Submitted by James, Nov 11, 2006 18:47

I am a surgeon in California, age 40.
I currently have personally witnessed the decline of education, motivation, and quality in both new trainees and currently practicing physicians.

Why? Nobody gets paid. When you siphon the money out of the system, the system goes rotten. Now you have anger and apathy, as everybody I know pretty much is assured that it is a crap shoot whether or not a "claim" gets paid, and it's a war with the insurer to get a penny.

Companies have been duped into a scam. Insurers assure them that they have "excellent" doctor networks of specialists (their lists are lies populated by dead MD's, people in different fields, or those that have left the area) and then tell them that the "costs" of doing medicine is going up so much (of course, driven by Evil Profiteering Doctors) that they have to raise rates every year.

Now, the insurers have a perfect scam: people believe, because the cost of their premiums is so high, that they've purchased a Magic Key to total health care coverage. In fact, EVERY POLICY, from "PPO" to "EPO" to "HMO" is as riddled with holes in coverage as Swiss Cheese. Patients have no clue what they have purchased for coverage, and get really pissed off when they find they have to shell out MORE money when they get sick. I can't even find out, when I have a patient's insurance card in front of me, what is or is not covered. When you query the insurer, they give you vague statements of assurances, only to find out that later some service isn't part of the plan, or isn't "authorized".

What a joke. These guys steal public money, make physicians and hospitals provide services with only a guess as to whether they get paid, and then stick the health care system with the bill.

Now, Residency programs can't even be filled with US Medical Grads. We have 26% of residency slots going to foreigners. Why? Because even with our wretched pay system, it still is slightly better than in the Third World. Worse off, our teaching hospitals have been abandoned by patients as their insurers, eager to drive away patients from expensive teaching programs (let's face it, in a teaching environment you order more labs/imaging/consultations-- got to learn some way...) have made the learning experience pathetic-- I have personally met surgeons who have graduated with less than a couple of dozen cases under their belts.

Medicare is leading the way into a new Dark Age. We expect to see a 5% paycut , EVERY year, from Medicare in 2007 onward. This is a deliberate plan to denegrate medicine in this country. Physicians have no representation in any body of government, and no friends publically-- we're all rich, overpaid, overeducated jerks, right? The plan is to drive every independent MD into big corporate entities, and control them. God knows, you don't want maverick doctors letting patients choose who to treat and who not to. Rather, this is best left in the hands of Big Money-- insurers, Kaiser, governement hospitals...

People-- you'll only know what is lost when we're really gone. Currently there are a few of the Old School still out here holding up some pretense of the old ideal-- do the right thing no matter what the cost to your personal/family life-- but that is changing. Now, new grads are choosing their lives first, and not bothering to really be good at anything. It's just not valued any more.

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