re: Medical Industry: Biggest Crooks Ever

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Well, it was a pointless endeavor in my experience. None of them could tell you and were all confused at the question to begin with.

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billing is a huge problem on both ends.

As well as a million other things that compile to make medical care expensive.

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Not completely calling you out, but what are your justifications for this statement?

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They do nothing. Closed orthopedic injury? Page Ortho, the resident will put on a splint. Oozing venous wound? Page surgery/vascular, "my attending would like you to see it and I don't feel comfortable putting surgicel or gel foam or arista on this." Patient has a foot? Page podiatry. Patient has a mouth? Page OMFS. Did I mention 90% of 3rd year ED residents can't put a sugar tong on a wrist or an ankle? Let alone reduce anything.

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Not much pisses those ED docs off quite as much as your nurse not wanting to squeeze in another appointment and telling your patient, "Just go to the ER."

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I work more than 10 days a month. And you want nurses diagnosing and treating patients over the phone? Y'all are dumber than I thought...

email karl denninger at Marketticker.org

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Did I mention 90% of 3rd year ED residents can't put a sugar tong on a wrist or an ankle? Let alone reduce anything.

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I admit you have a point. A lot of this; however, has to do with the nature of the entire academic center. Broken wrist? Ortho is hand trauma call? The consult for follow-up has to be made, and Ortho only wants their residents to put on the splint. Plastics on-call? Go ahead. Moonlighting is the key to the ER residents growing balls and figuring stuff out on their own. It's hard to do so if they aren't allowed to moonlight in their respective program. A lot of the academic attendings take advantage of having every service imaginable at their disposal, and I promise you that this also pisses off the ER residents who actually want to become competent physicians.

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And you want nurses diagnosing and treating patients over the phone? Y'all are dumber than I thought...

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No, I want patients who, when they are experiencing "this and that," and who are told to go to clinic/follow-up with their physician if they experience "this and that," to actually be seen in that physician's clinic rather than be told over the phone to just go to the ER. I hate walking into a patient's room for a sore throat and that patient has been in the waiting room for 6 hours. Then I look at the chart and see the follow-up instructions from their last clinic visit and a telephone encounter from that day saying "patient called saying that his throat still hurts. Advised he present to ER for work-up."

And good job summing up an entire nation's broken healthcare system with the generic "all ED docs are dumb" and acting like your clinic/work load is comparable to that of everyone else. Great job supporting your colleagues throughout the medical field. I'm sure your patients feel great when you generically bash other specialties and then tell them they need to go see that specialist.

Please detail your reasoning behind the belief that insurance makes a hospital stay or other medical encounter so expensive?

Insurance is why it was $10k. Zero accountability with insurance involved. If insurance didn't exist and people had to cover the costs, competition would keep costs in check.

Insurance companies use their large populations to garner the best discount possible.

It seems that folks have a belief that insurance makes health care costs rise when that's not the case especially during this time when more costs are being shifted to the insured with higher deductibles.


It appears that folks really don't understand the economics of the health care/insurance industry. Folks seemingly just want to lay the blame somewhere other than themselves. This is pretty much how we think now. It's always someone else's fault.

But the nurse practitioners are trying to take over! They have to make their money before it happens.

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Ortho only wants their residents to put on the splint.

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No I want the splint put on in a half way decent fashion which, since ED attendings won't and ED residents can't, ends up being on my residents.

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acting like your clinic/work load is comparable to that of everyone else. Great job supporting your colleagues throughout the medical field. I'm sure your patients feel great when you generically bash other specialties and then tell them they need to go see that specialist.

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I know my clinic/work load isn't comparable to that of everyone else. I work less than some and more than most. And unlike an ED doc who is not on a single panel and bills out of network for everyone they see in the ED, I save healthcare dollars. I'm in a group trying to be part of the solution and would love it if even a small minority of ED docs would too. Maybe when you finish residency you can lead the charge?

Insurance companies want fewer and less expensive claims. I'm not sure how you can tie them to higher health care costs with a straight face.