there was a clinic where 50% of the people were dying, my god YES you would want to fire some doctors. I believe they closed a hospital in LA because of the horrific outcomes.

Honestly, I just don't understand why expecting results its such a horrible idea to some of you.

[Hello_Kitty]

7. How about we fire some bad parents?

Or how about tying your parental tax breaks to your kids' grades?

[YvonneCa]

13. Sandnsea, are you a teacher? n/t

[Name removed]

14. Deleted message

Message removed by moderator. Click here to review the message board rules.

[txlibdem]

20. If only we studied the root causes of obesity and used all the high tech tools at our disposal

We should look at each obesity case individually, doing scans and tests designed by the best minds in the field to glean what is the true root cause of this person's obesity. Then develop a rational plan to bring that American into line with the truly needed standards for health.

There should be one, single, standard in the entire country for what obesity is and how to determine if a person has it. There should not be 50 different states making the rules for just exactly what is "obesity" versus what is "fluid retention." And certainly, each medical clinic should not be able to both define what is obesity and self-evaluate their success in treating and curing it.

[PittsburghKid]

21. The Food Industry is Guilty Too

I know a lot of folks like to blame McDonald's and other companies on marketing towards children, but they're not alone. Have you seen what's in some products lately? Go ahead, grab something out of your pantry (organic foods don't count) and try to comprehend the ingredient list without the help of a chemist or a linguist.

We may have eliminated stuff like trans fat from foods, but we still have high fructose corn syrup, which is a huge problem. The dyes are also an issue, but the corn syrup is part of the obesity epidemic. Why? The body doesn't process it like it does regular sugar and can't send the signal to the brain that it's full.

Then there is the portion problem. People who complain about food prices need to examine their portions. An honest serving of a food isn't really that expensive, even if the product is organic. Point is, we eat too much. All you need to do is dine at a Cheesecake Factory or Applebee's sometime and compare the portions to what is listed on the back of food packages to understand this.

Fast food doesn't help either (nor do other restaurants). Portions are large, prices are low, and the unhealthy options are usually the ones ordered. The healthy options should just be made the default--a Happy Meal should automatically come with the apple dippers instead of fries, or perhaps include a salad as the main entree as an option (especially true of vegetarians, who may get dragged to McD's on a school field trip or something). Chicken McNuggets should NOT be advertised as healthy--pick up the nutrition guides some McD's give out to learn the truth about what four sauce-drenched nuggets really contain!

We also need to eat less meat. It's bad for the environment and protein can be found in other ways. (Of course, I may be biased--I feel it is cruel to murder animals for meat; I do drink milk/eat milk products and eat eggs, but always buy from local farms and not huge conglomerates).

Exercise is always an issue here. I like the NFL's current Play60 campaign and would love to see it better advertised! Nintendo has done some great things with the Wii, making video games good for you for a change, but many kids will pass the Wii Fit games up in favor of conventional games. Perhaps adding Mario to the Wii Fit would encourage them more. Of course, kids aren't alone--when was the last time you exercised as an adult? (Hopefully it was in the last 24 hours!) Gym memberships may be costly, but this too can be avoided--buy some dumbbells and find a place to run at the local park. Most malls are good for power walking and some even open early to allow for this (I do this a lot in the winter since our PA winters can be brutal).

Then, of course, there are the parents, doctors, and health teachers. They all need to step up a notch and doctors must realize meds aren't the answer to everything. Of course, I do suspect some health organizations/docs are in bed with drug companies, but a good doctor who is interested in helping patients and not making money will do the right thing and prescribe balanced diets with proper portion sizes and plenty of exercise.

In short, we're all in this together with keeping healthy. We just need to idiot-proof ourselves and listen to good, old-fashioned advice and eat as naturally as possible.

[Smarmie Doofus]

22. We must hire *cheap* doctors. For the simple reason that....

.... well... they're CHEAPER.

[Recursion]

23. We do. We also compare outcomes of doctors

It's part of how Medicare determines how much to pay them.