|
I learned something interesting recently from a few of my doctor friends. Apparently, while pay for general practitioners (i.e. family doctors) is slightly higher in the coastal states, that's not true for specialists. Pay for specialists in places like Utah and Missouri and Ohio can often be hundreds of thousands of dollars more a year than in California or New York, because highly trained medical professionals are quite averse to living in the interior of the country. So coastal positions can get away with paying much less because those places are more competitive. For example, one of the people I talked to was a neurosurgeon in her last year of residency. She was just offered a $1.2m/year position in Utah, complete with access to a jet and a private butler. She turned it down, and so did everyone else in her class (and not [only] because Utah=Mormons). Instead, her ideal job is a $700,000/year gig (no special perks) working for a HMO in California, which is apparently really hard to get because that's also where everyone else wants to be. $700,000 is still a shitload of money, of course, but it's about half of Utah even without factoring in the much higher cost of living in SF or LA. The dermatologist and pediatric gastroenterologist at the table both agreed that this is the same situation in their field. The end result is that places not part of the "bi-coastal elite" have to pay a lot more money to attract doctors, even though those places are poorer to begin with, and even then they often only get the rejects that couldn't find a job in NYC/SF/LA. That strikes me as really messed up, but at the same time you really can't force people to live where they don't want to. It was also surprising that people would literally give up $500k a year (which is $1300+ a day) to avoid not being on the coast. So the hollowing out of the country continues.
|
#
?
Jan 8, 2017 07:19
|
|
|
|
| # ? Jun 9, 2024 19:24 |
|
|
there aint enough of it to fill a thread even in this dead gay forum :|
|
|
#
?
Jan 8, 2017 07:22
|
|
|
id like 1300$/day
|
|
#
?
Jan 8, 2017 07:31
|
|
|
Baloogan posted:id like 1300mL/day
|
|
#
?
Jan 8, 2017 07:32
|
|
|
highly educated high earners definitely don't want to put down roots in places where regressive governments are underfunding things like "healthcare for poors and olds" and "the educational system your future children will be exposed to" and other awful policies my wife is finishing up her residency next year and birmingham alabama will absolutely suck all the doctor dicks since they're trying extra hard to build a decent program there and whatnot. know what she's not gonna do? go practice in a place that, today, right now, would require her female patients to hold funerals for their miscarriages. i sure as poo poo wouldn't want to start a family in a place like that, since so many other options are available it goes way beyond "ew this noncoastal city doesn't have a decent opera"
|
|
#
?
Jan 8, 2017 07:59
|
|
|
Yeah. Doctors are people too with families, and even working in flyover country for a short time means putting family plans on hold, unless you wanted to start a family there in the first place. It's no longer being in school (students from the coast would GLADLY go to medical school in Iowa or Utah or something if it meant going to medical school at all) for a set amount of years before you gently caress off, it's living in a place for a potentially open ended period of time. There are plans in place to boost the number of doctors working in such areas (loan forgiveness after X years is a big one) but it's a problem with no easy fixes
|
|
#
?
Jan 8, 2017 07:59
|
|
|
i'd like serf to still have a foot how much would that cost
|
|
#
?
Jan 8, 2017 08:01
|
|
|
the loan forgiveness thing is p popular yeah. we're from southern louisiana and the typical one there (which links into a federal program for underserved areas) is the school locks you into ten years of work after graduation and louisiana has noooooo shortage of underserved areas she went to tulane so i didn't meet anyone doin that but i understand it was at least somewhat popular at LSU med
|
|
#
?
Jan 8, 2017 08:07
|
|
|
what if northern exposure, but in the hot part of the country
|
|
#
?
Jan 8, 2017 08:09
|
|
|
Loan forgiveness needs to be more appealing, imo. It takes too long and the issue is that it's usually at the time in their lives when they're having children / have young children, and nobody wants to live in Alabama or Louisiana for 10 years during that time.
|
|
#
?
Jan 8, 2017 08:15
|
|
|
oh yeah the jet thing one of her attendings used to practice in iirc oklahoma and fly back to the bay area on weekends. did it for a few years since the pay was so good. i bet that's what they were goin for in utah with a perk like that
|
|
#
?
Jan 8, 2017 08:20
|
|
|
just perform specialist operations in jets that literally flies over flyover country so simple rudatron has issued a correction as of 08:41 on Jan 8, 2017 |
|
#
?
Jan 8, 2017 08:33
|
|
|
Loan forgiveness should be State-level only. That way states who elect Republicans can continue to atrophy, and those who don't can get better.
|
|
#
?
Jan 9, 2017 20:37
|
|
|
Talmonis posted:Loan forgiveness should be State-level only. That way states who elect Republicans can continue to atrophy, and those who don't can get better. Yeah that works out well. State stuff sure helped the ACA be popular. I am straight shocked that someone you knew turned down millions and a private jet just to live in California. My dad took a job in a tiny town in Maine as a radiologist coming out of school, he never talked about how much it offered. I guess I never thought people turning down positions not because they don't want to move, but because they're moving to somewhere they consider backwards. It's jsut another way we've let everything outside of a few cities rot. Grondoth has issued a correction as of 21:05 on Jan 9, 2017 |
|
#
?
Jan 9, 2017 20:54
|
|
|
Sir, first off, that trick only works with teeth, and you're supposed to put it in water or milk, not Mountain Dew. Second, no, your foot is not going to grow back.
|
|
#
?
Jan 9, 2017 21:06
|
|
|
Private healthcare is a breach of human rights
|
|
#
?
Jan 9, 2017 21:19
|
|
|
Grondoth posted:Yeah that works out well. State stuff sure helped the ACA be popular. Popular? Nah man, I'm past the point where I believe that the midwest will ever vote for Liberal Democratic policies or politicians. The people of California should not be subsidizing the Republican "no taxes or programs ever" lifestyle in say, Kansas, while they (the Kansans who vote themselves into said situation) enjoy outsized political influence. If the Midwest still refuse to raise and pay taxes for programs to save their sorry selves from economic irrelevance, let them lay in that bed they made.
|
|
#
?
Jan 9, 2017 21:56
|
|
|
Talmonis posted:Popular? Nah man, I'm past the point where I believe that the midwest will ever vote for Liberal Democratic policies or politicians. The people of California should not be subsidizing the Republican "no taxes or programs ever" lifestyle in say, Kansas, while they (the Kansans who vote themselves into said situation) enjoy outsized political influence. If the Midwest still refuse to raise and pay taxes for programs to save their sorry selves from economic irrelevance, let them lay in that bed they made. Kansas will remain an immensely fascinating, and horrifying test case.
|
|
#
?
Jan 9, 2017 21:57
|
|
|
I'm glad my government are killing the NHS
|
|
#
?
Jan 9, 2017 22:00
|
|
|
Talmonis posted:Popular? Nah man, I'm past the point where I believe that the midwest will ever vote for Liberal Democratic policies or politicians. The people of California should not be subsidizing the Republican "no taxes or programs ever" lifestyle in say, Kansas, while they (the Kansans who vote themselves into said situation) enjoy outsized political influence. If the Midwest still refuse to raise and pay taxes for programs to save their sorry selves from economic irrelevance, let them lay in that bed they made. I don't care who they are. I don't want to see people suffer.
|
|
#
?
Jan 9, 2017 22:24
|
|
|
Grondoth posted:I don't care who they are. I don't want to see people suffer. The problem is that their votes, which are worth more than yours or mine, go toward hurting a lot of folks who didn't do anything wrong. There has to be a better way.
|
|
#
?
Jan 9, 2017 23:13
|
|
|
sincx posted:I learned something interesting recently from a few of my doctor friends. TBH if you're willing to turn down an extra $500k a year, which would be like a 40% pay bump, just to not live in (presumably) Salt Lake City, which has a metro area of over a million and is a short flight away from LA or SF then I think that's more of a problem with the doctors having weird priorities and biases than anything else. It's also being super generic since "flyover country" encompasses a huge area. There are lots of large metropolitan areas like Denver, Kansas City, or Minneapolis that are technically in "flyover county" but this seems like they're assuming that anything not within 20 miles of the coast is just Bumfuck, Idaho.
|
|
#
?
Jan 9, 2017 23:27
|
|
|
Thoguh posted:It's also being super generic since "flyover country" encompasses a huge area. There are lots of large metropolitan areas like Denver, Kansas City, or Minneapolis are technically in "flyover county" but this seems like they're assuming that anything not within 20 miles of the coast is just Bumfuck, Idaho. Theyre correct. Denver is a wasteland. please stop moving here
|
|
#
?
Jan 9, 2017 23:28
|
|
|
cities in flyover country do largely have adequate staffing by physicians. cities are generally liberal, are large (obviously), so they are able to attract a certain level of talent. but as soon as you drive fifty miles out to the small local hospital that nobody remembers are cares about, whoo boy tough luck
|
|
#
?
Jan 9, 2017 23:29
|
|
|
Thoguh posted:TBH if you're willing to turn down an extra $500k a year, which would be like a 40% pay bump, just to not live in (presumably) Salt Lake City, which has a metro area of over a million and is a short flight away from LA or SF then I think that's more of a problem with the doctors having weird priorities and biases than anything else. I have it on good authority that anyone who goes through pre-med, medical school, and residency (and probably a bunch of other stupid hoop jumping to cull the herd) is driven insane by the experience, they just all handle it differently
|
|
#
?
Jan 9, 2017 23:33
|
|
|
Talmonis posted:The problem is that their votes, which are worth more than yours or mine, go toward hurting a lot of folks who didn't do anything wrong. There has to be a better way. Buddy why do you think I live in a goddamn city
|
|
#
?
Jan 9, 2017 23:39
|
|
|
Fullhouse posted:I have it on good authority that anyone who goes through pre-med, medical school, and residency (and probably a bunch of other stupid hoop jumping to cull the herd) is driven insane by the experience, they just all handle it differently i can confirm that all medical students are both incredibly intelligent for getting in but also incredibly stupid for doing it in the first place
|
|
#
?
Jan 9, 2017 23:40
|
|
|
Des Moines is pretty okay.
|
|
#
?
Jan 9, 2017 23:48
|
|
|
Thoguh posted:TBH if you're willing to turn down an extra $500k a year, which would be like a 40% pay bump, just to not live in (presumably) Salt Lake City, nope probably not even provo. i'd be guessing a place w/ population below or around 100k that has the only regional hospital within an hour's drive or so places like that are the ones which are having trouble recruiting doctors (and nurses), not major cities containing airports that have multiple terminals in them
|
|
#
?
Jan 9, 2017 23:48
|
|
|
Nonsense posted:Kansas will remain an immensely fascinating, and horrifying test case. nc is more horrifying more fascinating and more tests
|
|
#
?
Jan 10, 2017 00:01
|
|
|
That's not true. I've heard that Stanford will subsidize the costs of heir doctors to have them live close by in Palo Alto even if they have a spouse earning six figures plus as well. I think doctors over all are the kids of rich people usually anyway and don't want to be surrounded by uncultured yokels. I mean would you rather take a drive to Napa with your rich engineer husband friends or skeet shooting in freezing Shitfuck, Iowa?
|
|
#
?
Jan 10, 2017 00:01
|
|
|
logikv9 posted:cities in flyover country do largely have adequate staffing by physicians. cities are generally liberal, are large (obviously), so they are able to attract a certain level of talent. but as soon as you drive fifty miles out to the small local hospital that nobody remembers are cares about, whoo boy tough luck i'm told that apparently oncology is already crazy out there, that doctors and even surgeons who practice in those areas are frequently unfamiliar with current practices and the patients are of course not able to afford to go to md anderson or even whatever good onc guy is in the nearest big city for the latest treatment the stories i've heard included instances of inadvertently seeding tumors during surgery (when you spread a tumor by cutting into it) and improperly biopsying moles leading to too-shallow of a removal (so you essentially get an invisible skin cancer). at least that's how they were explained to me i don't work in medicine - but yeah basically these docs aren't super familiar with cancers so they get mishandled and that's apparently really common outside of the cities i mean it's not like they're getting onc specialists. a lotta the time the doctors that work out there are only there because they're from the area in the first place H.P. Hovercraft has issued a correction as of 00:06 on Jan 10, 2017 |
|
#
?
Jan 10, 2017 00:03
|
|
|
H.P. Hovercraft posted:nope yeah plenty of high-demand medical specialists would be fine living in SLC, hell find one that's mormon and they'd be happy to live in mormon jerusalem the problem is like, how do you get doctors into Tickbite, Arkansas, or Fishpiss, Montana, or Kneepit, Ohio the answer right now is that you bribe them with an enormous amount of money and hope they don't notice that they end up spending the difference on flying their kids to out-of-state private schools and frequent travel to places where their quality of life would be higher even with a 50% pay cut
|
|
#
?
Jan 10, 2017 00:04
|
|
|
fits my needs posted:I think doctors over all are the kids of rich people usually anyway 
|
|
#
?
Jan 10, 2017 00:04
|
|
|
H.P. Hovercraft posted:i'm told that apparently oncology is already crazy out there, that doctors and even surgeons who practice in those areas are frequently unfamiliar with current practices and the patients are of course not able to afford to go to md anderson or even whatever good onc guy is in the nearest big city for the latest treatment absolutely, the quality of the physicians who generally end up in these locations are poor simply because they probably had no other option. the good spots were taken up by people with better step scores and dean's letters
|
|
#
?
Jan 10, 2017 00:07
|
|
|
I live in a small town in Tennessee. Pretty much every doctor is godawful unless you want to drive 2 hours to Knoxville or 3 to Nashville. For example: my primary care doctor gave me muscle relaxers when I came in with gallbladder attacks. The only doctors who come here either got run out of somewhere else, or were born here and didn't want to leave. Things are even worse for my family in Eastern Kentucky. Their primary doctor is an 80 year old missionary who's retiring this year. Any specialist who works an hour away in town even smaller than mine is also awful. They likely got run out of a town like mine.
|
|
#
?
Jan 10, 2017 03:17
|
|
|
there's also some hay to be made about the laws around quality of healthcare service. the current system is one of community, customary care. The duty of care for poor doctors in the middle of nowhere is practically nothing and this leaves you unable to take any action against the poor care. There's no incentives to increase the care because they just have to "try their best" with whatever training they have gotten. Everyone gets a bad deal here as quacks abound and they're invincible.
|
|
#
?
Jan 10, 2017 05:47
|
|
|
I think essentially every state has a medical school (I'm probably wrong on this, I've looked at the list there's an upsettingly small amount of medical schools in the United States), but those medical schools located in states with large underserved areas should certainly branch out and make serving said areas part of the preceptorships (probably too short) or the away rotations for that school. This gives constant attention to said areas, but like how some charity organizations approach third world nations, it just provides relief as long as the relief is being given. There is no actual fix for the topic at hand, and students can't really even provide care without an attending with them, but it might help with at least a few helping hands?? I really can't figure out a fix in my head. You can't force people to live where they don't want. You need to provide a competitive salary to physicians for them to even consider living in such areas (unless, as previously mentioned, they have ties to the area). And even then, it could probably be argued that there might not be enough specialists in the country to adequately give everybody coverage for every medical condition. Maybe one of the most productive or effective "fixes" would be to literally continue relying on local doctors, bad or not, for PCP / simple care, and provide subsidized or free transportation to cities to visit the big-name specialists.
|
|
#
?
Jan 10, 2017 06:40
|
|
|
whoa its almost like hte economy should be planned by a council of those involved in it #wow #whoa
|
|
#
?
Jan 10, 2017 06:44
|
|
|
|
| # ? Jun 9, 2024 19:24 |
|
|
http://i.imgur.com/ZbE4WNJ.gifv
|
|
#
?
Jan 10, 2017 06:56
|
|