re: Dental student dies in ICU. Only MD present for hours was telehealth.

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All it would take is to accept enough students to medical school to fill our neeeds.

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The amount of medical students is at an all time high. That’s not the problem. Nor is the main problem residency spots though it does contribute.

The shortage is in speciality and distribution. Speciality being primary care and distribution being smaller cities or towns. For example, family medicine increased the amount total residency spots and yet they had a high rate of unfilled positions. Why? Because lots of medical students don’t want to do family medicine. Lots of people also don’t want to practice medicine in rural areas or even small cities sometimes. Even though the Drs in those places have much more disposable income and get paid more.

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They are the ones that set prices

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Well that isn't true.

When i have to pay money because my doctor is charging more than my insurance will pay, I do not call that the insurance company setting prices.

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The more money they handle, the more they make.

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I agree. But again, they are not setting prices. A doctor does not have to charge the full amount of coverage paid by an insurance policy. The doctor can charge more. Or less (how often does that happen?).

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They also burden practices with overhead required for complex coding/billing, precerts, PA's. If shite went back to 1999. I could cut my overhead by at least half, probably much more.

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So you don't think fraud exists?

There are some cultures that think you are stupid if you do not take advantage of failures in the system.

I know that a lot of things feel like a hassle, but there are a lot of people out to make money regardless of ethics. I dont think that is on the insurance companies.

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When i have to pay money because my doctor is charging more than my insurance will pay, I do not call that the insurance company setting prices.

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I can charge a $million. They are going to pay what they allow. We charge a little over what they allow in case they go up, we'll know. We don't get fee schedules anymore so you don't want to leave money on the table. No one pays the higher amount except assholes.

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I agree. But again, they are not setting prices. A doctor does not have to charge the full amount of coverage paid by an insurance policy. The doctor can charge more. Or less (how often does that happen?).

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Yes they do. So you're going to leave money on the table when they pay us less than we got 20 years ago? I hope you never run a business. Our number one driver of overhead is employees and other expenses required to file, bill and deal with insurers. I'll charge less to cash pays, unless they are assholes. Pretty standard to charge less than insurance allows if someone will pay cash and I don't have to deal with insurance.

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So you don't think fraud exists?

There are some cultures that think you are stupid if you do not take advantage of failures in the system.

I know that a lot of things feel like a hassle, but there are a lot of people out to make money regardless of ethics. I dont think that is on the insurance companies.

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And I incur overhead to prove I'm not fraudulent which results in higher prices. That is 100% on the insurers. It could be easier, cheaper and more streamlined, but they would rather hold on to the money and draw interest. It can take years for me to get paid for claims. There is a cost to that.

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and a "promising" one at that?
Like would the story garner any less sympathy if the dude was a dumbass at the bottom of his class?

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“Mediocre dental student dies …”

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Medical school enrollment was a record high last year and you think you were making a point with this nonsense.

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What is the average years of practicing before retirement today compared to 20 years ago?

What about average hours worked compared to 20 years ago?

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if you meant urgent care I guess it's understandable if you thought the wait would be shorter.

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it was an urgent care, my mistake.

absolutely ridiculous experience. unless I’m dying I’m done with urgent care centers now too.

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Waited a full 2 hours and left. Called tele-doc instead.

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You went to a “local emergency care type of place”’with a runny nose?

yep, sure did. it’s been 10 days of drainage and congestion. wanted a steroid to kick it before a vacation later this week. urgent care.

don’t worry, your friend Jose got the help
he needed for his stitches!

Should have gone to a different hospital.



And there’s no way that happened like the article says it did.

As an icu physician, I can tell you teleicu or eicu is a common thing nationwide - depending on the institution there is however an on call physician who can come in.

99% of the time, I can manage things from home unless there's a procedure that needs to be done emergently. So it's not unreasonable of a service. Most of the time the emergent chest tube or intubation is done by our ed colleagues depending on the hospital.

In fellowship, I can tell you I had gone in a fair amount of times even when things are dire because of this situation - the optics look horrible even if my presence makes 0 difference - but it's the humility and humanity of being a good person/physician to talk to patients and family in person rather than on a screen if there's an option.