The government has no right to privacy from the people, therefore this is not 'lawyerly equivocating.' The people are *supposed* to have oversight on government activities.
No, I am not an anecdote, as the only thing I mentioned that referred to my personal experience was the case of a single pediatrician. Everything else I mentioned was industry-wide; far from anecdotal evidence. The widespread closure of EDs is not anecdotal; mean physician incomes are by definition empirical rather than anecdotal (go on, give it a google.)
PAs will never come close to replacing physicians. PAs are taught primarily technical medical skills, where they can offer aid to a physician in the clinical (and sometimes, surgical) setting. What they lack is precisely the period of training that characterizes doctors as well distinct from most any other profession - the residency. It is in medical residency that doctors gain their greatest raft of experience and training in diagnosis. Remember diagnosis? The *important* part of the medical profession?
PAs might replace doctors for placing swan caths, but most basic procedures are already handled by the better-trained nurses or the underpaid residents. Diagnostic medicine will not and cannot be replaced by PAs precisely because it relies on the very parts of medical training that are reserved for physicians alone.
Only doctors recieve the full gamut of doctorly training - who could have imagined that?
The idea that doctors are paid 'insane rates' is one not borne out by reality, and is rather a survivor of a world that has been dead for a few decades.
The average internist makes approximately 120k/yr; hardly an extravagance considering the cost of four years of college, four years of medical school, and then 3-5 years of Residency (average Resident income: $27k/yr). The average general surgeon makes closer to $250k/yr.
Most physicians now end up paying off their school loans until they're in their mid-50s, and saving for retirement thereafter. Few physicians make the sort of 'insane rates' that have them driving BMW 7-series cars with any haste.
Hell, I shadowed for a pediatrician for ~5 years before I went off to medical school. Most of the time his only income was a patient's co-pay of $10-$20; insurance would, at best, reimburse his costs. Medicaid patients were the worst, for their insurance wouldn't even cover his costs - after cost of immunizations, he usually wound up losing money on those kids.
This is why most physicians now pack their waiting rooms and rush from patient to patient all day long: you would too if you went through the hell of med school and residency, had $200-300k in loans, and wound up making $10-$20/patient.
Moreover, Congress set a schedule of costs associated with various medical procedures years ago, more-or-less unrelated to proceeding inflation or actual costs to doctors. All government-sponsored insurance systems use this schedule, and many private insurance companies follow suit. As such, a great number of procedures are vastly *under*priced when it comes to reimbursing the physicians.
The best doctors - and these are a very, very few - can afford not to take any insurance at all. Most of the best simply restrict themselves to what their parent hospital absolutely requires. *These* can make a great deal of money, and as outliers, skew upward the mean income of doctors in general. But these are few and far between: I can count off the names of about 50% of New York City's non-insurance-accepting doctors in my head.
I'm not even going to go into the cost of practicing insurance. Internists spend between 5k-10k a year just on insurance; surgeons can spend up to 30k. Hospital costs are even higher: hospitals across the country are closing Emergency Departments due to the fact that EDs are *always* money-losing propositions, but with rising costs of ED-related insurance the costs have gone from "loss" to "crippling." Pennsylvania State is notorious for currently suffering a crisis of ED shortages; it's in the worst position, but it's doubtful it will be the sole occupant of that position for long.
Medical litigation does not impose a significant burden on the medical community as far as costs are concerned. It's much like automotive features: the insurance company may blame the rate hike on whatever it likes, but at the end of the day, the insurance rates hike because the insurance companies can get away with it. *Should* there be some changes? Yes. But the changes instituted will not save you costs: they serve only to protect the industry instead of the patients. Let us not forget that that litigation is the single tool with which patients can protect themselves from malpractice.
Neither should you imagine that medication "over" pricing is black and white. It is the same old capitalist rigmarole, but it is true: companies put hundreds of millions into R&D to make a profit, not for the good of mankind. The profit motive is what drives innovation and advances. There is a reason other countries *don't* have this thriving pharma economy, and those that come closest (i.e., India) do so by ripping off intellectual property of pharmaceuticals based in America and Germany. There are blatant instances where greed and corruption have been given a pass: for instance, Caduet was recently released under a new patent (thus preventing expiration of the preceding patent) by now being a "Race Specific" drug targ
The aforementioned studies were not comparing homeopathy and acupuncture; they were comparing real pain-killers vs. acupuncture, and part of the study design naturally compared them vs. placebo (which I suppose is the same as homeopathy).
The study design began by selecting patients for whom traditional remedies had already failed, and split them into an acupuncture group and a 'traditional group'. You can see the selection bias at work: there is no blinding, and *one of the groups has already proven not to respond to the treatment it's recieving!* The 'traditional' group would not even benefit from placebo effect, because they knew they were continuing to receive the traditional therapy that had failed them.
Moreover, the acupuncture group was allowed 2 (or was it 3? I forget) 'rescue' treatments of traditional pain relievers per week, without being considered to be a 'failing' regimen. The 'traditional' group was not, creating an uneven standard of success and failure.
Ultimately, it's not surprising that the acupuncture group showed a result better than 'placebo'. The placebo here was of tablet form, and thus not truly blinded: it was a "placebo" for a treatment they already knew didn't work! The 'traditional' group obviously was going to do worse, as again, the patients were rounded up from a sample for whom that treatment had already failed. And last, the bar for success was lower in the case of acupuncture.
Better studies in which acupuncture is compared against retractable needles (that is, acupuncture placebo) has shown no advantage over placebo.
All said, the moral of the story is that a poorly designed study can support any conclusion one wants to see.
Every professor in my university has had a policy of either:
1) Try not to go to Wikipedia, but cite it just in case you do. They will not consider this a real source, but you need to cite not to be considered a borderline plagiarist.
2) If they catch you getting data off Wikipedia, you're automatically failing the paper.
And my university is a relatively lax one - the City University of New York.
I can only imagine that you attend a trade school? Are you looking to become a plumber, perhaps?
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The government has no right to privacy from the people, therefore this is not 'lawyerly equivocating.' The people are *supposed* to have oversight on government activities.
No, I am not an anecdote, as the only thing I mentioned that referred to my personal experience was the case of a single pediatrician. Everything else I mentioned was industry-wide; far from anecdotal evidence. The widespread closure of EDs is not anecdotal; mean physician incomes are by definition empirical rather than anecdotal (go on, give it a google.)
PAs will never come close to replacing physicians. PAs are taught primarily technical medical skills, where they can offer aid to a physician in the clinical (and sometimes, surgical) setting. What they lack is precisely the period of training that characterizes doctors as well distinct from most any other profession - the residency. It is in medical residency that doctors gain their greatest raft of experience and training in diagnosis. Remember diagnosis? The *important* part of the medical profession?
PAs might replace doctors for placing swan caths, but most basic procedures are already handled by the better-trained nurses or the underpaid residents. Diagnostic medicine will not and cannot be replaced by PAs precisely because it relies on the very parts of medical training that are reserved for physicians alone.
Only doctors recieve the full gamut of doctorly training - who could have imagined that?
The idea that doctors are paid 'insane rates' is one not borne out by reality, and is rather a survivor of a world that has been dead for a few decades.
The average internist makes approximately 120k/yr; hardly an extravagance considering the cost of four years of college, four years of medical school, and then 3-5 years of Residency (average Resident income: $27k/yr). The average general surgeon makes closer to $250k/yr.
Most physicians now end up paying off their school loans until they're in their mid-50s, and saving for retirement thereafter. Few physicians make the sort of 'insane rates' that have them driving BMW 7-series cars with any haste.
Hell, I shadowed for a pediatrician for ~5 years before I went off to medical school. Most of the time his only income was a patient's co-pay of $10-$20; insurance would, at best, reimburse his costs. Medicaid patients were the worst, for their insurance wouldn't even cover his costs - after cost of immunizations, he usually wound up losing money on those kids.
This is why most physicians now pack their waiting rooms and rush from patient to patient all day long: you would too if you went through the hell of med school and residency, had $200-300k in loans, and wound up making $10-$20/patient.
Moreover, Congress set a schedule of costs associated with various medical procedures years ago, more-or-less unrelated to proceeding inflation or actual costs to doctors. All government-sponsored insurance systems use this schedule, and many private insurance companies follow suit. As such, a great number of procedures are vastly *under*priced when it comes to reimbursing the physicians.
The best doctors - and these are a very, very few - can afford not to take any insurance at all. Most of the best simply restrict themselves to what their parent hospital absolutely requires. *These* can make a great deal of money, and as outliers, skew upward the mean income of doctors in general. But these are few and far between: I can count off the names of about 50% of New York City's non-insurance-accepting doctors in my head.
I'm not even going to go into the cost of practicing insurance. Internists spend between 5k-10k a year just on insurance; surgeons can spend up to 30k. Hospital costs are even higher: hospitals across the country are closing Emergency Departments due to the fact that EDs are *always* money-losing propositions, but with rising costs of ED-related insurance the costs have gone from "loss" to "crippling." Pennsylvania State is notorious for currently suffering a crisis of ED shortages; it's in the worst position, but it's doubtful it will be the sole occupant of that position for long.
Medical litigation does not impose a significant burden on the medical community as far as costs are concerned. It's much like automotive features: the insurance company may blame the rate hike on whatever it likes, but at the end of the day, the insurance rates hike because the insurance companies can get away with it. *Should* there be some changes? Yes. But the changes instituted will not save you costs: they serve only to protect the industry instead of the patients. Let us not forget that that litigation is the single tool with which patients can protect themselves from malpractice.
Neither should you imagine that medication "over" pricing is black and white. It is the same old capitalist rigmarole, but it is true: companies put hundreds of millions into R&D to make a profit, not for the good of mankind. The profit motive is what drives innovation and advances. There is a reason other countries *don't* have this thriving pharma economy, and those that come closest (i.e., India) do so by ripping off intellectual property of pharmaceuticals based in America and Germany. There are blatant instances where greed and corruption have been given a pass: for instance, Caduet was recently released under a new patent (thus preventing expiration of the preceding patent) by now being a "Race Specific" drug targ
The aforementioned studies were not comparing homeopathy and acupuncture; they were comparing real pain-killers vs. acupuncture, and part of the study design naturally compared them vs. placebo (which I suppose is the same as homeopathy). The study design began by selecting patients for whom traditional remedies had already failed, and split them into an acupuncture group and a 'traditional group'. You can see the selection bias at work: there is no blinding, and *one of the groups has already proven not to respond to the treatment it's recieving!* The 'traditional' group would not even benefit from placebo effect, because they knew they were continuing to receive the traditional therapy that had failed them. Moreover, the acupuncture group was allowed 2 (or was it 3? I forget) 'rescue' treatments of traditional pain relievers per week, without being considered to be a 'failing' regimen. The 'traditional' group was not, creating an uneven standard of success and failure. Ultimately, it's not surprising that the acupuncture group showed a result better than 'placebo'. The placebo here was of tablet form, and thus not truly blinded: it was a "placebo" for a treatment they already knew didn't work! The 'traditional' group obviously was going to do worse, as again, the patients were rounded up from a sample for whom that treatment had already failed. And last, the bar for success was lower in the case of acupuncture. Better studies in which acupuncture is compared against retractable needles (that is, acupuncture placebo) has shown no advantage over placebo. All said, the moral of the story is that a poorly designed study can support any conclusion one wants to see.
Every professor in my university has had a policy of either: 1) Try not to go to Wikipedia, but cite it just in case you do. They will not consider this a real source, but you need to cite not to be considered a borderline plagiarist. 2) If they catch you getting data off Wikipedia, you're automatically failing the paper. And my university is a relatively lax one - the City University of New York. I can only imagine that you attend a trade school? Are you looking to become a plumber, perhaps?