1
0

America's doctors are overpaid


 invite response                
2013 Feb 25, 9:15am   32,332 views  150 comments

by tovarichpeter   ➕follow (7)   💰tip   ignore  

http://www.slate.com/articles/business/moneybox/2013/02/american_doctors_are_overpaid_medicare_is_cheaper_than_private_insurance.html

American health care costs a lot because the prices Americans pay for health care services are very high. And hospitals charge those high prices for the same reason any other business would—because they can. It’s easy to see why a health care provider is almost uniquely well-positioned to bilk you. If you don’t get treatment, you or someone you love might die. It’s a high-pressure emotional situation that makes it extremely difficult to bargain, comparison shop, or just decide to cut back. Most of us, fortunately, get to outsource most of that bargaining to our insurance companies. Cold-blooded executives, not...

« First        Comments 64 - 103 of 150       Last »     Search these comments

64   Homeboy   2013 Feb 27, 1:33pm  

CL says

I'd say that they deserve it simply because there are so few that make it to that echelon. Even when they do, their careers are often short due to strain and injury.

So, the best in the world compete and win repeatedly to get highly paid for a short time. Sounds fair. Maybe even less fair for them if you think about it.

That makes no sense. A typical wage earner could work for 30 years and still in their entire life, not make anywhere close to what an NBA player makes in a single year. This is not simply compensation for having a short career; it goes way, way, way beyond that. And besides that, NBA players get a pension after they retire. Sorry, try again.

65   Rin   2013 Feb 27, 1:41pm  

Homeboy says

It seems you entirely missed the point. You are arguing WHY NBA players make what they do. What is the point of such an argument?

What point am I missing? I have an A- undergrad GPA; I also took the MCAT and scored a 34. Instead of attending medical school, since I had *the numbers* for admissions, I went into the biopharma industry and eventually found myself in IT and then, hedge fund work.

Now, despite my interest in junior varsity basketball, there's pretty much, zero chance of me making it into the NBA, or even one of the smaller leagues, where players don't make over $100K. Here why ... I can't develop LeBron James' athleticism, by simply running and lifting weights. Those are attributes which one needs to be born with, to want to be in the NBA. I would not make any of David Stern's cutoffs, to be in his clubhouse.

In contrast to professional b-ball, numerous scientists and engineers have the intellectual ability to complete medical school and become doctors. Doctors are not all born with photographic memory and 220 IQs. The problem ... not enough seats (overall) and two, everyone needs to borrow up to 4 years worth of tuition & expenses, to attend any US medical school.

My conclusion is that medicine is another educated labor field, not too distinct from engineering or the applied sciences. There's no shortage of entrants into any of the aforementioned areas, and many non-management S&Es earn less than $120K/yr, esp the postdocs in biosciences, who earn less than $45K/yr.

Allow more scientists and engineers to enter the field of medicine, by shortening the number of years of borrowed money, and you'll see qualified entrants into the practice.

66   curious2   2013 Feb 27, 2:06pm  

Rin says

Allow more scientists and engineers to enter the field of medicine, by shortening the number of years of borrowed money, and you'll see qualified entrants into the practice.

But that's why it doesn't happen. PhRMA doesn't want more entrants with less debt, especially engineers, because the current entrants are so much easier to control: indoctrinated into allopathy, deeply in debt, needing to prescribe whatever PhRMA wants to sell. Actual scientists?!? No way, they might cure something, or at least notice that Homefool's toxic SSRI's don't work, which would disrupt the business model of making diseases into revenue centers (and manufacturing diseases to turn them into still more revenue centers). You seem to be suffering the engineer's cognitive failure to grasp that the medical industrial complex is not designed to help people, it is designed to make money. There are plenty of ways to increase the supply of qualified doctors, e.g. by not driving the honest ones out of the profession (see above), and costs could be reduced further by eliminating the federally mandated artificial demand (Rx requirements, Obamacare, etc.). But those don't happen either, for the same reason, they would interfere with the revenue model.

67   Rin   2013 Feb 27, 2:17pm  

curious2 says

Actual scientists?!? No way, they might cure something, or at least notice that Homefool's toxic SSRI's don't work, which would disrupt the business model of making diseases into revenue centers (and manufacturing diseases to turn them into still more revenue centers). You seem to be suffering the engineer's cognitive failure to grasp that the medical industrial complex is not designed to help people, it is designed to make money.

Sure, I got all that, however, if they're going to use the examination system, as the primary gateway, then they have to either live or die by it. Realize, medicine is not management consulting, where BS reigns supreme. In the end, 90% on an exam involving any applied science, like causes of genomic mutations, is still an 'A' mark. This is where medicine can't pull the same stunts as bankers, in restricting access to the field.

The only thing they can do is threaten to fire scientists, if they blow the whistle on the existing practices. And for the most part, that's not much different from corporate America, where clearly, better work could be done, if S&Es had more freedom from management. And likewise, engineers entering medicine, will be forced to follow the rules or be blacklisted. End result, doctors salaries go from $250K, down to $150K, but again, everyone plays the game.

68   Meccos   2013 Feb 27, 2:40pm  

Rin says

My conclusion is that medicine is another educated labor field, not too distinct from engineering or the applied sciences.

Yeah, im sure cutting into someone's chest and heart is not too distinct from designing a circuit board... Gotta have nerves of steel and steady hands to design those boards eh?

69   Rin   2013 Feb 27, 2:42pm  

Meccos says

Every time you speak about doctors making too much money and how "scientists and engineers" are just as smart, it only makes you sound like you regret the choices you made and are very bitter about it.

I earn over $700K/yr, working in a hedge fund. My regret about my line of work is that it's basically sales and not, science & engineering, a worthy profession for someone, who cares about something other than the bottom line.

I've railed against management consultants and their like, because unlike in my prior line of work, those individuals are empty suits with little to contribute to the world.

And thus, my only goal now, is to become financially independent, and then, apply to medical school, and contribute something of value, without needing to worry about an income stream. And yes, unlike many others, I've seen all sides of the fence.

70   Rin   2013 Feb 27, 2:43pm  

Meccos says

Yeah, im sure cutting into someone's chest and heart is not too distinct from designing a circuit board... Gotta have nerves of steel and steady hands to design those boards eh?

Tell that to a dermatologist, neurologist, pathologist, or radiologist. I'm sure they're all cutting out someone's chest.

71   Rin   2013 Feb 27, 2:50pm  

Meccos says

Stop complaining and go become a doctor yourself.... furthermore dont make stupid requests like the quote above... it only hurts your arguments about doctors making too much money.

Does it hurt my argument or are you simply trying to find a way of shutting me down? In other words, do you, yourself, have a photographic memory and a 220 IQ & thus, are too brilliant for ordinary Joes like myself who've studied applied chemistry and chemical engineering. My arguments stem from the fact that many S&Es have the intellect to pass the medical school basic sciences curriculum. That hasn't changed.

72   Meccos   2013 Feb 27, 2:56pm  

Rin says

I earn over $700K/yr, working in a hedge fund. My regret about my line of work is that it's basically sales and not, science & engineering, a worthy profession for someone, who cares about something other than the bottom line.

Great... go get into medical school and do something instead of bitching all day. And if you truly wanted to speak about people getting paid too much, then you should investigate your current line of business.... especially yourself.

Um scientists and engineers are not the only worthy profession. Please get your head out of your ass...

BTW, there are some people in every profession who care only about the bottom line. SInce we are on the topic of medicine, look at big pharma and medical device companies. They are filled with "scientist and engineers" who care only about the bottom line.

Rin says

those individuals are empty suits with little to contribute to the world.

YOu mean like working in a hedge fund?

Rin says

And thus, my only goal now, is to become financially independent, and then, apply to medical school, and contribute something of value, without needing to worry about an income stream. And yes, unlike many others, I've seen all sides of the fence.

700k should make you fairly financially independent already... whats stopping you? Furthermore since you are going into medicine and will be "way overpaid" as you suggest why do you even need the money???

Lastly, I find it funny that you think when you go into medicine you will contribute something of value, yet you seem to imply that physicians currently do not contribute something of value. Your ego is enormous, but i guarantee you, once you get into medical school and residency your ego will be shattered in many ways.

73   Meccos   2013 Feb 27, 3:03pm  

Rin says

Meccos says

Yeah, im sure cutting into someone's chest and heart is not too distinct from designing a circuit board... Gotta have nerves of steel and steady hands to design those boards eh?

Tell that to a dermatologist, neurologist, pathologist, or radiologist. I'm sure they're all cutting out someone's chest.

Tell the cardiothoracic surgeon who is cutting into someone's heart that his job is indistinct from the lab rat working in microbiology.

Tell the neurosurgeon that sawing open someones head that his job is indistinct from someone writing code.

Tell the pain physician who is implanting spinal cord stimulators onto someones spinal cord that his job is indistinct to designing a circuit.

BTW, the radiologist, pathologist, dermatologist that you seem to belittle make life and death decisions all day. They are crucial in the diagnosis of a malignant cancer that may one day save you or a loved one.

OH btw, you want to go into medical school so that "you can contribute"... which useless field are you going into???

74   curious2   2013 Feb 27, 3:14pm  

Meccos says

the difficulties of becoming a physician is only partially about learning the subject matter, but also the sacrifices in time and effort which you do not seem to comprehend

In other words, barriers to entry that increase costs without improving results.

75   curious2   2013 Feb 27, 3:29pm  

@Meccos, you're getting upset and contradicting yourself, please try switching to de-caf. You're also setting up an all-or-nothing false choice fallacy, i.e. all of the current medical industrial complex or faith healing. Other countries find plenty of middle ground. Some medicines are useful, others are not, but paid salesmen are not necessarily the best or most objective guides.

76   Meccos   2013 Feb 27, 3:30pm  

Hm. why are my posts being deleted... Lovely...

77   Meccos   2013 Feb 27, 3:33pm  

curious2 says

@Meccos, you're getting upset and contradicting yourself, please try switching to de-caf. You're also setting up an all-or-nothing false choice fallacy, i.e. all of the current medical industrial complex or faith healing. Other countries find plenty of middle ground. Some medicines are useful, others are not, but paid salesmen are not necessarily the best or most objective guides.

yes, this is when people start resorting to personal insults or putting words into peoples mouth. I suppose my arguments are done here now..

78   Meccos   2013 Feb 27, 3:35pm  

BTW seriously why do people find the need to delete my posts. I believe 2-3 posts here were just deleted in the past few minutes...

79   Homeboy   2013 Feb 27, 3:42pm  

Rin says

What point am I missing?

I'm sure I was clear.

People here are complaining that doctors make too much money.

I said NBA players make some 30 times more money for playing with a ball.

That makes it seem rather silly to complain about doctors' salaries.

Surely you can understand that, if you do actually make $700K a year.

What aren't you getting?

80   Homeboy   2013 Feb 27, 4:01pm  

Meccos says

BTW seriously why do people find the need to delete my posts. I believe 2-3 posts here were just deleted in the past few minutes...

Because you challenge their little "nobody deserves anything... except me" world view.

81   Meccos   2013 Feb 27, 5:05pm  

Rin says

Allow more scientists and engineers to enter the field of medicine, by shortening the number of years of borrowed money, and you'll see qualified entrants into the practice.

Every time you speak about doctors making too much money and how "scientists and engineers" are just as smart, it only makes you sound like you regret the choices you made and are very bitter about it.

Stop complaining and go become a doctor yourself.... furthermore dont make stupid requests like the quote above... it only hurts your arguments about doctors making too much money.

82   Meccos   2013 Feb 27, 5:05pm  

Rin says

Does it hurt my argument or are you simply trying to find a way of shutting me down? In other words, do you, yourself, have a photographic memory and a 220 IQ & thus, are too brilliant for ordinary Joes like myself who've studied applied chemistry and chemical engineering. My arguments stem from the fact that many S&Es have the intellect to pass the medical school basic sciences curriculum. That hasn't changed.

NO one ever said that you have to be a genius to be a physician. I believe you made that argument up by yourself. However just because you studied applied chemistry and chemical engineering doesnt make you fit to be physician.
BTW, i agree with you. Many non-medical people can bass the basic science curriculum. No one will disagree with you about that. Unfortunately the basic sciences are a FRACTION of what is taught in medical school. In fact the basic sciences probably make up less than a year of the medical school curriculum. Furthermore, the difficulties of becoming a physician is only partially about learning the subject matter, but also the sacrifices in time and effort which you do not seem to comprehend.... perhaps you do since you are quoted as saying the following:
Rin says

Allow more scientists and engineers to enter the field of medicine, by shortening the number of years of borrowed money, and you'll see qualified entrants into the practice.

83   Meccos   2013 Feb 27, 5:05pm  

curious2 says

Meccos says

the difficulties of becoming a physician is only partially about learning the subject matter, but also the sacrifices in time and effort which you do not seem to comprehend

In other words, barriers to entry that increase costs without improving results.

Yeah your so-called "barrier to entry" is called medical school and residency. Yes you actually have to spend some time to learn the stuff... Heaven forbid people actually force you to learn things in great detail before they let you cut people open or prescribe medications that may kill someone...

Its not like the "scientist and engineers" who can learn their craft during the 4 years of undergraduate school...

84   Meccos   2013 Feb 27, 5:05pm  

@curious

Instead of complaining about these "barriers", perhaps you should rebel against the medical establishment and go see the neighborhood shaman next time you have some serious medical issue...

85   Meccos   2013 Feb 27, 5:05pm  

curious2 says

Meccos says

the difficulties of becoming a physician is only partially about learning the subject matter, but also the sacrifices in time and effort which you do not seem to comprehend

In other words, barriers to entry that increase costs without improving results.

The so called "barriers" you suggest are called medical school and residency. THis is where doctors actually learn their craft. So you call it a barrier... I find that funny.

This is the second time posting this since someone deleted my previous post...

86   Rin   2013 Feb 27, 9:56pm  

Homeboy, here's what you don't seem to understand about the nature of work.

If non-NBA small leagues had their own advertisement money flowing in, then playing professional basketball would be a lower paid profession. Instead, in America, if one is not up to David Stern's standards of athleticism, then there's little chance of ever playing in his ball club. Since no one else has created an alternative league, to challenge him for ratings, the NBA serves as a de facto monopoly. And thus, as an umbrella organization, how they break up their earnings, call it profit/loss statement, is up to them. That's the nature of ownership.

In my field, hedge fund work, a similar principle applies, however, allegedly, anyone with deep pockets can join in. In the end, the combination of pooled capital and trading techniques (or sometimes insider information), determines who stays and who fades away. And then, inside a particular fund, a profit/loss statement determines compensation and that's why you read about these fellows, earning $1M to $100M per year. Again, this isn't about labor, it's about the ownership of capital. And thus, I'm now aware that it's a lot different, being on a team, where one's essentially a part-owner vs a worker bee. But looking at it from a wider perspective, what I really am is a salesman, shoring up the clients and protecting our interests.

Outside of the above, most lines of work revolve around the concept of labor and that's that one exchanges his time/skills for money. This includes plumbers, cabbies, engineers, doctors, lawyers, & just about everyone else out there. People who are in the laboring classes, will seldom have the type of pricing power, as someone in the ownership class.

Now, to Mecco's credit, if doctors, like let's say the military's special forces, can indicate that they have a skill level, which no other laborer could match, using some combination of hours trained in A, B, & C, and exam scores X, Y, & Z, then certainly, they can earn over $200K/yr and it wouldn't be an issue. But last I'd checked, most enlisted Navy recruits, could try out for the SEALs BUDS training, however, less than 30% make it through that basic training, before the additional year of training.

The difference between let's say the NBA and hedge fund world vs medicine is that no one has to watch any of Stern's teams and likewise, no one has to invest in my parent company, however, much of the population does need to see a doctor, from time to time.

87   Rin   2013 Feb 27, 10:20pm  

Meccos says

@curious

Instead of complaining about these "barriers", perhaps you should rebel against the medical establishment and go see the neighborhood shaman next time you have some serious medical issue...

Actually, I think folks are already opting for medical tourism for a number of issues these days, like hip replacement, $12K in first world Singapore vs $50K in the US.

88   Rin   2013 Feb 27, 10:25pm  

Meccos says

700k should make you fairly financially independent already

That's 2012, the first year where I'd seen money like I'd never seen before. And my plan is to retire, once I have banked $5M+, hopefully in another 4-6 years. And then, it's off to medical school.

89   MMR   2013 Feb 27, 10:33pm  

Medical basic sciences is typically 4 semesters, or two years. And medical basic sciences lays the foundation for what a person will see in the 3rd and 4th year on the wards. Still, a lot of things are taught in a cursory way (nutrition) and in other instances, not at all (exercise physiology).

A lot of time is spent on cardiovascular disease in physiology and pathology, as well as diabetes. Which is good, however there is absolutely no emphasis on prevention. Only to say that, diabetes is treated, first and foremost with diet and lifestyle changes. However, nothing in a medical school education (basic science, clinical science, residency) prepare an individual for this type of intervention. Predominantly drug therapy. Even a fellowship in nutrition would prepare a person to do research in nutrition, but not necessarily to help an individual to improve their own nutrition.

Even a high percentage of cancers are attributable to lifestyle. But that is never mentioned. Some cancers have a strong genetic foundation (about 15%).

While medical school should teach disease and treatment, the lack of emphasis on prevention is something that needs to be addressed. As such, people like myself are in the minority, but it is a significant minority and growing with time.

The public is wising up to the fact that allopathic medicine doesn't do a good job of addressing the scourge of chronic diseases precipitated by lifestyle choices.

Medicine is still the best choice for people with acute issues or trauma.

Doctors learn their craft, but it mostly consists of regurgitation. Very little in terms of critical thinking. In many instances, the professor will say something that is wrong or contradicted by current research. Argue with that individual and see where it gets you.

That being said, other than emphasizing prevention and coming up with a standard of care, I'm not sure if there is a better way to teach the craft other than cramming, testing, regurgitating and doing it over and over again until reaching the hospital, then seeing as many cases as possible and solidifying it through a residency or fellowship.

Medicine is taught in a way that a person can retain a high percentage of a high volume of information for a very long time, which is useful for diagnosing things or building a decision tree in the mind when a Dr sees a patient with a specific group of symptoms.

Meccos says

Many non-medical people can bass the basic science curriculum. No one will disagree with you about that. Unfortunately the basic sciences are a FRACTION of what is taught in medical school

90   MMR   2013 Feb 27, 10:44pm  

Nearly completely driven by the 'fat' in the system and layers added by insurance and corresponding administration. To a lesser extent HIPAA, OSHA, Joint Commission.

If insurance was used for catastrophic coverage only (what it was originally designed for), it would be a lot easier to return to equitable pricing in the US.

Hip replacement=lifestyle issue that doesn't have the best results in the world with regard to mobility. Ditto for knee replacement and spinal fusion surgery.

I'm feeling lazy to look it up, but Orthopedics is a cash cow procedural field which does procedures that currently have limited utility, based on current literature. Maybe it will improve in the future.

How many hip replacements are necessary in a world where diet, exercise and lifestyle are promoted. I'm not saying that they shouldn't be available, just that they should be about 75-80% less frequent.

Osteoarthritis may be inevitable, but it doesn't mean that it should necessarily result in hip replacement.

Autoimmune diseases are often triggered by the type of food one consumes. But autoimmune diseases where the joints are attacked represent a more worthwhile pursuit for orthopedic joint replacement surgeries, where knowledge on diet and lifestyle to avoid the issue are still limited.

Rin says

Meccos says

@curious

Instead of complaining about these "barriers", perhaps you should rebel against the medical establishment and go see the neighborhood shaman next time you have some serious medical issue...

Actually, I think folks are already opting for medical tourism for a number of issues these days, like hip replacement, $12K in first world Singapore vs $50K in the US.

91   MMR   2013 Feb 27, 10:47pm  

Although I think some of the course material is harder in engineering in terms of having to use logical thinking, overall medicine is significantly harder than engineering, due to the time commitment and also the fact that you can't just 'go at your own pace' as one might be able to do in engineering (go part time).

Meccos says

Furthermore, the difficulties of becoming a physician is only partially about learning the subject matter, but also the sacrifices in time and effort which you do not seem to comprehend.... perhaps you do since you are quoted as saying the following:

92   Rin   2013 Feb 27, 10:51pm  

MMR says

That being said, other than emphasizing prevention and coming up with a standard of care, I'm not sure if there is a better way to teach the craft other than cramming, testing, regurgitating and doing it over and over again until reaching the hospital, then seeing as many cases as possible and solidifying it through a residency or fellowship.

I'm not sure if this can be changed. Even today, those with adult onset diabetes, type II, tend to self-medicate with vitamins, on advice from friends and nutritionists. For example, thioctic acid (R-lipoic acid), cheap & widely available in many vitamin stores w/o prescription, has been shown to normalize insulin levels, while increasing glutathione production, however, from the allo perspective, only glucophage (metformin) is prescribed to control blood sugar levels via hepatic manipulation.

93   MMR   2013 Feb 27, 11:25pm  

My relatives who are doctors (all 30 of them) do not know even this simple fact. Only one ever mentioned it, and couldn't tell the difference between R-lipoic acid and alpha lipoic acid. The difference is that the R enantiomer is more active while standard alpha lipoic acid contains both R and S enantiomer which is useless.

Also fenugreek works to normalize insulin levels

Also bitter melon or bitter gourd has a profound effect on insulin levels. This is commonly found in Indian grocery stores; also Chinese stores consistently carry it along with the Chinese bitter melon which is similar, but with a smooth surface.

Cinnamon is also useful in the treatment of diabetes

Grape seed extract is also useful in the treatment of diabetes

vitamin C is also useful in normalizing slightly elevated blood sugar

Metformin is probably the safest drug, as you stated, limits hepatic conversion of amino acids to glucose (gluconeogenesis). It does have the side effect of lactic acidosis.

All this is good but it is not a substitute for actually dropping body fat through macronutrient manipulation, resistance training + high intensity interval training or cardio. Of course, most people are lazy +brainwashed to believe that a pill will solve their problems.

People with type II diabetes don't consistently exercise, that's for sure. If they did, they probably wouldn't get type II in the first place, even with a purported strong genetic predisposition (that's what they claim in the books anyway).

That is where personal trainers are required. How many doctors at the primary care level have personal trainers that they can refer people to? In my family of 30 doctors, the answer is zero. Only other drs in their referral networks.

Changing attitude towards food is also something that most obese people, not just diabetics.

For those who don't exercise, ketogenic diet is probably the way to go, but adherence is an issue. Most drugs outside of metformin have significant side effects.

For those who do resistance training + cardio, a cyclic ketogenic diet might be better as weight training with glycogen depletion is an uphill battle

http://en.wikipedia.org/wiki/Cyclic_ketogenic_diet

In many cases, drugs buy a little bit of time before the patients renal function declines to the point where they have to be put onto dialysis. It's a known fact that over 80% of people on dialysis due to end stage renal disease are also diabetic (usually type II). Reason: no money in prevention

Are patients going to follow doctors who tell them to lose weight without telling them how? Furthermore, are patients going to exercise when their doctor doesn't exercise themselves or have anyone in their referral network who is an exercise specialist.

On the average, patients relying on insurance to pay and doctors relying on insurance to get paid will never solve this issue.

Medicine was once a calling, then a profession; now, it's all about business. While the majority want the easy way out, there is a business opportunity for those individuals who want to learn and put in the work with money out of their pocket. That's my target market

Rin says

or example, thioctic acid (R-lipoic acid), cheap & widely available in many vitamin stores w/o prescription, has been shown to normalize insulin levels, while increasing glutathione production,

94   MMR   2013 Feb 27, 11:32pm  

Also, many diabetics are deficient in B complex vitamins, C, D and even K, which I just realized.

This is just a cross sectional study, but vitamin K, especially K2 does have a lot of emerging science behind it.

http://www.ncbi.nlm.nih.gov/pubmed/23034962

95   MMR   2013 Feb 27, 11:34pm  

Alzheimer's Disease might very well be "type III diabetes" as it is characterized by brain insulin resistance. News to me but I know that AD and type II DM share one thing in common: amyloid deposits (AD in brain and type II DM in pancreas).

http://www.rhodeislandhospital.org/wtn/Page.asp?PageID=WTN000249

96   Rin   2013 Feb 27, 11:38pm  

MMR says

My relatives who are doctors (all 30 of them) do not know even this simple fact. Only one ever mentioned it, and couldn't tell the difference between R-lipoic acid and alpha lipoic acid. The difference is that the R enantiomer is more active while standard alpha lipoic acid contains both R and S enantiomer which is useless.

One other point on thiotic acid, the L enantiomer is actually unnatural & cytotoxic, in vivo, in higher dosages. The R, however, is the opposite, has even been indicated to increase lifespan in rodent studies, which perhaps, may have something to do with the glutathione antioxidant support.

My mother had developed adult onset diabetes and today, both as a result of calorie restriction post-6PM and taking R-LA, she's doing a lot better. None of her internal medicine doctors have given her the aforementioned course of actions. Instead, it was simple a regimen of metaformin prescriptions. She's spread the word, among her friends, and now, many of them have their conditions under control w/o the assistance of a consulting physician.

97   MMR   2013 Feb 27, 11:41pm  

Do obese and 'skinny-fat' IM doctors who do not engage in consistently tell their patients to do resistance training and to avoid obvious food choices (soda).

Most times after a blood test revealing high blood sugar, the average primary care doc will say "we have to keep an eye". The RESPONSIBLE doctor, treats a prediabetic like they've already got diabetes by strongly promoting diet and exercise. Alas, so few of those in the primary care industry.

Which doctors even know about vitamins and nutritional supplements? How much are they taught about it in biochemistry? Jack and Jack

98   Rin   2013 Feb 27, 11:51pm  

MMR says

Which doctors even know about vitamins and nutritional supplements? How much are they taught about it in biochemistry? Jack and Jack

I think the training here involves something other than just making the rounds at a hospital.

For instance, growth hormone secretion is countered by insulin spikes. Thus, for a person to gain the best GH secretion in his sleep, he needs to be a least 3+ hours removed from his prior meal. This is more important than worrying about a sugary donut or waffle, for breakfast. Thus, my mother has now, made breakfast/lunch her largest meal of the day. For dinner, it's basically a half portion of meat and vegetables. She also takes an R-LA pill, with each and every meal. End result, she wakes up refreshed, each and every day & has her diabetes under control.

99   CL   2013 Feb 28, 1:59am  

Homeboy says

A typical wage earner could work for 30 years and still in their entire life, not make anywhere close to what an NBA player makes in a single year.

Keyword here is "typical". How many millions WANT be in the NBA and never make it? It doesn't always look like it, but these are the very best of the very best of the very best. They work from childhood, really, uncompensated and achieve greatness.

Think of it as deferred compensation, and of how many entertain us for next to nothing or nothing.

100   Rin   2013 Feb 28, 2:11am  

CL says

Homeboy says

A typical wage earner could work for 30 years and still in their entire life, not make anywhere close to what an NBA player makes in a single year.

Keyword here is "typical". How many millions WANT be in the NBA and never make it? It doesn't always look like it, but these are the very best of the very best of the very best. They work from childhood, really, uncompensated and achieve greatness.

Think of it as deferred compensation, and of how many entertain us for next to nothing or nothing.

I think the way to break this down is this ...

NBA = immediate millionaire to multimillionaire status
European/International leagues = quarter of million to millionaire status
All other semi-prof B-ball clubs = secretarial to junior engineering salaries

Thus, if you exclude the NBA, a.k.a the Monied David Stern Club, 90% of basketball players get paid like every other group of performing artists out there. This is not too different from being a member of an elite rock group (i.e. Metallica, U2, Beatles, Aerosmith) vs playing in your local town's music club, which pays some $100-$200 per gig, which is why music is generally considered a hobby by most persons out there.

Therefore, how much an NBA player gets paid is not relevant to the argument of whether or not they get paid too much. It's Stern's entertainment company and if one doesn't like it, then go watch one's local YMCA leagues duke it out.

Likewise, let's boycott U2 shows and album/mp3 releases, shrink their fan & advertising base, since Bono, Edge, and Clayton don't deserve to be millionaires over a guy who plays out in his hometown's school gymnasium. I mean that's the essence of homeboy's argument.

101   MMR   2013 Feb 28, 3:39am  

That's wonderful, I wish I had such compliance with my own mother. Still I managed to get her to reduce her metformin by 50% and she has been exercising with some reduction of body fat, but not enough.

I keep R-Lipoic Acid in the house but she doesn't take it. I managed to get her to take fish oil and vitamin D though.

But since the Doctor gave it to her, she is reluctant to try non-drug therapies which you and I know work with a high rate of efficacy in mild cases.

Absolutely right on the growth hormone

Rin says

She also takes an R-LA pill, with each and every meal. End result, she wakes up refreshed, each and every day & has her diabetes under control.

102   Rin   2013 Feb 28, 3:41am  

chanakya4773 says

You tell the firefighter who has to dive in to FIRE to save your precious little life when your house blows up in fire. Tell him why you need to get paid many times more than him because you are going to do a run of the mill surgery in which you personally have zero risk and the rate of success is just another statics.

I think his argument will go something like this ... did that guy gets A's in biology, a high MCAT, and get accepted to an extremely prestigious program plus residency, and thus, gave up his weekends, nights, etc, just to have the privilege of slicing open a person and having the power of God over them, while hiding behind the blanket coverage of malpractice insurance, along with the *code of silence* among peer surgeons?

You see, that's the essence of how premeds and MDs see themselves. I'd worked with plenty of these personality types during undergrad research projects. They are worthy of praise, money, and prestige because their academic accolades awarded 'em with it. Everyone else, those HS "dropout quality" firemen, the NASA engineers who play with circuit boards, the Navy SEALS guy (who works for only a military pension) are mediocre, not dedicated, & not worthy of high pay and prestige.

In fact, I'm pretty sure that if I'd publicly stated, in a live meeting of people, that I'd helped manage my mom's Type 2 diabetes w/o a consulting physician recommending R-LA, that he'd have me charged for practicing medicine w/o a license despite the fact that my mother's IM physicians did little for her.

103   MMR   2013 Feb 28, 3:51am  

Definitely! But that doesn't necessarily make it less relevant. There is good research for many dietary supplements, but much of it doesn't reach a doctors consciousness because it isn't published in JAMA, NEJM or Annals of Internal Medicine, for example. For a number of reasons, good research can't make it into the top journals, mostly due to political issues.

The genius author of Jurassic Park, Michael Crichton, MD said it best: I regard consensus science as an extremely pernicious development that ought to be stopped cold in its tracks. Historically, the claim of consensus has been the first refuge of scoundrels; it is a way to avoid debate by claiming that the matter is already settled.

The journals are perpetrators of "consensus science". Most medical students fall for it hook, line and sinker.

Although, on an anecdotal level, none of the drs in my family are convinced enough of the benefit of dietary supplements to actually keep any in their home, other than something along the lines of centrum.

It seems that the vast majority strongly believe in pharmaceutical therapies designed to be taken for a lifetime.

Rin says

I think the training here involves something other than just making the rounds at a hospital.

« First        Comments 64 - 103 of 150       Last »     Search these comments

Please register to comment:

api   best comments   contact   latest images   memes   one year ago   random   suggestions