With a current shortage of 400,000 doctors, and ten percent more insured people who will visit your doctor, be prepared for longer waits. Since he will now be judged by the government on your outcome, why should he want to ruin a good batting average by trying to help you if you are have medical risks, and are in bad health.
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Today most doctors work over 60 hours a week, and irregular hours. Ninety two percent of all doctors work full-time, and one third of them work over 60 hours. They travel between offices and hospitals to care for you, their patients. Their formal education and training requirements are the most demanding of any occupation or specialty.
PREMEDICAL SCHOOL
As premedical students, they studied physics, mathematics, English, biology, and inorganic and organic chemistry. Courses in humanities and the social sciences were also required. Many volunteered at local hospitals or clinics to gain practical experience. Most who enter medical school, received a bachelor's degree or advanced degrees.
MEDICAL SCHOOL
There are today, 146 medical schools in the United States and entry to medical school is extremely difficult and highly competitive. Letters of recommendation, transcripts, and good scores from the Medical College Admission test are a must. Most schools require personal interviews with potential students, where their character, personality, leadership qualities, and participation in extracurricular activities are evaluated. After graduating from medical school, the new doctor may enter a residency program and then finally receive some monetary compensation for his on-the-job training in the hospital.
FINANCIAL DEBT
Over eighty percent of medical school graduates are in severe debt from educational expenses they incurred, and are often required to practice two years after residency before they can become certified for any specialty board.
QUALITIES NECESSARY FOR A DOCTOR
Your doctor must have other qualifications: a desire to serve patients, be self motivated, and survive the pressures of long hours of medical education and practice. He must have a good bedside manner, be emotionally stable, and be able to make decisions in emergencies. He must continually take continuing education classes and study throughout his medical career to keep up with medical advances in technologies.
THE CAREER OF A DOCTOR
Most doctors today join group practices, others teach residents and some go into managerial and supervisory roles in hospitals, clinics and other medical settings. Today, doctors are likely to take salary jobs in group practices, hospitals and clinics. Only fifteen percent of doctors today are self-employed. Eighteen percent are employed by hospitals. Half of all doctors involved in patient care are in primary care. DH of a sole practitioner is gone. Many shortages now are seen in specialties as general practice, internal medicine, and OB/GYN. Since doctors take many years to become trained, they don’t change jobs very often, work longer hours, delay their retirement, and increase their productivity by using more support staff as physician assistants and nurses. Those who are self-employed must provide their own health insurance, retirement insurance, and high cost malpractice insurance.
AVOIDANCE OF RURAL AREAS
The rarely practice in rural areas because of rural areas provide less control over their work hours. They feel in rural areas they would be isolated from other medical doctors, and have personal and social issues. Currently, a doctor has the most stressful time consuming specialized job around.
SPECIALISTS REWARDED
Our fee for service structure rewards specialists who perform complex procedures. Rarely do monetary rewards go to primary care doctors, who practice preventive medicine. A primary doctor sees about 35 patients a day, and makes around $135,000. A brain or heart specialist makes four times that salary for performing complex procedures. Doctor salaries average $132,000. Emergency room doctors, get by working long hours in the emergency room they have the most stressful work environment around, and earn around $42,000 more. Pediatricians have the lowest physician salary jobs, since they choose their own hours and can pursue their passion for working with children on their own schedules.
WHY DOESN'T YOUR DOCTOR SEE YOU ON TIME?
Most of us are frustrated when we make an appointment for a certain time, and are kept waiting for long periods of time before they are seen. This happens because Insurances and Medicare pay doctors for every patient they see. They are paid by seeing the patient and doing procedures, not by the amount of time they spend with you. To maximize their income, they schedule as many patients they can each day. The more patients they see and the more procedures they do, the more income they make.
Each day the doctor is not sure what services he will be performing for individual patients. Some procedures may take more time than others. Equipment can break down, and there may even be a hospital emergency, as delivering a baby.
WHY DOES THE DOCTOR”S SCHEDULE NOT RUN ON TIME?
The doctor gets his income from the procedures he does not the time he spends with you. When he gets behind, you are kept waiting. The more specialized he is, the longer you will wait.
The fewer specialist doctors in your area, the longer you will also wait. You may wait for a brain surgeon for an hour, but are disturbed if you wait for an internist for the same time.
Your relationship with your doctor has a lot to do with how patient you are. If you've been as patient of his for many years, and he has often been on time, you are not upset if you must wait on a particular day.
HOW CAN YOU REDUCE THE TIME DID YOU SPEND IN A DOCTOR'S OFFICE?
Take the first appointment in the morning or afternoon. You'll avoid a backup of patients, and have a better chance to get home early. Ask his secretary what day of the week he has the lowest patient load. Hopefully that day you will have a shorter waiting time.
BOOKING YOUR APPOINTMENT
Ask his secretary, if the doctor is just returning from a vacation or a conference, or has been off from the office a period of time. Book your appointment on a school day not on a day when children are off. Avoid Saturdays and evenings. If you are told there'll be a 15-minute wait, start speaking up a minute later. The squeaky wheel gets the oil. Ask what the holdup is, how much longer you'll have to wait, and be firm and definite, but not demanding or loud.
SEEING A SPECIALIST
You may wait a long time if your doctor is a sub specialist, in great demand. You haven't much choice. Why not make your waiting time less stressful by leaving home earlier, and not scheduling something on the heels of your doctor visit. Bring a good book or magazine with you to kill time. Expect your appointment to last far longer than you anticipated.
WHY IS YOUR DOCTOR ALWAYS IN A HURRY?
You may wonder why the doctor won't spend more time explaining things to you. How can you get your doctor to help you coordinate your care? Why is he doing so many tests, and why won't he accept my insurance?
JUST FOLLOW THE MONEY.
Specialists’ incomes rose more than 35% between 1999 and 2003. Your general practitioner's income during that time rose less than 8%.
COMMENTARY
With a current shortage of 400,000 doctors, and ten percent more insured people who will visit your doctor, be prepared for longer waits. With no tort reform, less compensation, more stress and paperwork, your doctor may just take an early retirement, He never was asked how he should practice medicine.
Since he will now be judged by the government on your outcome, why should he want to ruin a good batting average by trying to help you if you are have medical risks, and are in bad health. That’s where cost containment really will hurt. No one asked him how medicine should be practiced. After all, the lawyers in Congress know all the answers and will soon fix the system so you will not recognize medicine, as we know today.
Visit www.drneedles.comwww.americanacupuncture.com for more discussion of controversial medical subjects.
Source: American Medical Association, physician characteristics and distribution in the United States, 2007
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