# 41 medical secrets



## MissToodles (Jul 25, 2008)

I received the link in an email. It's from "Reader's Digest" and full of interesting tidbits such as the below quote:


" It's pretty common for doctors to talk about their patients and make judgments, particularly about their appearance. "
Family physician, Washington, D.C. 
http://www.rd.com/living-healthy/41-medical-secrets/article75920.html


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## Dr. Feelgood (Jul 25, 2008)

For people who are making money hand over fist, doctors sure whine a lot, don't they? My favorite was "the most unsettling thing is when the patient doesn't trust you or believe you." Gee...wonder why that is?


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## RunPainFree.org (Jul 26, 2008)

my favorite is- 

"I know that Reader's Digest recommends bringing in a complete list of all your symptoms, but every time you do, it only reinforces my desire to quit this profession."
--Douglas Farrago, MD


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## velia (Jul 31, 2008)

I thought this was particularly lovely:

_In most branches of medicine, we deal more commonly with old people. So we become much more enthusiastic when a young person comes along. We have more in common with and are more attracted to him or her. Doctors have a limited amount of time, so the younger and more attractive you are, the more likely you are to get more of our time.
--Family physician, Washington, D.C. _


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## Tina (Jul 31, 2008)

That Douglas Farrago guy is a real puke, and he's all over the place there, whining (note he had nothing constructive to say in the Free Advice section, which, BTW, is the smallest part of the article, of course). I feel sorry for his patients. For some of them it's just a load of whining from overpaid snivelers with God complexes -- note: I speak of the snivelers. Not all are snivelers and not all are overpaid. Some of them aren't worth a buck, and others are golden, I'm guessing.

I found this instructive, and it's good to know:


> Avoid Friday afternoon surgery. The day after surgery is when most problems happen. If the next day is Saturday, you're flying by yourself without a safety net, because the units are understaffed and ERs are overwhelmed because doctors' offices are closed.
> --Heart surgeon, New York City



These I'd like to hug:


> &#8226; If a sick patient comes to me with a really sad story and asks for a discount, I take care of him or her for no charge.
> --Surgeon, Dallas/Fort Worth
> 
> &#8226; Though we don't cry in front of you, we sometimes do cry about your situation at home.
> --Pediatrician, Chicago


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## GenericGeek (Aug 3, 2008)

Dr. Feelgood said:


> For people who are making money hand over fist, doctors sure whine a lot, don't they? My favorite was "the most unsettling thing is when the patient doesn't trust you or believe you." Gee...wonder why that is?



While being a doctor might once have been a license to print money, it certainly isn't now! In the US, insurance companies have them coming & going -- on the one end, docs have to pay pretty hefty malpractice premiums, while the amounts health insurance will pay effectively limits their ability to earn.

The result? "5 minute consults", for one thing. Your doc is under a tremendous amount of pressure to get you diagnosed, prescribed, & out the door as fast as possible -- which is hardly consistent with the best possible patient care.


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## Jane (Aug 4, 2008)

Yes, doctors do talk about you, but they don't use your name, and the discussion is very clinical. If not, or if they discuss another patient with you, RUN do not walk to the exit.


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## goofy girl (Aug 4, 2008)

Dr's really don't rake it in like alot of people think they do. I guess if they have a good specialty maybe, and they definitely do OK, but a PCP only makes about $35.00 for an hour long physical.


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## Dr. Feelgood (Aug 4, 2008)

goofy girl said:


> Dr's really don't rake it in like alot of people think they do. I guess if they have a good specialty maybe, and they definitely do OK, but a PCP only makes about $35.00 for an hour long physical.



YOUR doctor certainly isn't raking it in if he takes an hour to do a fifteen-minute physical! Seriously, I don't think I've ever had a physical that took longer than that. And I strongly suspect the $35 is your co-pay: it was mine last week for a medical visit that took ten minutes, but my insurance company reimbursed the doc an additional $58 for his time. I'd say anybody who gets paid $500 an hour is doing pretty well. Mind you, I'm not claiming he doesn't deserve it...just that he's a long way from skid row.


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## Frankie (Aug 4, 2008)

Dr. Feelgood said:


> YOUR doctor certainly isn't raking it in if he takes an hour to do a fifteen-minute physical! Seriously, I don't think I've ever had a physical that took longer than that.



I was struck by this because my routine annual physicals take two to three hours and cost $1,500 to $2,000.  Granted, it's a slow moving physical, but they really exam you from head to toe.


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## goofy girl (Aug 5, 2008)

Dr. Feelgood said:


> YOUR doctor certainly isn't raking it in if he takes an hour to do a fifteen-minute physical! Seriously, I don't think I've ever had a physical that took longer than that. And I strongly suspect the $35 is your co-pay: it was mine last week for a medical visit that took ten minutes, but my insurance company reimbursed the doc an additional $58 for his time. I'd say anybody who gets paid $500 an hour is doing pretty well. Mind you, I'm not claiming he doesn't deserve it...just that he's a long way from skid row.



Ok, my Dr is a she and I don't have a copay with my insurance.

A yearly physical is booked with a 45 min -60 min appointment. I do medical billing, and the reimbursement for a routine office visit is usually $43.00-55.00. This is only what the Dr gets paid...which he or she then needs to pay rent, office staff, supplies etc etc.

If your Dr takes 15 minutes to complete a full yearly exam I suggest switching Dr's. Just the paper work alone should take at least 10-15 minutes


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## Jane (Aug 5, 2008)

goofy girl said:


> Ok, my Dr is a she and I don't have a copay with my insurance.
> 
> A yearly physical is booked with a 45 min -60 min appointment. I do medical billing, and the reimbursement for a routine office visit is usually $43.00-55.00. This is only what the Dr gets paid...which he or she then needs to pay rent, office staff, supplies etc etc.
> 
> If your Dr takes 15 minutes to complete a full yearly exam I suggest switching Dr's. Just the paper work alone should take at least 10-15 minutes



A yearly physical is not a routine office visit.


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## goofy girl (Aug 5, 2008)

Jane said:


> A yearly physical is not a routine office visit.



I meant to edit that out, I noticed it after I typed it :huh:


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## Miss Vickie (Aug 5, 2008)

I'm sure that a lot depends on what part of the country you live in. My yearly physical was about $300, not including labs. My insurance paid 100% of it because I've paid my total out of pocket for the year (one of the very few advantages of having cancer -- everything is at 100% until the end of the year). The other thing to take into account is malpractice insurance which is prohibitively expensive for some specialties like OB/GYN's. So yes, they do take in a lot of money, but they also pay a lot out.


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## Jane (Aug 5, 2008)

Does anyone know what doctors are currently charging for pregnancy care, all prenatal, l&d, postpartum package? It's been so long since I worked for a doctor who delivered, I have no idea the current costs.


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## Miss Vickie (Aug 5, 2008)

Jane said:


> Does anyone know what doctors are currently charging for pregnancy care, all prenatal, l&d, postpartum package? It's been so long since I worked for a doctor who delivered, I have no idea the current costs.



Boy, I have no idea. Back when I worked for a midwife with a freestanding birth center, she charged under $3000 for everything -- all prenatal visits and labs, the fee for the birth center, delivery and postpartum care. It was way less than what OB's charge -- not even taking into account the hospital fees, which must be astronomical.

I'll try to remember to ask when I go back to work later this week.


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## goofy girl (Aug 5, 2008)

My accounts are Rehab Hospitals and Lung Disease Assoc, so I haven't seen any claims for gyn stuff. Now I'm curious though...


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## SocialbFly (Aug 5, 2008)

Miss Vickie said:


> I'm sure that a lot depends on what part of the country you live in. My yearly physical was about $300, not including labs. My insurance paid 100% of it because I've paid my total out of pocket for the year (one of the very few advantages of having cancer -- everything is at 100% until the end of the year). The other thing to take into account is malpractice insurance which is prohibitively expensive for some specialties like OB/GYN's. So yes, they do take in a lot of money, but they also pay a lot out.



i have a friend who has an OBGYN close friend, this person stopped the ob part, cause a full 50% of his money was going to the insurance, that is the bullshit that medicine has become from crazy law suits....that being said, i think the future of medicine would be better if they put caps on amounts people can sue for...i know there are bad docs out there, and they should be dealt with, but the good docs get screwed in it too...and in turn, it screws us...


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## Jane (Aug 5, 2008)

SocialbFly said:


> i have a friend who has an OBGYN close friend, this person stopped the ob part, cause a full 50% of his money was going to the insurance, that is the bullshit that medicine has become from crazy law suits....that being said, i think the future of medicine would be better if they put caps on amounts people can sue for...i know there are bad docs out there, and they should be dealt with, but the good docs get screwed in it too...and in turn, it screws us...



I disagree completely.


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## Admiral_Snackbar (Aug 5, 2008)

I follow the 80/20 rule when it comes to doctors, 90/10 when it comes to pediatricians.

The thing that terrifies me is that everything is an off-the-cuff diagnosis now. No one does blood tests, x-rays, CAT scans like you see in the hospitals. No one cultures my son's throat to find out what sort of bacteria is causing him issues with his cough or his ear infection. When my wife complains of certain issues that haven't been solved by throwing Rx at her, they throw more Rx at her and I have to seek out MD/PhD clinicians who dig a little deeper and still don't bother to follow up.

No one cares, and those that do are woefully underrepresented by the general group of doctors.


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## Ernest Nagel (Aug 5, 2008)

SocialbFly said:


> i have a friend who has an OBGYN close friend, this person stopped the ob part, cause a full 50% of his money was going to the insurance, that is the bullshit that medicine has become from crazy law suits....that being said, i think the future of medicine would be better if they put caps on amounts people can sue for...i know there are bad docs out there, and they should be dealt with, but the good docs get screwed in it too...and in turn, it screws us...





Jane said:


> I disagree completely.



Texas has had medical malpractice caps since '03 and despite the laments of the trial lawyers our quality of care seems stable with costs generally trending downward.


HEALTH BLOG
WSJs blog on health and the business of health.

October 5, 2007, 9:11 am
*After Texas Caps Malpractice, Docs Move In*
Posted by Jacob Goldstein

Four years ago, malpractice payments joined the short list of things that are not bigger in Texas. Now doctors are flocking to the state, the New York Times reports.

A 2003 referendum barred courts from interfering with malpractice caps set by the Legislature  $250,000 from the doctor for pain and suffering, and $1.6 million in death cases. (Payments for medical costs and lost income are over and above those caps.)

The number of medical licenses granted in Texas has climbed 18% since 2003. And in the past fiscal year, the state granted 30 percent more licenses than it had in the previous year. The increase in doctors has been twice the rate of the overall population increase, and theres a backlog of nearly 2,500 applications, according to the NYT. Malpractice premiums have fallen more than 20 percent.

The docs seem delighted, but not everybodys pleased. Weve lost our system of legal accountability, N. Alex Winslow, executive director of Texas Watch, a consumer advocacy group, told the paper. Just having more doctors doesnt make patients safer. It remains to be seen who is coming to our state.
Permalink | Trackback URL: http://blogs.wsj.com/health/2007/10/05/after-texas-caps-malpractice-docs-move-in/trackback/


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## Jane (Aug 5, 2008)

Ten percent of doctors cause 50 percent of malpractice claims. That ten percent should not be practicing.

You know, I could have said a lot more on my disagreement post, but I chose not to. Just accept that I disagree, and that I have researched it to come to that conclusion.


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## TearInYourHand (Aug 5, 2008)

Jane said:


> Ten percent of doctors cause 50 percent of malpractice claims. ....



Where is that stat from? I'm genuinely curious. I've never heard that before, and it is pretty shocking.


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## Jane (Aug 6, 2008)

TearInYourHand said:


> Where is that stat from? I'm genuinely curious. I've never heard that before, and it is pretty shocking.



I was wrong. It's 5%...this was just the quickest cite I found:

http://www.citizen.org/pressroom/release.cfm?ID=1222

also, http://washparkprophet.blogspot.com/2008/01/another-view-of-medical-malpractice.html


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## SocialbFly (Aug 6, 2008)

Jane said:


> Ten percent of doctors cause 50 percent of malpractice claims. That ten percent should not be practicing.
> 
> You know, I could have said a lot more on my disagreement post, but I chose not to. Just accept that I disagree, and that I have researched it to come to that conclusion.



Jane, it is of course, absolutely your right to disagree. Congrats for being so succinct.

i see people work the system everyday for stupid stupid reasons....i dont disagree that there are bad docs, but i also personally know some of the lawsuits that some f my friends have been involved in...and i promise you, most were horrible things that happened, that no one could have prevented...

caps on lawsuits would change medicine...but you also have to have people who would sit on an impartial board to get rid of those docs that are an issue...

change in medicine MUST and WILL come...we will have no choice about it...the costs are too high for change not to come...


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## Shosh (Aug 7, 2008)

That doctors talk about their patients and judge them? That is a given.
My previous neurologist was really tough on me and I think judged me about my weight.
I have a new female neuro now who is very pro active and allows me to be involved in decisions regarding my ongoing treatment with this illness.
She is from Ireland.


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## CausticSodaPop (Aug 7, 2008)

I think all this article shows is that doctors are human. Ideally, given their occupation, they would be above reproach in every way but none of us live up to that standard. The reality is that they _all _have their prejudices, pet peeves, bad habits, unsavoury secrets and off-days. 

Have to say though, with all this talk of insurance and fees, I am exceptionally glad to live in the UK! Our national health service may be a bit tatty around the edges (mainly thanks to the assaults of the past two governments) but, ultimately, my medical care is free at the point of use and I feel very lucky to have access to it.


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