Gas Price.....Too High?
 

"Dave" wrote in message
...
On Tue, 09 May 2006 00:14:59 GMT, "Maxprop" said:

So - if those truly motivated in the main by money & prestige choose
some other profession than medicine, good. I don't regard a doctor
practising family medicine as all that much superior to a good auto
mechanic, to tell the truth.

Ridiculous. Next time you are seriously ill, consult your local mechanic.

Not at all ridiculous. A good analogy, in fact. The reply is absurd.

Both a good doctor and a good mechanic have the skill of applying
knowledge
of an extensive knowledge base to diagnosing a specific problem and
finding
the right solution to that problem. To suggest that you can't expect
someone
looking at the wrong knowledge base to solve a problem is obvious, but
utterly beside the point.

A predictable legal response.

It's the extent of the knowledge base that differentiates the two. If an
auto mechanic's knowledge base were as extensive and voluminous as that of
the physician, mechanics would be in very short supply, and it would cost
you thousands to repair a clogged fuel injection system. Auto mechanics,
when repairing a vehicle, have the luxury of taking a moment to consult a
parts list or a diagram of the particular device or subassembly upon which
they are working. Physicians have no such luxury. Cars don't die on the
mechanic while he takes a look at the repair manual followed by a coffee
break.

Max

Gas Price.....Too High?
 

"Dave" wrote in message
...
On Tue, 09 May 2006 00:14:59 GMT, "Maxprop" said:

It's more than just boredom. It's frustration with the legal climate
surrounding health care, the governmental intervention that imposes more
and
more controls over how a qualified physician can practice medicine, and
the
eroding doctor-patient relationship, thanks to the first two items.

Undoubtedly true. He who pays the piper calls the tune. The combination of
third party payment systems and a greedy plaintiff's bar puts less and
less
emphasis on what the patient wants or needs. The medical profession is
coming closer and closer to the media business model, in which those using
the service are not the consumers of the service, but the product sold to
those who pay for the service. Just as a newspaper makes money by selling
advertisers access to its readers, so MDs succeed by developing a large
base
of product in the form of patients, and selling third party payors access
to
those patients.

A nice analogy, but inaccurate. It's the third-party payors who sell the
product (patients) to the practitioners. Speak with any physician who has
watched his long term patients perform a mass exodus from his practice when
a third party, with which he is not a provider, sells his patients, or their
employer, their song and dance.

Max

Gas Price.....Too High?
 

In article , Maxprop
wrote:

"Peter Wiley" wrote in message
. ..
In article et,
Maxprop wrote:

Yeah, I know that. But the big driver is interest/obsession IME. For
the best ones, at least.

Try taking away their big NIH grants or corporate salaries/bonuses and see
how many of them still are obsessed.

Shrug. Some R&D is so expensive, it either gets funded by Govts
(directly or indirectly) or by big corporations. Nobody else can afford
it. Not a matter of obsession at that point.

Costs my group some $3 mill to stage a single research cruise. Even in
USD that ain't cheap and it doesn't include the salaries of up to 70
scientists & techs, nor ship fuel.

About as useful and sensible as the next time I have a problem with my
interrelated software/hardware control systems, I should consult a
doctor. You'll have to do better than that, Max. I didn't say doctors
weren't skilled. Mostly, they are. The surgeon who put my arm together
did a pretty good job of it considering how badly I managed to smash
it. I'm happy with the end result. So what? A top orthopaedic surgeon
is a real good bone mechanic :-)

Yes, he is. But he is also a powerful physiologist, diagnostician, and
therapist.

Matter of opinion. The surgeon didn't have much to do with me after the
op except a couple checkups. My physiotherapist, OTOH, spent a lot of
time up close & personal. She's not a doctor. He wasn't a therapist in
the sense I'm using.

If he weren't those things, your anaesthetic-induced arythmias
might prove fatal during your total hip replacement.

Different specialty. Doctors are rarely extensively cross trained once
they've become senior specialists IME. We employ such doctors (cross
trained ones) because we send them places where there's no possibility
of backup and the surgical nurses, anesthetists etc are people like -
me. As I said one trip, you better not get badly hurt because I'll be
operating the anaesthetic while the doc does the work :-)

Or the microbial
pathogen you contracted during the surgery might undo all he did with his
"bone mechanics."

Ditto. That's either good aseptic control on the part of the hospital
or maybe downright carelessness I guess. Nevertheless I got my butt
outa hospital and home ASAP. Had a hairline fracture of the pelvic
girdle and wasn't supposed to be walking for 6 weeks, but I was outa
there 3 days after they'd finished pinning my arm back together. 3 ops
over a week, I learnt the benefits of a morphine drip under patient
control :-) Thank God I wasn't in the USA, the DEA probably woulda
locked everyone up for abuse of narcotics.

If the fuel pump the auto mechanic replaced did not
solve your car's stalling-at-stoplights problem, he'll replace something
else until he gets it right. Either way your car lives to drive another
day. Bad comparison, doctor vs. mechanic.

I'll agree that the consequences of failure might be higher with an
auto mechanic, but possibly not with, say, an airline one.


We have been/are losing doctors in the OB/GYN specialties due to plain
stupid lawsuits so I hear you. Occasionally there's a glimmer of hope.

http://www.news.com.au/story/0,10117...9-1702,00.html

I had a suggestion for 'wrongful life' cases. We should just offer to
terminate them now, end of problem.

LOL. What crap litigation that was. Seriously, however, the problem of
junk suits won't go away here, mostly because the trial lawyers groups in
this country are too powerful, not to mention that so many of our
congressmen, senators, and presidents are attorneys. If ever there was a
special interest group overrepresented in our government it is lawyers.

My cousin is doing primarily OB now. He has religious qualms with abortion,
so he cannot participate in the GYN end of his group practice. But he knows
his time as a physician is probably limited. Any baby born with birth
defects or with delivery complications is a potential lawsuit these days.

Our High Court has no settled the birth defect one at least insofar as
'wrongful life' claims go.

He's been sued five times for complaints so far beyond his control as to
stretch the imagination. All five cases were dismissed for lack of evidence
of neglect on his part, but he still had to endure the expense, the mental
turmoil, and the negative publicity such suits have wrought. OB is in a
unique position in that young women know that if they sue the doctor and
win, the damage to the profession won't affect them in the future, provided
they are through with childbearing. So such suits are plentiful. Let the
upcoming generations worry about where to find OB care---it's no longer my
problem.

We had one woman who sued because she was advised to have a C-section
rather than a vaginal delivery, because of some factor(s) I forget. End
result was a healthy mother & baby, but she sued because she'd been
deprived of the experience of a natural childbirth. Can't remember if
she won or not, but it's crap like that causes doctors to give it away.

Don't get me started on lawyers.

(see above) You've already gotten me started.

Second group against the wall, come the revolution.....


The media paint a very one-sided, distorted view of medical people, Pete.
If you are forming your impressions from them, you really need to change
your information-gathering methods.


Umm, Max, I'm one of those oddball people who *read*. I don't own a TV
or a radio.

Sorry, but that doesn't prevent you from getting one-sided info. Much of
the written media these days have rather anti-medical biases.

Sure, but it cuts down the crap no end. Big improvement in the S/N
ratio, similar to killfiling Bob here.

Years ago physicians were regarded in near-godlike terms. Today most people
are aware that they, like everyone else, are just humans with the same
fallibility, idiosyncrasies, and problems. I don't believe the current crop
of physicians *wants* you to be in awe of them. To the contrary, most of
them want you to know up front that they are doing their level best and do
care for your welfare, but are not free from error or misjudgment. Times
have changed in the medical world. Ego and arrogance are not absent, but
they do not define the doctor any longer.

I agree. We've drifted far from the starting point by now. I still
don't think it requires top level SAT/TER scores to make a good doctor.
Academic ability (or ability to pass exams) is useful but not
sufficient. If I had to pick a 'talent', it'd be the ability to
synthesise a raft of information and make a correct diagnosis more
often than an incorrect one. I don't underestimate the ability of doing
this, nor do I think that lawyers, who can't do it themselves even with
100% hindsight, aid the process one iota.

The population at large may well no longer be in awe of doctors, but
they sure are in contempt of lawyers. I can't see that changing any
time soon.

PDW

Gas Price.....Too High?
 

In article et,
Maxprop wrote:

"Dave" wrote in message
...
On Tue, 09 May 2006 00:14:59 GMT, "Maxprop" said:

So - if those truly motivated in the main by money & prestige choose
some other profession than medicine, good. I don't regard a doctor
practising family medicine as all that much superior to a good auto
mechanic, to tell the truth.

Ridiculous. Next time you are seriously ill, consult your local mechanic.

Not at all ridiculous. A good analogy, in fact. The reply is absurd.

Both a good doctor and a good mechanic have the skill of applying
knowledge
of an extensive knowledge base to diagnosing a specific problem and
finding
the right solution to that problem. To suggest that you can't expect
someone
looking at the wrong knowledge base to solve a problem is obvious, but
utterly beside the point.

A predictable legal response.

It's the extent of the knowledge base that differentiates the two. If an
auto mechanic's knowledge base were as extensive and voluminous as that of
the physician, mechanics would be in very short supply, and it would cost
you thousands to repair a clogged fuel injection system. Auto mechanics,
when repairing a vehicle, have the luxury of taking a moment to consult a
parts list or a diagram of the particular device or subassembly upon which
they are working. Physicians have no such luxury. Cars don't die on the
mechanic while he takes a look at the repair manual followed by a coffee
break.

Hmmm. I guess you've spent no time in a public hospital recently.
Waiting times in Casualty in Australia, some people *have* died and the
delay times are generally sufficient for people to have a 3 course
dinner let alone a coffee break.

Few doctors outside casualty & surgery operate under those time
pressures, Max. You're using a small group to stand for all. It simply
isn't so.

Not to mention doctors' extensive libraries, reference materials and
computers......

PDW

Gas Price.....Too High?
 

In article , OzOne wrote:

On Wed, 10 May 2006 03:58:39 +0100, Peter Wiley
scribbled thusly:

Hmmm. I guess you've spent no time in a public hospital recently.
Waiting times in Casualty in Australia, some people *have* died and the
delay times are generally sufficient for people to have a 3 course
dinner let alone a coffee break.

Can be fixed by education.
GPs offices are empty while cas waiting rooms are full, mostly with
people who have flu or a headache, or a kid with a temperature.

Won't argue with that. Lotta cas stuff *is* trivial, could be dealt
with by a GP. Dunno about fixing it, tho. Only thing I can see working
is to charge for the use of the service to discourage trivial
complaints. That's a can of worms and I can see a lot of ways it could
backfire badly. Education - no.

PDW

Gas Price.....Too High?
 

"Peter Wiley" wrote in message
. ..

Matter of opinion. The surgeon didn't have much to do with me after the
op except a couple checkups. My physiotherapist, OTOH, spent a lot of
time up close & personal. She's not a doctor. He wasn't a therapist in
the sense I'm using.

I don't know how things are done there, but here the doctor plans and orders
the therapy. He just doesn't peform it. That's what physical therapists
are for.

If he weren't those things, your anaesthetic-induced arythmias
might prove fatal during your total hip replacement.


Different specialty. Doctors are rarely extensively cross trained once
they've become senior specialists IME. We employ such doctors (cross
trained ones) because we send them places where there's no possibility
of backup and the surgical nurses, anesthetists etc are people like -
me. As I said one trip, you better not get badly hurt because I'll be
operating the anaesthetic while the doc does the work :-)

The surgeon is the skipper in charge of the patient's welfare during surgery
here. Even if the anaesthesiologist disagrees with him over a point of
procedure, the surgeon has the final say in the matter. And that is the way
it should be, because it's the surgeon who will be named the primary
recipient of litigation of something goes awry.


Or the microbial
pathogen you contracted during the surgery might undo all he did with his
"bone mechanics."

Ditto. That's either good aseptic control

Today it's "sterile," not aseptic. Hasn't been for over half a century.

on the part of the hospital
or maybe downright carelessness I guess. Nevertheless I got my butt
outa hospital and home ASAP. Had a hairline fracture of the pelvic
girdle and wasn't supposed to be walking for 6 weeks, but I was outa
there 3 days after they'd finished pinning my arm back together. 3 ops
over a week, I learnt the benefits of a morphine drip under patient
control :-) Thank God I wasn't in the USA, the DEA probably woulda
locked everyone up for abuse of narcotics.

Not necessarily. We use patient-controlled morphine drips here, too. But
the total amount administered is limited over time, as was yours.

If the fuel pump the auto mechanic replaced did not
solve your car's stalling-at-stoplights problem, he'll replace something
else until he gets it right. Either way your car lives to drive another
day. Bad comparison, doctor vs. mechanic.

I'll agree that the consequences of failure might be higher with an
auto mechanic,

Say what??

but possibly not with, say, an airline one.

Did you mean "doctor?"

We have been/are losing doctors in the OB/GYN specialties due to plain
stupid lawsuits so I hear you. Occasionally there's a glimmer of hope.

http://www.news.com.au/story/0,10117...9-1702,00.html

I had a suggestion for 'wrongful life' cases. We should just offer to
terminate them now, end of problem.

LOL. What crap litigation that was. Seriously, however, the problem of
junk suits won't go away here, mostly because the trial lawyers groups in
this country are too powerful, not to mention that so many of our
congressmen, senators, and presidents are attorneys. If ever there was a
special interest group overrepresented in our government it is lawyers.

My cousin is doing primarily OB now. He has religious qualms with
abortion,
so he cannot participate in the GYN end of his group practice. But he
knows
his time as a physician is probably limited. Any baby born with birth
defects or with delivery complications is a potential lawsuit these days.

Our High Court has no settled the birth defect one at least insofar as
'wrongful life' claims go.

He's been sued five times for complaints so far beyond his control as to
stretch the imagination. All five cases were dismissed for lack of
evidence
of neglect on his part, but he still had to endure the expense, the
mental
turmoil, and the negative publicity such suits have wrought. OB is in a
unique position in that young women know that if they sue the doctor and
win, the damage to the profession won't affect them in the future,
provided
they are through with childbearing. So such suits are plentiful. Let
the
upcoming generations worry about where to find OB care---it's no longer
my
problem.

We had one woman who sued because she was advised to have a C-section
rather than a vaginal delivery, because of some factor(s) I forget. End
result was a healthy mother & baby, but she sued because she'd been
deprived of the experience of a natural childbirth. Can't remember if
she won or not, but it's crap like that causes doctors to give it away.

Amen.


Don't get me started on lawyers.

(see above) You've already gotten me started.

Second group against the wall, come the revolution.....


The media paint a very one-sided, distorted view of medical people,
Pete.
If you are forming your impressions from them, you really need to
change
your information-gathering methods.


Umm, Max, I'm one of those oddball people who *read*. I don't own a TV
or a radio.

Sorry, but that doesn't prevent you from getting one-sided info. Much of
the written media these days have rather anti-medical biases.

Sure, but it cuts down the crap no end. Big improvement in the S/N
ratio, similar to killfiling Bob here.

Good point. Especially about Bob.


Years ago physicians were regarded in near-godlike terms. Today most
people
are aware that they, like everyone else, are just humans with the same
fallibility, idiosyncrasies, and problems. I don't believe the current
crop
of physicians *wants* you to be in awe of them. To the contrary, most of
them want you to know up front that they are doing their level best and
do
care for your welfare, but are not free from error or misjudgment. Times
have changed in the medical world. Ego and arrogance are not absent, but
they do not define the doctor any longer.

I agree. We've drifted far from the starting point by now. I still
don't think it requires top level SAT/TER scores to make a good doctor.
Academic ability (or ability to pass exams) is useful but not
sufficient. If I had to pick a 'talent', it'd be the ability to
synthesise a raft of information and make a correct diagnosis more
often than an incorrect one. I don't underestimate the ability of doing
this, nor do I think that lawyers, who can't do it themselves even with
100% hindsight, aid the process one iota.

The population at large may well no longer be in awe of doctors, but
they sure are in contempt of lawyers. I can't see that changing any
time soon.

Agreed, and that can be the final statement on this topic. Good one, Pete.

Max

Gas Price.....Too High?
 

OzOne wrote in message ...

Can be fixed by education.
GPs offices are empty while cas waiting rooms are full, mostly with
people who have flu or a headache, or a kid with a temperature.

We have the same issues with our emergency services here, but our
physicians' waiting rooms are not empty. As of 2002 70% of the geographic
USA was underserved by medical people, from slightly to substantially.

Not to mention doctors' extensive libraries, reference materials and
computers......

Which is a good thing. The broader the information base available on
instant demand to physicians, the better patients can be served. It is
predicted that by 2015 most surgical theaters will have voice controlled
computer screens over the operating table from which a physician can access
almost any medical information he requires, including the past and present
medical history of the patient. That, of course, will be no substitute for
a doctor's knowledge and skill, but access to broader knowledge is always a
good thing.

Max

Gas Price.....Too High?
 

OzOne wrote in message ...
On Wed, 10 May 2006 23:14:02 GMT, "Maxprop"
scribbled thusly:


"Peter Wiley" wrote in message
m...

Matter of opinion. The surgeon didn't have much to do with me after the
op except a couple checkups. My physiotherapist, OTOH, spent a lot of
time up close & personal. She's not a doctor. He wasn't a therapist in
the sense I'm using.

I don't know how things are done there, but here the doctor plans and
orders
the therapy. He just doesn't peform it. That's what physical therapists
are for.

Bit different here,
The doc orders the therapy, the therapist plans and executes it.

If he weren't those things, your anaesthetic-induced arythmias
might prove fatal during your total hip replacement.


Different specialty. Doctors are rarely extensively cross trained once
they've become senior specialists IME. We employ such doctors (cross
trained ones) because we send them places where there's no possibility
of backup and the surgical nurses, anesthetists etc are people like -
me. As I said one trip, you better not get badly hurt because I'll be
operating the anaesthetic while the doc does the work :-)

The surgeon is the skipper in charge of the patient's welfare during
surgery
here. Even if the anaesthesiologist disagrees with him over a point of
procedure, the surgeon has the final say in the matter. And that is the
way
it should be, because it's the surgeon who will be named the primary
recipient of litigation of something goes awry.
Interesting,
Here, the anethetist is number one, inconsultation with the surgeon.
He has the patient hovering, at times, close to death and will tell a
surgeon that he has to complete to whatever point he can so the
patient can be revived.

Actually the gas passer has some control here, too, much as you describe.
He can put a halt to the surgery if the patient is becoming sentient or
going critical, but it's still the surgeon's game. He's in charge.

Max