Most who have went through medical school are self motivated people. The largest asset they possess is a work ethic and drive to succeed. They could have chosen many other paths and been successful. Oh, yeah they have a 4 year or other advanced degree before their MD, many in a completely unrelated field. A lot are leaving clinical practice. A few examples of where I have seen some of my colleagues go:

-2 got their law degree in 3 years of night classes and now do consulting work

-many move to non-clinical healthcare management

-moves to teaching

-moves into the pharmacy and medical device industry

-quit to run restaurants or other businesses

-50% of grads are now women and many decide not to use their degree at all or practice part time.

FMG’s are filling some of the void. They are mostly good, you just might not be able to understand them.

But let’s be honest – what are they going to do? The vast majority of physicians do not have the skills to immediately step into another job that pays just as much. And the vast majority of them, like everyone else, likely have debt service that requires them to make that much money. So really, where are you guys and girls going?

At worst you’ll quit serving poor people and taking govt. money, at least a few of you will, but the truth is the majority of you really don’t know how to go to another payment model, and all of you can’t stop taking govt. cash and stay afloat.

You’re still not going to want to move to Podunk, Mississippi no matter what CMS reimbursement rates are or how much tort reform there is. For the same reason Ruth Chris’ doesn’t open steakhouses in every little town – there’s not enough people there, and a lot of you simply don’t want to live there.

So if you get caps, how many neurosurgeons will they get within 3 hours of that hospital? What’s the guarantee? You guys keep making these claims that because you have no caps, we get no care. So what are you promising in return? How many specialists, and which kind are you going to put in every rural community in America?

“b) failed to set limits on what personal injury attorneys can take home which only drives each and every settlement through the roof as you and your colleagues take over 30% of all monies.”

You have clearly not ever settled a case if you think that what the lawyer makes determines what the insurer will pay. Insurers study verdicts, and that’s how they set their numbers. They don’t care what the attorney makes. Although, if you can find a way for indigent people to pay me hourly, like you do your attorney, and I have no risk in the case, like your attorney, I’m all for it. You do want to cap what BOTH sides can pay their lawyer, don’t you? You aren’t advocating for hamstringing just one side are you?

“directly due to the fact that congress has a) Failed to set limits on noneconomic damages that can not be deemed “unconstitutonal” by judges whose colleagues are personal injury attorneys ”

The US Congress cannot set limits on state law actions. But, since you raised it, how much are neurosurgeon premiums on average in Illinois, and say, California (a state with caps)? If you believe this to be true, please explain why. Since we’re looking for the truth and all.

Incidentally, do these judges not know any defense lawyers? None? If personal injury attorneys give to a judge and the Chamber of Commerce gives to a judge, do the respective donors dictate the outcome, or do these judges have minds of their own? Again, since you’re looking for honesty, I assume you’ve worked that out before essentially calling all judges who don’t agree with you corrupt. After all, you’re looking to save a few dollars yourself with your support of tort reform, aren’t you?

Medicaid cuts payments for birthing? Access to care threatened:

http://www.birthcenters.org/news/breaking-news/?id=85

State cuts funding for Medicaid? Access to care threatened:

http://www.louisianamedicalnews.com/news.php?viewStory=1295

Medicare cuts – Seniors face an access to care crisis:

http://seniorjournal.com/NEWS/Medicare/6-03-17-AMASaysSeniorCitizen.htm (this one even comes with this quote: “bout 29% of responding physicians said they plan to reduce the number of beneficiaries they take as new patients if the cuts take effect, and 16% said they plan to stop accepting any beneficiaries as new patients.” What certainty!

More Medicaid cuts – cardiac care at risk now!

http://www.stltoday.com/stltoday/news/stories.nsf/editorialcommentary/story/578419E54BEDDA3886257621001D894E?OpenDocument

And from 2007:

http://www.aapsonline.org/newsoftheday/003

“In what has become an annual ritual, Medicare announces a cut in physicians’ fees, and physicians threaten that patients will lose access to care. And this time they really mean it.”

Let’s be honest, you use this “access” threat every chance you get. And the truth is, where are you physicians going to go? Nowhere. There’s no other job most of you can do where you can immediately make the money you are making now. And like everyone else, many of you probably can’t afford to take a drastic pay cut. You couldn’t service your debt.

And now if you don’t get damage caps you’re not going to provide care? Be serious.

I have a copy of the same article on my site (linked here via my name), with footnotes to all sources.

(1) The premiums data comes by way of A.M. Best (see footnote 3), which rates insurance company financial health for banks and investors. I’m not able to break it down for each state; if you want more data, you’re going to have to ask the insurance companies and/or the medical societies, both of which keep a tight lid on these figures, except when they selectively release partial (and potentially inaccurate) figures for political reasons.

(2) I don’t know anything specifically about Illinois and so can’t comment on it. All I can do is refer you to the GAO and CBO, both of which looked at this exact issue and didn’t find any of these “facts” that you describe, nor did they find any utility in altering noneconomic damages or contingent fees. (All such reports are footnoted in my post). Indeed, I don’t see how either of those would really do much to increase care, since neither would make it much easier to set premiums or to give the doctor confidence in their treatment. They’d just cheat some patients out of damages (for the caps) or out of suit entirely (lawyers won’t work for free — the typical medmal case requires the lawyer pay at least $25k-$50k out of pocket just to get to settlement discussions).

Glad I could help you find the truth.

I had one tell me yesterday my client, who had been rearended, was at fault for stopping and attempting to turn left and having their blinker on because “you can’t make a left turn on a state highway like that.” So now I have to file suit to explain the rules of the road.

ERs charge more since they do more tests since they don’t know you and don’t know if you’ll follow up. Also, they are designed to test for emergencies and things that will kill or seriously harm you in the immediate future.

As far as the settlement it was relatively low amount(considerably less than $500K but more than $100K) equally split between the attending and then me/hospital shared the other half. I presume that was since I was a intern at the time and probably couldn’t be seperately listed. However I am not a lawyer and do not understand the details of that.