Not Attending Medical School---Fuck Obama Care
This is my personal story for any monkey's contemplating going to medical school or dental school.
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For the longest time I wanted to become a doctor. I was passionate about it and wanted to make a difference in this world, I was working on a start up during my undergraduate time and because of that my grades slipped so I could not attend medical school in the United States. I scored a high MCAT (in the 92%) and was allowed to attend a foreign medical school (not Caribbean) and was contemplating going right until I had to put my deposit in for the school because about I was read how the American Health Care Act was raising premiums for across the country (yes I know there are some that went down but those states are the minority).
I was confused at first because the American Medical Association endorsed Obama Care but no one really knew what the final bill was going to look like, they still don't. I concluded that these people who make up the Q&A had hardly any debt after they had graduated a million years ago and had already made a name for themselves ($ and persteejjgggge), so they made a convenient decision to endorse it because it wouldn't affect them in any significant way. Even knowing that fact, I wasn't completely sure whether I shouldn't go to medical school so I did further research and found that there is already a shortage of doctors. The insurance companies that have contracts with doctors are going to bind the doctors into whatever they mandated and eventually most doctor's will have too accept ACA patients, its already happening (look at the link I posted at the bottom). If you think there is a long wait to see a doctor now, wait until this law fully goes into effect. In addition, some friends who were on the path to medical school or dental school dropped their offers because of the uncertainty of the bill. At that point I reneged my admission to the school I was looking at. My parents fought my decision but ultimately understood the implications of bill after I explained it to them. Eight plus years of school and 300k of debt is not worth such a risk when considering the opportunity cost and questionable salary after graduating. I care about people ''and want to help them but I need to be financially stable before I can commit to helping others. I owe my future family more than I owe anyone else. I'm not going to spend my twenties and early thirties in debt until I'm forty.
Our overall population may not be the brightest but have no doubt, we have some of the absolute brightest minds in the world, this bill is going to deter more people from going into high level high care careers due to uncertainty, student debt and the length of medical school. This is going to cause even a bigger shortage of doctors than there already is. Obama's people are sly and they know this so to combat this they are recognizing nurse practitioners and physician assistants in place of actual medical doctors. These glorified nurses are allowed to do anything a doctor can in many states now. To illustrate the incompetence of these individuals, I went in to see a nurse practitioner for insomnia. She proceeded to prescribe me Xanax, I was shocked. Although the Xanax was a great time; there is an enormous white collar addiction problem with this drug. One can't prescribe it right off the bat for off label usage to anyone who says they can't sleep, that''s ineptitude and ignorance displayed in it's highest form. There is a class of drugs called hypnoics like Ambien that are specifically for insomnia and I get prescribed a hard benzo which is for panic disorder and anxiety. Are you fucking kidding me?
Take a look at this link to a NY Post article which shows individual doctors are against this bill. Doctors are already being forced by some insurance agencies to take ACA patients, these doctors have contracts with them and they are being forced to accept Obama Care, very soon most doctor will become slaves to insurance agencies. Universal health care is needed but this bill is as about useful as chicken shit. Unfortunately the Q&A does not respect the needs of doctors or their patients who will be severely affected by this bill, I believe they are a partisan group now. Take a look at this article from the NY Post where it specifically states that most doctors are against this bill, not just for their own self interest but because of their patients.
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Quoted from the article one doctor said, "I plan to retire if this disaster is implemented, This is a train wreck."
Wait, did I mistakenly sign up for physiciansoasis.com.
lol
--> Patrick: Spin-Off?
www.studentdoctor.net/
already own the domain DoctorOasis.com ....too busy with jdOasis.com and WSO :-)
Forgot to add that I'm going into finance now.
This is for monkeys who are deciding to go to med school or go into finance or a related field. If this doesn't pertain to you, you're free to move on.
It seems to me you did a shitty job doing research and probably made a bad life decision. With big regulation there always comes large opportunities for $$. The smart physicians will learn how to make the ACA work for them.
The demand for physicians is drastically increasing, due primarily to demographic factors (not due to the ACA, though that will have an effect), while the supply side of the curve is constrained by the very same demographics. You basically turned your back on a profession that will be in increasingly high demand and increasingly short supply right as you are entering the workforce (Baby Boomer retirement). Congrats.
Sweet Xanax anecdote.
concierge medicine groups... these guys do very well. that is until concierge medicine is deemed unfair by the powers that be
My fundamental problem with using medicine as a path to wealth is you need to do a LOT more direct damage to people to get there (especially with the ACA taking some of the low-hanging fruit, like ortho and interventional cardio away). And you generally need to look these people in the eye while they thank you before and after you screw them over. Check out the crazy stent doc from LSU, or a similar guy they caught for overbilling Medicare in MI.
The only way to really make a killing in healthcare services is from commercial payors - gov't rates are set in stone (with certain adjustments) and patient payment rates are extremely low (generally negotiated to a small fraction of billed rates). In the end, you need to figure out how to best maximize payments from insurance cos (fraud aside), not out of pocket payors or aid beneficiaries. Seems like an easier pill to swallow from a moral ground (whether or not it is in reality).
It's good you're not going into medicine. Glad to know no one's life will be in the hands of another idiot.
With all the legitimate sources you probably could have found, why the NYPost?
Glad your're not going be a doctor. There is a demand for physicians now and, depending on what specialty you are in you can still make bank.
ACA defenders had a softball tossed to them with this post, to actually tell OP why you think the ACA isn't as bad as it's made out to be. Nah, it's more fun to be a dick on the internet and throw out vagueries about smart people overcoming (bad) regulation. Call him an idiot, etc. yawn
It's not about overcoming regulation. It's about ignoring the biggest factor affecting healthcare employment - demographics.
I understand the sentiment, and you're not the only one who feels this way. But I'd urge you to see clearly how things are, as opposed to just telling yourself a story in order to justify to yourself skipping med school for business. There's a couple of things I take issue with though, and I just spoke to a cousin (who is a doctor, as well as her husband) this weekend about this. It seems you're operating under the same misguided zeal that Princeton students harassing GS recruiters a few years ago were.
Insurance companies took over medicine in the US a very long time ago, as in, well before you were born. This should not surprise you. Every major pay trend in medicine for the last few decades has been driven primarily by the insurance companies. Everyone hates this system, with the exception of the insurance companies. At this point, introducing exposure to the public decision making process, as well as more market forces (as opposed to the completely fucked billing of HIPPA) absolutely will benefit doctors down the line.
AMA is run by people who are intimately aware of the financial situation of medical students and isn't "screwing them over" on that basis. Check your premisis here. You're rebelling against a figment of your imagination.
Doctor shortages are, as stated above, largely driven by demographics. By this logic, demand and therefore pricing will go up. Also, many doctors (notably women) are forgoing practice for research, and this is a problem the AMA will be addressing at some point.
Medicare/medicaid payments are on par with ACA payments: they're guaranteed. It's like the section 8 housing market....the payments aren't huge but they're 100% likely to be honored. The benefit to this is balanced books, whereas other types of payments can linger or go into default. People like guarantees.
If you're waiting to become financially stable before medical school, you aren't cut out for it. I left pre-med a decade ago because I was more interested in business and have plenty of friends who are now doctors. No one, I repeat, NO ONE went to medical school expecting to be financially stable for a long time. If money is your primary interest, medicine isn't for you. At least not now. Call a spade a spade.
PA's have their roots in recognizing the experience of combat medics who came back from wars with far more practical knowledge than most medical personel (even quite a few doctors). It's one thing to treat heart attacks in the ER, it's quite another to be a frontline triage medic. I'm personal friends with the PA who spearheaded the creation of the entire PA designation. I know less about NPs, but one nurse getting one prescription wrong (or you just didn't agree? I don't know the full story) doesn't make a case. NPs typically spend decades in the trenches of their respective focus and tend to be extremely knowledgeable. You're also assuming doctors never screw up. They're people. They make mistakes.
As far as the press goes, the Post is a owned by News Corp, of course they're going to look for doctors who oppose this. This is like asking Sean Hannity the last time he voted democratic, and is a one sided "conversation" (aka propoganda). The reality is that there is a very broad spectrum of reactions to ACA within the practicing medical community. Some doctors absolutely hate it, others thing it's a great idea. It goes very far beyond the cardboard 'left/right' BS political 'debate'. This is a huge system that affects many moving parts, and if you actually want the full range of understanding, I's suggest doing a little more reading.
That said, welcome to the fold. A lot of people have jumped ship on med school for business, it's not uncommon. I also know a few MD^2....medical doctors who became managing directors in finance. You should see their titles: "M.D.D., M.D., C.F.A., etc" it's a trip. You're completely entitled to your political views here, but anyone is also entitled to argue with you. This is one of the better sites to learn how to break in, and I wish you the best of luck.
Right, just like the ABA isn't screwing over young lawyers.
Haha
@UFOInsider
Do you ever write short posts? Whenever I see a wall of text inside a thread, I assume you posted there.
I don't know. I see a big demand for Nurse Practitioners and Physicians Assistants coming from Obamacare. They can most of what a GP can do and at half the cost.
There aren't enough to fill the gap. Pre-ACA, the the AAMC was projecting a 124,400 physician shortage by 2025. The bill has some measures to address this shortage, but the numbers simply don't converge without an influx of foreign MDs and significant expansion of med school enrollments.
Blame your low undergrad GPA to push you toward expensive, but low value foreign medical school path. This will also stop you from some fancy finance career.
Please don't give us the crap about helping people and saving lives. We know its all about the money.
(Almost) none of us would have a passion for finance if it wasn't for the bling.
Canada has a HUGE doctor shortage because the system fucks them over. So happy we are bringing that system over.
@ Amphipathic - not really. I don't see med schools churning out 2 doctors for every job. It also doesn't matter much where you went to medical school unless you're looking at very particular niches. If anything, the AMA is too restrictive and has helped create a system where not enough doctors are graduating...hence the current problems.
If anyone is to blame for screwing doctors, it's the insurance industry. I honestly don't understand why doctors have been so passive in having their profession hijacked by another industry. It's really bizarre. Imagine if bankers suddenly had lawyers deciding their pay, the financial industry would go to war against them. But doctors....nothing. They've really just laid down and taken it. If people were happy, it would be another story, but everyone hates the system as it has existed for the last couple of generations. Patients, doctors, nurses, admin staff, they all hate it. The only ones smiling are the insurance carriers. Now, they're going to be competing against each other more directly. In the short term, insurance loves having people required to buy their wares....in the medium and longer run, they're going to see their profit margins shrink. Probably not bad for the industry overall given they're taking a smaller part of the pie but the pie will be much larger.
Maybe, but the guys in medicine who really kill it either 1) are specialists or 2) own a practice and have a diversified business. It's totally possible to make millions a year as a doctor, but money isn't the central focus of the career. You will be financially stable, but if being filthy stinking rich is your goal, business is going to pay a whole lot more for a whole lot less schooling and work.
Let me address a couple things.
1.) @TwoThrones @thekid1 Of course I want to make a good living. Do any of you guys want to be 300k debt and start out what some projections are calling 80-100k at 30 + years old, with the threat of constant lawsuits and the stress of making a mistake. This isn't an accounting error motherfucker, these are peoples health. I'm not expecting 600k my first year or even ever, I'm happy making an upper middle class or middle class living but I'm not going to settle for below that, the stress is not worth it.
2.) @abacab I'm not dumb boy, I made more money in undergrad than you will your first couple years of what ever you're doing or going to do. I was going to let my brother run my business or sell it and go into medicine. Look at my thread history if you want to know what I'm talking about the low value medical school your talking about is in Australia, which is pretty much equates to an Ugandan medical school to you I guess. I have drive and I can do whatever I want.
3.) @ucmaroon The government is transferring power from the doctors too the insurance companies.Like you said, they want to get rid concierge medical practices.
4.) @duffmt6
The demand side of the health care market will increase but are you forgetting that there is a government price ceiling imposed through the insurance companies, demand is going to increase with all the people who are going to start going to the doctor. Doctors are going to try every way not to take these patients because ask any dentist who works in a rural area that has to accept Medicaid, processing of documents eats up paperwork is a major part of their overhead in addition to waiting for payments to come in. Do you what that does smart guy? It's called an artificial shortage, doctors are going to do whatever they can to not accept these patients UNLESS the rules are changed. I suggest you go read an Econ book.
6.) @thekid1
This is true not all specialties will be affected by the bill but those spots are comparable to getting a spot at somewhere like KKR, so I'm not going to bet on that.
5.) If I had become a doctor, I want free reign in using any medicine I want or treatment. This is not to make money but to make sure I do my damnedest job in making sure my patient. I don't want insurance to be more invasive than it is already, you might as well put a robot in front of a patient then.
The whole premise behind ACA is to reduce the federal budget spent on health care on the premise of preventive care. How many people who don't go to the doctor now will start going to the doctor for just a check up? I bet it's in the lower than 5%, if that. People are still going to go when they get a major disease because they neglect going in for a regular check up. If people don't go to the doctor regularly. Our health care spending is gong to increase.with this bill if it can't even make people go to the doctor regularly.
The main reason I didn't go into medicine was because of the uncertainty. To be fair, this bill will change, it has too, the only thing is that I'm not going to wait around to see how it turns out. For example, our government can't even run our VA system, how is it going to manage this? I hope they get it right but I don't trust them, we need a bill but the ACA is terrible. We are not a small European country or Massachusettes by itself, managing some multiple of 10 million people is not the same as managing a population of 300 million +. It's much harder to scale. To you chemistry nerds, this is explained by the law of entropy.
Anyways, is anyone else in the same place as me?
*Disclaimer: There's doctors in my family and I knew more about this career than most people on this site. I didn't just post the NY Post because it has a Republican bias but the fact that so much of the anecdotes in the article ring true with my experiences talking to physicians.
I'm only going to read this part since it was addressed to me, and I feel like I might get stupider if I read any more.
Please explain to me a "government price ceiling imposed through the insurance companies", because that phrase in and of itself makes no fucking sense. Price ceilings are really only imposed on Medicare/Medicaid services. Most of the expansion to Medicaid will pull people from the uninsured to the gov't imposed rates. The uninsured have repayment rates that are just about nonexistent, so this expansion will actually reduce the amount of pro bono work completed by physicians. It's hard to even argue with this comment since it doesn't make sense.
How does a physician shortage (artificial or not) reduce compensation for doctors? I've seen a few supply and demand curves in my day.
Thank god you are not going to become a doctor.
Let me break it down for you. Medicaid/Medicare and the ACA are all based on transfer payments and subsidies. The fact that you can't even understand that there is a price ceiling baffles me. You have not read shit.
Scenario 1: No ObamaCare
Doctor1 performs specific serice for patients Doctor1 charges market price and gets cmpensated by insurance Doctor1 keeps performing service for patients
Scenario 2: ACA
Doctor 2: Provides same sort service as doctor 1 but is restricted on what he/she can fully do Doctor 2: Charges money but only gets half of market price from insurance* Doctor 2: Will not accept ACA patients again because he can't lose other patients who are not ACA on which he can provide full service for
Result: ACA patients will only go to doctors who accept it, those doctors will have more patients and the lines for those doctors will be longer but they will still be making less revenue (still have to have integrity to care for the patients and to avoid law suits)
What will happen is that the people with the best insurance will still get quality care while people with inferior insurance will get screwed. Getting denied to specific service that was supposed to be available is the definition of an artificial shortage. Lower prices=less service. Do i need to draw a chart out for you?
Again, you make literally no sense. What in the ever living fuck is an ACA patient? You mean someone who moves to private insurance from being uninsured? The Medicaid expansion?
To make real money in medicine you don't even want to practice medicine. You want to invent a process or a medical device. These have economies of scale that can never be achieved in practice. Even owning your own practice that has doctors that work in it you can never really achieve the economies of scale that can be acheived in other types of businesses. When you come down to it, doctors are just highly trained employees. No real difference from bankers.
This is true. Our socialist in chief put a 50% tax on medical devices in the ACA. Though It may have been appealed now.
Yes, however the tax will just be paid by customers. If you invent a new artificial joint and you license it out you will not have to worry about the tax. If your joint license profits you 10,000 per unit then you make your 10,000 and have no impact by the ACA.
...and so you decided to become an investment banker?
.
It's uncertainty. I know some broke GP's, I can't go in that direction especially when there are nurse "insert any specialty". For example a nurse anesthesiologist. Right now my school has one GP and all nurse practioners, this is rediculous. There are shortages of doctors but they are being replaced with nurses with advanced degree's. This happening right now, I'm not setting myself up to be broke in the long term. This is my life, I'm just trying to see if there are others on this forum who can relate to me.
I'm definitely no right wing nutjob or anything like that but I have mixed feelings on ACA. I don't want something discouraging people from entering the medical profession (not making any judgement on whether or not this will, because honestly I have no idea) and I definitely don't want deterioration of coverage quality or increased wait times. I guess we'll see how things shake out.
Also DoctorOasis could be pretty great...could overtake WebMD and chit like that. Just have to tack on a couple disclaimers so people don't start getting sued all over the place.
Can't wait until 2016... "Fuck HillaryClintonBank". We socialist now! Only thing you'll be saying in 3 years brah. If you're concerned about regulations and taxes you're going to lose. Just imagine if corporations weren't allowed to have an IB division if they had a commercial/retail banking division. If short-selling was banned, puts were banned, all the banks forced to unwind and phase out CDSs and MBSs, etc. There's a lot of red tape in finance now but it can go entirely non-profit and they can turn this into a game where people are forced to hold stocks for 24 hours before selling, trading is halted on a stock after a 5% gain or drop in a day, 0.25% transaction tax on every stock trade, etc.
Think this sounds like nonsense? A bunch of idiots in Massachusetts elected Elizabeth Warren to the Senate, and she'd love nothing more than to destroy the finance sector. Hillary gets elected, and soon enough Warren is head of the SEC, gulag master ("czar") of the entire banking industry, FINRA, SIPC, etc. Senate hearings on evil bankers foreclosing on innocent deadbeat Americans. Multi-billion dollar fines to every big bank for some BS reason like taking on too much risk in a trade.
But hey, you want to get scared of regulations, go for it. I'm just curious, what are you going to do when the socialists cap earnings of bankers to $200,000/year?
Wow, for finance dudes, you guys sure know a lot about the medical field.
For a website full of self-proclaimed superior intellects, I am pretty fucking disappointed after reading these responses to the OP. If you guys said half this shit to any superior personnel at your firm they would probably back-hand you and then show you the door. The OP is so spot-on I can't believe I'm having to defend him.
Doctor's wages are going down. Hospitals budgets are shrinking. Cleveland Clinic: Lowering budget by 300mm/year for the next 10 years. You ask why? Price ceilings are being introduced, certain procedures are being regulated, nurses are all of a sudden doctors, collections on deductibles will drop even more and already meager insurance receivables are being sliced in half. All of that = Doctor's wages going down, down, down (think Blink182 song).
Hospitals already only collect 10-15% of patient deductible receivables, and now that ANYONE gets healthcare, do you really think that number gets any better? No, it doesn't. How do hospitals make up for it? Volume. OK, but doesn't that mean they should hire more doctors to satisfy the volume and try to increase revenue? No, because nurses will fill those roles at 1/3 of the wage price (and that's generous, probably 1/4 or 1/5). Hire 3 nurses to handle the new rise in volume and there's your new business plan. More nurses = more margin = more capacity. Doctors, unless specialized, and I mean really fucking specialized, are a bottle-neck in the new system. And that is why wage rates for general doctors will go down. End of story.
There are gigantic nurse shortages in the US, especially for NPs, because there aren't enough schools or clinical opportunities to educate them. Not to mention nurses are susceptible to the same demographic factors as physicians. Saying nurses will close the gap for physician shortages is overly simplistic.
I would also like someone to explain to me these price ceilings. If you run a private practice, you can bill whatever it is that you want for a given procedure. The question is - what will you be compensated for, which is generally determined by either gov't established rates or what an insurance company is willing to pay for. It is the insurance companies who are dictating compensation, not some fictional ACA price ceilings.
OP was simply trying to reinforce his thought process for a terrible life decision by firing up some WSO free marketers. In reality, the ACA isn't the real issue here. It's OP's shortcomings (academic or otherwise).
My grades were not preventing me from doing what I wanted to do and I'm not complaining about not being able to get into a U.S school. It wouldn't have effected my decision either way.
The ACA is an issue, rube. I know other people who didn't go to medical school for the same reasons I posted. This was the whole reason for the post, to see if anyone else could relate to me.
I have concluded that you lack basic reading comprehension skills and are belligerently ignorant. I'm done arguing with you, have a good day.
And this is ACA's fault??? The things your are complaining about are insurance company policy. At some point, I think Americans are going to realize that a pure for-profit health system can't be very effective over the long run. I'd actually prefer to see a return to the non-profit hospital paradigm, but given that they get squeezed out, having the gov't come in is the only viable option. Other thing is that hospitals are not where doctors get rich and never has been. Private practice and specialties are where the big money is. Think of hospitals as the "sell side" where you get training and connections but where many prefer to jump out of at some point.
Do any of you even know the intended use of health insurance? The ACA is pushing health insurance to a breaking point and way further from it's initial intended purpose. When health insurance was created it was intended for major catastrophic cases. It wasn't meant for perscriptions, it wasn't meant doctors visits, it wasn't meant for minor out patient procedures. It was meant for real emergency room visits, major surgery, and life support. Then people started to complain that it needs to cover this and that and everything under the sun. Then people start to bitch that it costs more. Well no shit you want more services you pay more for them. I see way more doctors than any of you do, I pay straight cash and I bet I pay less per year in total than you all do with co pays and insurance premiums. Health care services aren't in themselves expensive. Its all of the extra shit they have to do to keep in line with regulations and insurance paperwork that drives the cost up. Your doctors office has to fill out all of these forms to comply with laws and then a bunch more to get paid by the insurance company. They have to pay people to do this so they bill you and your insurance company more to pay for it. Next time you go to the doctor ask them how much it would cost if you paid cash out of pocket. I bet you will be surprised.
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