To say someone is a doctor (physician) is a very mixed message these days. Assuming that he is 28-29 years old, then he has finished medical school and is probably doing a residency somewhere to acquire specialized training, mediocrely paid and perhaps with a load of medical school debt on top of college debt. I have heard some young physicians at this stage boast of the large cars and houses they plan to buy; their long-term personal prospects are good. I have also talked with physicians in practice who regard our health care delivery system as a terrible one and would opt for a system of national health care. I hope that the recent elections are not a fluke, and that they are the beginning of a new populism (small-d democratic)in which a reshaping of the American health care system will be one of the first foci of attention, after we get out of an involvement in Iraq which cripples American care of its own population. On another level, I gather that it was a good tenth-year reunion. Enjoy the reconnections you have made. LinguistFriend
It's an exciting time in Medicine because of what can be done for patients today.
Whether that will mean more wealth for doctors under the current system or the one Linguest Friend suggests, I don't know.
I've worked with Docs in the UK's NHS modernization office and one of their frustrations are all the systems bottle necks discharging patients from actue to subacute care... they tolerate longer lengths of stay because their system is so badly cooridinated (Hospitals, Nursing Homes, outpatient all have their own budget plans and they don't talk with each other).
But I think anyone involved with health care today has to be excited by the technology and the systems design... patient centric concepts.. it all comes out of the US mostly.
I do not doubt that much of the technical aspect of modern medicine is exciting; I have watched it from fairly close up as an academic researcher in neuromuscular physiology. And I am quite aware that much of what is new by way of research comes out of the US rather than from those countries that have national health care. I have wondered to what extent personal profit is in fact a constructive driving factor creating medical research. This has its anomalies also: I have also seen a med school department use publicity from departmental research to bring in patients, even where the department had no clinical expertise to match the research. For the area in which I have worked, to do with the larynx, the US contribution has been disproportionate in recent decades. But we do not know what has been done in some cases because of our ignoring research not published in English; when I gave a Russian medical research institute in St. Petersburg a book during a visit, the librarian pulled important Russian monographs in my field off the shelf to show me, which I scrambled to find when I returned to the US. I am quite at home in Russian, but the work had just been ignored in the West. The UK system which Bill Baar notes as a parallel in terms of clinical care has been relatively minor as a research contributor in my area, just as Bill notes that in his experience it was and is unsatisfactory in terms of the organization of patient care. Clearly it has not been optimized either in terms of research or patient care, but that does not mean that it is impossible to do so within the national health care framework. There are areas in which our system does very badly. (My observations were mainly from the point of view of a surgical department based at a large county hospital which dealt disproportionately with poor immigrants.) Prenatal care of mothers is quite inexpensive, for instance, but the results of lack of it, in terms of care of newborns born with medical problems, can rapidly become catastrophically expensive. Further expenses in terms of the effects of the child on the long-term family life become so enormous that the expense of prenatal care is insignificant by comparison. The response of the present administration has been to move towards denial of infant care to irregular foreign residents in such cases. That is the wrong direction of movement. I did not suggest a particular reorganization of health care, and am not qualified to suggest one, but there are many such anomalies that need to be rationalized. LinguistFriend
(((Prenatal care of mothers is quite inexpensive, for instance, but the results of lack of it, in terms of care of newborns born with medical problems, can rapidly become catastrophically expensive.)))
And since the baby is an American citizen, the taxpayers are still paying for it, they are just paying more.
"And since the baby is an American citizen, the taxpayers are still paying for it, they are just paying more."
Given the conservative trend toward wanting the U.S. to go European (i.e. identifying a national language, seeing immigrants as outsiders to "our" culture, guest worker programs), I don't think it will be long before Republicans suggest that we rewrite the 14th Amendment so not all persons born in the United States are citizens. Just delete "All persons born or naturalized in the United States, and subject to the jurisdiction thereof, are citizens of the United States and of the state wherein they reside," have Congress legislate that children born of illegal immigrants are not citizens, and Republicans won't have to worry about caring for the illegal immigrant mother *or* her baby.
6 comments:
To say someone is a doctor (physician) is a very mixed message these days. Assuming that he is 28-29 years old, then he has finished medical school and is probably doing a residency somewhere to acquire specialized training, mediocrely paid and perhaps with a load of medical school debt on top of college debt. I have heard some young physicians at this stage boast of the large cars and houses they plan to buy; their long-term personal prospects are good. I have also talked with physicians in practice who regard our health care delivery system as a terrible one and would opt for a system of national health care. I hope that the recent elections are not a fluke, and that they are the beginning of a new populism (small-d democratic)in which a reshaping of the American health care system will be one of the first foci of attention, after we get out of an involvement in Iraq which cripples American care of its own population.
On another level, I gather that it was a good tenth-year reunion. Enjoy the reconnections you have made.
LinguistFriend
It's an exciting time in Medicine because of what can be done for patients today.
Whether that will mean more wealth for doctors under the current system or the one Linguest Friend suggests, I don't know.
I've worked with Docs in the UK's NHS modernization office and one of their frustrations are all the systems bottle necks discharging patients from actue to subacute care... they tolerate longer lengths of stay because their system is so badly cooridinated (Hospitals, Nursing Homes, outpatient all have their own budget plans and they don't talk with each other).
But I think anyone involved with health care today has to be excited by the technology and the systems design... patient centric concepts.. it all comes out of the US mostly.
It's a good time to be a Doc.
And this chap's Daddy was a high-powered Washington lawyer.
I doubt med school debt will be such a problem.
(Even at seven, I could pick em...)
CC
I do not doubt that much of the technical aspect of modern medicine is exciting; I have watched it from fairly close up as an academic researcher in neuromuscular physiology. And I am quite aware that much of what is new by way of research comes out of the US rather than from those countries that have national health care. I have wondered to what extent personal profit is in fact a constructive driving factor creating medical research. This has its anomalies also: I have also seen a med school department use publicity from departmental research to bring in patients, even where the department had no clinical expertise to match the research. For the area in which I have worked, to do with the larynx, the US contribution has been disproportionate in recent decades. But we do not know what has been done in some cases because of our ignoring research not published in English; when I gave a Russian medical research institute in St. Petersburg a book during a visit, the librarian pulled important Russian monographs in my field off the shelf to show me, which I scrambled to find when I returned to the US. I am quite at home in Russian, but the work had just been ignored in the West.
The UK system which Bill Baar notes as a parallel in terms of clinical care has been relatively minor as a research contributor in my area, just as Bill notes that in his experience it was and is unsatisfactory in terms of the organization of patient care. Clearly it has not been optimized either in terms of research or patient care, but that does not mean that it is impossible to do
so within the national health care framework.
There are areas in which our system does very badly. (My observations were mainly from the point of view of a surgical department based at a large county hospital which dealt disproportionately with poor immigrants.) Prenatal care of mothers is quite inexpensive, for instance, but the results of lack of it, in terms of care of newborns born with medical problems, can rapidly become catastrophically expensive. Further expenses in terms of the effects of the child on the long-term family life become so enormous that the expense of prenatal care is insignificant by comparison. The response of the present administration has been to move towards denial of infant care to irregular foreign residents in such cases. That is the wrong direction of movement. I did not suggest a particular reorganization of health care, and am not qualified to suggest one, but there are many such anomalies that need to be rationalized.
LinguistFriend
(((Prenatal care of mothers is quite inexpensive, for instance, but the results of lack of it, in terms of care of newborns born with medical problems, can rapidly become catastrophically expensive.)))
And since the baby is an American citizen, the taxpayers are still paying for it, they are just paying more.
CC
"And since the baby is an American citizen, the taxpayers are still paying for it, they are just paying more."
Given the conservative trend toward wanting the U.S. to go European (i.e. identifying a national language, seeing immigrants as outsiders to "our" culture, guest worker programs), I don't think it will be long before Republicans suggest that we rewrite the 14th Amendment so not all persons born in the United States are citizens. Just delete "All persons born or naturalized in the United States, and subject to the jurisdiction thereof, are citizens of the United States and of the state wherein they reside," have Congress legislate that children born of illegal immigrants are not citizens, and Republicans won't have to worry about caring for the illegal immigrant mother *or* her baby.
Post a Comment