Why not follow the same procedure that was already done in 1936? The Rural Electrification Act gave federal loans to the electric companies with the sole purpose of delivering electricity to all rural areas. The act created the Rural Utilities Service that also oversaw telephone. Perhaps adding data access to their purview...
Being a doc, I have signed and deal with non competes all the time.
To have a valid non-compete clause, you must satisfy 2 legal requirements: 1. Duration of time the non-compete lasts 2. Location
Both of these requirements must also be considered "fair" and not run against restriction of trade. So, a non compete could not exclude someone from working in their field for 10 years at a radius of 1000 miles from the previous place of employment. Usual non-competes last 1-2 years and the mileage varies depending on the industry/location/etc.
I have been an avid gamer since the Atari 2600 first graced my home when I was a kid. Since then, I have gotten married, become a doctor and had 2 kids...so, my time is a little stretched.
What needs to be realized is that your time does not all belong to you. It is divided up into things like: work time, family time, couple time, etc, and last comes personal/alone time. Different people will place different priorities on these categories. What is important is knowing that you have to budget all of them into your day. Some days have more of one type than others, but at the end of your week/month/whatever, the majority of time should not fall into the alone category. If you wanted to be alone most of the time, why be in a relationship?
As for me, I tend to be a night owl and my wife is not. So, the solution came pretty quickly...I play when everyone else is in bed. That way I maximize the couple and family times while everyone else is awake and everyone wins.
The FDA has responsibility to assure safety and efficacy for medicine AND medical devices. This includes devices that are implanted and ones that are not. Some examples include diagnostic equipment (MRI, CT, PET), implantable devices (joints, pacemakers, breast implants), and assistance type equipment.
Look at it this way, what would happen if this company sold their product and it failed....often? Many people could be injured or killed. It's the job of the FDA to try and prevent these incidents by reviewing and "approving" medicine and medical devices.
It would be extremely difficult to track small pieces of debris. That's why you have to get rid of junk when it's big....before it becomes little pieces.
Remember, the energy a moving mass has (kinetic energy) is defined as: Kinetic Energy = 1/2 * mass * velocity ^ 2
What that means is that velocity is much more important than mass. To give an example, a small bolt about 1/4" in diameter traveling at 17,500 mph has the same kinetic energy as a bowling ball traveling at 60 mph.
Let me clear up another misunderstanding concerning physician billing. In a nutshell, PHYSICIAN BILLING IS HIGHLY REGULATED. First of all, physicians are paid by insurance companies (mostly), not individuals. Physicians have contracts with these companies that VERY specifically spell out what a physician will be paid for a specific service. All of these insurances have differences but for the most part are in the same ball park.
Most "high priced" type medical services involved are in the minority and are usually performed by people with high levels of expertise even by physician standards.
I know that everyone looks to the $400,000 transplant or the $10,000 pacemaker implant as examples of excessive fees.... But did you know that the average person spends less than $500 a year on their own health care? That is the logic behind insurance deductables. They know that your average bills for the year will be less than $500-$1000 so that's what they set the deductable at. In the end, they collect your (or your employers) premiums while never spending a dollar for your medical care.
The other interesting fact is that about 75% of the medical dollars spent for your ENTIRE LIFE will be used during the last 3-4 weeks of your life. Think about it. At the end of your life by definition you are dying....so you are in the intensive care unit, getting all sorts of tests, drugs and procedures that in the end can't help you.....because everyone will die sometime. It also means that if you have the need for all of these expensive things, you must be pretty sick to begin with.
My overall point here is that physician fees are fixed and shopping around won't help you because THERE IS NO DIRECT CORRELATION BETWEEN HOW MUCH THE PHYSICIAN CHARGES AND HOW MUCH YOU PAY. Don't think for a moment that insurance rates reflect what the physician charges or gets paid. It's estimated that health care costs increased by 12-13% last year. I can tell you it's not due to me increasing my charges or increasing the number of test that I run.....because I practice the same now that I did last year. The increase in medical costs are due to drug prices, medical equipment, increased utilization by patients (they see doctors more often) and most of all INSURANCE COMPANY PROFITS.
Don't ever forget that. Insurance companies exist to make money first and help you second. In the end, their loyalty is to their shareholders.
Misunderstandings....
on
Complications
·
· Score: 4, Informative
There seems to be a lot of assumptions towards physician salaries, intentions, etc.
Salaries The average physician makes about $150,000 per year. I know that seems like a lot. But think about this. The average physician has $150,000 in educational debt after they finish residency.....that's when they turn 30! So, you're thirty, have tons of debt, no savings, and you are just starting. How does one determine how much a person should earn anyway? It seems to me there are 4 factors that SHOULD govern this process. 1. Physical exertion 2. Level of training/education 3. Level of responsibility 4. Contribution to society It seems to me that for a physician 2-4 are very high. Lastly, I can't stress this enough. PHYSICIANS ARE NOT INTO MEDICINE FOR THE MONEY!!!!! I couldn't have made it through medical school and residency if money was my motivation. Almost all physicians due this for some higher/noble purpose of helping others. It was that reason that let me get through not seeing my wife and new daughter in residency. It was that higher purpose that allowed me to be worked like a slave.
Responsibility Bad things happend....that's life. I know that everyone has a story about a relative or friend that had a bad experience in medicine. Why do people automatically start looking for someone to blame? Doctors are able to predict a lot of things with the human body. There are a lot of things they cannot. There is a saying in medicine:it's half preventing fires and half putting them out. Unexpected things crop up all the time....it's unavoidable. Yes, sentinnel type of events like amputating the wrong leg have blame, but most bad things that happen could not have been predicted by anyone. Flesh Mechanics I hate this comparison. Why? Because it implies that the human body is just as simple as a car engine. It implies that every body is the same. Imagine you are a mechanic. You know that the car you are working on has an engine, electrical system, and exhaust. Now imagine that you kind of know how everything is connected but aren't sure because no 2 cars are the same. That's the way people are. EVERYONE is different. Reactions to medications are different....both good and bad. Reactions to surgery are different....both good and bad. All physicians have are statistics on how these things affect MOST people....not all. Ever hear of the uncertainty principle? Well, it's present in every aspect of medicine and no amount of research, knowledge or training will change that.
Many people have a problem with personal responsibility. It's your God given right to smoke, drink and do drugs. It's your God given right to drive without a seatbelt and participate in unprotected sex. But how do these behaviors magically become the doctors fault? A good example is the lawsuit against the tobacco industry. Yes, they hid research that suggested nicotine was addictive. Yes, they did not tell the public that tobacco was bad for you. There is one person that did.....the Surgeon General of the United States.....back in the 70's. So, it seems to me that if you started smoking after the 1970's, you knew the facts and CHOSE to ignore them. Why should you be entitled to any of that settlement. Yes, THEY were wrong but YOU made the choice and now have to live with that choice.
Physician Intentions I know I touched on this earlier, but I cannot emphasize this enough. Every single doctor that I know (including myself) is in this field for the most noble reason I can think of....to help people. Most of us try to educate our patients so they can make informed decisions.....and they are YOUR decision. The "paternalistic model"(doing what the doctor says) of physician interaction ended in the 70's. We now live in a world where medical information is easily accessible by the public...and this is a good thing. What is frustrating is when the doctors information conflicts with the patient. I know many people feel this is just the doctor being arrogant because they "know best." Medicine rarely changes the way it treats a patient based on one study. Not all studies are good ones. All studies have limitations. Physicians know this and merely want to better educate you.
Litigation This is a difficult topic....simply because I don't know the answer. Suing a doctor into oblivion isn't the answer. What does that get you? You have then successfully punished a doctor for all eternity and ruined his/her career and livelyhood (docs have families too) despite all the good he/she has done because of something he/she may not have done wrong. That hardly seems fair. I have made mistakes.....none of which hurt anyone...but mistakes that I lost sleep over...not because I might get sued, but because something bad might have happend to a fellow human being. I would also like to flip the coin here. Let's assume that I see you as a patient. Let's assume that you see me over the course of your life, follow my advice, and I treat appropriately your diseases appropriately. Let's say that all of that care EXTENDS your life by 10 years (I'm being conservative). How much is 10 years of your life worth? It seems to me that if you can sue me for taking 10 years of your life away for millions of dollars, why wouldn't giving you 10 years of life be worth millions of dollars? I am not trying to suggest that I bill that amount....that would be ridiculous.....I merely want to illustrate the point that legal action settlement are a little over the top.
Thanks for reading.....I just want everyone to know that the great majority of physicians care about you and about what you think.
Kudos to walt-sjc!!!
Don't mean to get off the subject of the parent post, but I feel compelled to educate everyone on our medical reimbursement system and how doctors operate. I am a physcian and am, unfortunately, very familiar with medical billing.
walt-sjc was absolutely correct. Physician reimbursement is based on fee schedules (lists of prices for services) that are determined by the Health Care Finace Authority (HCFA) - a government agency in charge of lowering the cost of MEDICARE health care. What all insurance companies have done is to also base their payments on this fee schedule. MEDICAID for example pays approximately 50% of medicare. Along with this, HCFA also requires very specific documentation points to qualify for different levels of payment. If a physician is found to bill in error - regardless of intent - that physician can be fined $10,000 per occurance and possibly face jail time.
Where electronic medical records (EMR) comes into play is this last portion. The EMR will monitor your documentation for a particular service and then pick the billing level for you....guaranteeing that you are in compliance. The other benfits include reducing overhead and speeding up insurance payments.
So you see, adding an electronic medical records system only adds money to the physicians pocket because of decreased overhead and heaven forbid, an audit that would result in several fines.
Slashdot Mirror
Why not follow the same procedure that was already done in 1936? The Rural Electrification Act gave federal loans to the electric companies with the sole purpose of delivering electricity to all rural areas.
The act created the Rural Utilities Service that also oversaw telephone. Perhaps adding data access to their purview...
Does anyone know if the primary and secondary launch stages landed safely? I can't find any info on this.
Does this give the Dutch Pirate Party reasonable grounds to vacate the decision? (IANAL)
It's a magical time when those who would speak out against same sex marriage have feel the need to hide from the public.
Irony can be fun!
Being a doc, I have signed and deal with non competes all the time.
To have a valid non-compete clause, you must satisfy 2 legal requirements:
1. Duration of time the non-compete lasts
2. Location
Both of these requirements must also be considered "fair" and not run against restriction of trade. So, a non compete could not exclude someone from working in their field for 10 years at a radius of 1000 miles from the previous place of employment. Usual non-competes last 1-2 years and the mileage varies depending on the industry/location/etc.
I often check /. prior to performing a colonoscopy on a patient.
:)
Yes, I am a physician.
I have been an avid gamer since the Atari 2600 first graced my home when I was a kid. Since then, I have gotten married, become a doctor and had 2 kids...so, my time is a little stretched.
What needs to be realized is that your time does not all belong to you. It is divided up into things like: work time, family time, couple time, etc, and last comes personal/alone time. Different people will place different priorities on these categories. What is important is knowing that you have to budget all of them into your day. Some days have more of one type than others, but at the end of your week/month/whatever, the majority of time should not fall into the alone category. If you wanted to be alone most of the time, why be in a relationship?
As for me, I tend to be a night owl and my wife is not. So, the solution came pretty quickly...I play when everyone else is in bed. That way I maximize the couple and family times while everyone else is awake and everyone wins.
The FDA has responsibility to assure safety and efficacy for medicine AND medical devices. This includes devices that are implanted and ones that are not. Some examples include diagnostic equipment (MRI, CT, PET), implantable devices (joints, pacemakers, breast implants), and assistance type equipment.
Look at it this way, what would happen if this company sold their product and it failed....often? Many people could be injured or killed. It's the job of the FDA to try and prevent these incidents by reviewing and "approving" medicine and medical devices.
Sorry, didn't actually do the calculation....read the example somewhere else.... The point was that small things going fast are bad.
It would be extremely difficult to track small pieces of debris. That's why you have to get rid of junk when it's big....before it becomes little pieces.
Remember, the energy a moving mass has (kinetic energy) is defined as:
Kinetic Energy = 1/2 * mass * velocity ^ 2
What that means is that velocity is much more important than mass. To give an example, a small bolt about 1/4" in diameter traveling at 17,500 mph has the same kinetic energy as a bowling ball traveling at 60 mph.
Yikes!
Let me clear up another misunderstanding concerning physician billing. In a nutshell, PHYSICIAN BILLING IS HIGHLY REGULATED. First of all, physicians are paid by insurance companies (mostly), not individuals. Physicians have contracts with these companies that VERY specifically spell out what a physician will be paid for a specific service. All of these insurances have differences but for the most part are in the same ball park.
Most "high priced" type medical services involved are in the minority and are usually performed by people with high levels of expertise even by physician standards.
I know that everyone looks to the $400,000 transplant or the $10,000 pacemaker implant as examples of excessive fees.... But did you know that the average person spends less than $500 a year on their own health care? That is the logic behind insurance deductables. They know that your average bills for the year will be less than $500-$1000 so that's what they set the deductable at. In the end, they collect your (or your employers) premiums while never spending a dollar for your medical care.
The other interesting fact is that about 75% of the medical dollars spent for your ENTIRE LIFE will be used during the last 3-4 weeks of your life. Think about it. At the end of your life by definition you are dying....so you are in the intensive care unit, getting all sorts of tests, drugs and procedures that in the end can't help you.....because everyone will die sometime. It also means that if you have the need for all of these expensive things, you must be pretty sick to begin with.
My overall point here is that physician fees are fixed and shopping around won't help you because THERE IS NO DIRECT CORRELATION BETWEEN HOW MUCH THE PHYSICIAN CHARGES AND HOW MUCH YOU PAY. Don't think for a moment that insurance rates reflect what the physician charges or gets paid. It's estimated that health care costs increased by 12-13% last year. I can tell you it's not due to me increasing my charges or increasing the number of test that I run.....because I practice the same now that I did last year. The increase in medical costs are due to drug prices, medical equipment, increased utilization by patients (they see doctors more often) and most of all INSURANCE COMPANY PROFITS.
Don't ever forget that. Insurance companies exist to make money first and help you second. In the end, their loyalty is to their shareholders.
There seems to be a lot of assumptions towards physician salaries, intentions, etc.
Salaries
The average physician makes about $150,000 per year. I know that seems like a lot. But think about this. The average physician has $150,000 in educational debt after they finish residency.....that's when they turn 30! So, you're thirty, have tons of debt, no savings, and you are just starting.
How does one determine how much a person should earn anyway? It seems to me there are 4 factors that SHOULD govern this process.
1. Physical exertion
2. Level of training/education
3. Level of responsibility
4. Contribution to society
It seems to me that for a physician 2-4 are very high.
Lastly, I can't stress this enough. PHYSICIANS ARE NOT INTO MEDICINE FOR THE MONEY!!!!! I couldn't have made it through medical school and residency if money was my motivation. Almost all physicians due this for some higher/noble purpose of helping others. It was that reason that let me get through not seeing my wife and new daughter in residency. It was that higher purpose that allowed me to be worked like a slave.
Responsibility
Bad things happend....that's life. I know that everyone has a story about a relative or friend that had a bad experience in medicine. Why do people automatically start looking for someone to blame? Doctors are able to predict a lot of things with the human body. There are a lot of things they cannot. There is a saying in medicine:it's half preventing fires and half putting them out. Unexpected things crop up all the time....it's unavoidable. Yes, sentinnel type of events like amputating the wrong leg have blame, but most bad things that happen could not have been predicted by anyone.
Flesh Mechanics
I hate this comparison. Why? Because it implies that the human body is just as simple as a car engine. It implies that every body is the same. Imagine you are a mechanic. You know that the car you are working on has an engine, electrical system, and exhaust. Now imagine that you kind of know how everything is connected but aren't sure because no 2 cars are the same. That's the way people are. EVERYONE is different. Reactions to medications are different....both good and bad. Reactions to surgery are different....both good and bad. All physicians have are statistics on how these things affect MOST people....not all. Ever hear of the uncertainty principle? Well, it's present in every aspect of medicine and no amount of research, knowledge or training will change that.
Many people have a problem with personal responsibility. It's your God given right to smoke, drink and do drugs. It's your God given right to drive without a seatbelt and participate in unprotected sex. But how do these behaviors magically become the doctors fault? A good example is the lawsuit against the tobacco industry. Yes, they hid research that suggested nicotine was addictive. Yes, they did not tell the public that tobacco was bad for you. There is one person that did.....the Surgeon General of the United States.....back in the 70's. So, it seems to me that if you started smoking after the 1970's, you knew the facts and CHOSE to ignore them. Why should you be entitled to any of that settlement. Yes, THEY were wrong but YOU made the choice and now have to live with that choice.
Physician Intentions
I know I touched on this earlier, but I cannot emphasize this enough. Every single doctor that I know (including myself) is in this field for the most noble reason I can think of....to help people. Most of us try to educate our patients so they can make informed decisions.....and they are YOUR decision. The "paternalistic model"(doing what the doctor says) of physician interaction ended in the 70's. We now live in a world where medical information is easily accessible by the public...and this is a good thing. What is frustrating is when the doctors information conflicts with the patient. I know many people feel this is just the doctor being arrogant because they "know best." Medicine rarely changes the way it treats a patient based on one study. Not all studies are good ones. All studies have limitations. Physicians know this and merely want to better educate you.
Litigation
This is a difficult topic....simply because I don't know the answer. Suing a doctor into oblivion isn't the answer. What does that get you? You have then successfully punished a doctor for all eternity and ruined his/her career and livelyhood (docs have families too) despite all the good he/she has done because of something he/she may not have done wrong. That hardly seems fair.
I have made mistakes.....none of which hurt anyone...but mistakes that I lost sleep over...not because I might get sued, but because something bad might have happend to a fellow human being.
I would also like to flip the coin here. Let's assume that I see you as a patient. Let's assume that you see me over the course of your life, follow my advice, and I treat appropriately your diseases appropriately. Let's say that all of that care EXTENDS your life by 10 years (I'm being conservative). How much is 10 years of your life worth? It seems to me that if you can sue me for taking 10 years of your life away for millions of dollars, why wouldn't giving you 10 years of life be worth millions of dollars? I am not trying to suggest that I bill that amount....that would be ridiculous.....I merely want to illustrate the point that legal action settlement are a little over the top.
Thanks for reading.....I just want everyone to know that the great majority of physicians care about you and about what you think.
You should check out the Qbe Vivo. Nice setup with a built in wireless ethernet card and all the extras...
Check it out at www.qbenet.com
Kudos to walt-sjc!!! Don't mean to get off the subject of the parent post, but I feel compelled to educate everyone on our medical reimbursement system and how doctors operate. I am a physcian and am, unfortunately, very familiar with medical billing. walt-sjc was absolutely correct. Physician reimbursement is based on fee schedules (lists of prices for services) that are determined by the Health Care Finace Authority (HCFA) - a government agency in charge of lowering the cost of MEDICARE health care. What all insurance companies have done is to also base their payments on this fee schedule. MEDICAID for example pays approximately 50% of medicare. Along with this, HCFA also requires very specific documentation points to qualify for different levels of payment. If a physician is found to bill in error - regardless of intent - that physician can be fined $10,000 per occurance and possibly face jail time. Where electronic medical records (EMR) comes into play is this last portion. The EMR will monitor your documentation for a particular service and then pick the billing level for you....guaranteeing that you are in compliance. The other benfits include reducing overhead and speeding up insurance payments. So you see, adding an electronic medical records system only adds money to the physicians pocket because of decreased overhead and heaven forbid, an audit that would result in several fines.