For those of you with health insurance, How does it feel to employ the Mafia?

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Mine is by the government mafia, feels good! 🐶🐾🤣🤣🤣

I am burning 50k per month and treating 30 patients per day. Doing around 15 surgeries per week.

I am paying to go to work.

If I’m not taking a check by June, I’m going to close down and do something else.

I am killing myself with work and spending my savings to do so.

That is just horrible. Is that how it works in USA for doctors? I honestly have no idea šŸ¶šŸ¾šŸ«‚ā¤ļø

wait what?

my math is not mathing here

Insurance is trying to not pay, I guess. They are like Mafia in US, from what I understand šŸ¶šŸ¾šŸ«”šŸ«‚

Many insurers pay less than the cost of the equipment I have to use.

That’s just not right. Are you able to ā€œsecureā€ the price before making any procedures? šŸ¶šŸ¾šŸ«‚

This is wild. Sad. And terrible. Reimbursements for us keep getting slashed year after year. We train for years and years to be able to stick sharp instruments into peoples eyes under a microscope, assume all the risk and liability and stress, and get paid a few bucks after overhead. Almost not worth it.

Will do my best for 7:30, share this, may need help

Every field and profession is subject to malinvestments.

Is this in regard to private practices? It seems if possible they’ll squeeze everyone into conglomerates. Dental and vet trending the same way.

Very much true for dentistry and vets. Private equity money is pouring in. The money is enticing, but we were shocked by the terms you need to agree to in the sale. Profit optimization and optimal health care for patients don’t mix.

Worked in dentistry for a few years after college. Seemed that way. Very difficult to ride the line of providing optimal care without influence of profit incentive.

Don’t want to waste your time but would you consider doing it all over? Studying for the DAT right now..

If you can do it without taking out exorbitant loans, then yes I would. Otherwise no. Every young dentist we interviewed for an associate position with $500k+ in loans ended up working at a chain because we couldn’t pay them the same (offered no commission). All of them we have kept up with hate their jobs and one even called it ā€œsoul suckingā€. If you don’t have a lot of student loans, you can get a business loan to buy a practice and make a great living without compromising your ethics.

That’s wild. Great insight! I just talked to my buddy (also ophtho) with 475k in loans. The interest alone on those was terrifying. Hard to say if I’d recommend it. Being on the other end I do absolutely love what I do, as I’m sure most docs do. Went into this because I enjoy helping people and vision is a profound gift to be able to give.

Also, I don’t need to be exceedingly rich, but need to keep the lights on and make sure I can support my family. Luckily (depending on how you look at it), I joined the military to pay for med school so have zero debt. Military medicine is a whole different convo, and will be interesting to see how private practice is this spring when I’m done with my commitment. Luckily it’s a nice little practice in a small town and there are no shortage of old retired folks with eye issues!

You are going to do great šŸ«‚

What I worry about is the big picture - not necessarily what others have commented on malinvestment, etc…but bright young people no longer choosing medicine altogether in a system already short doctors, especially patients with limited access to specialists and care.

It's the same for a lot physicians in Canada too. Overhead is killing them, dues are ridiculous, but at least they don't have to worry as much about liability. They still pay for insurance, but not nearly as much.

That’s unreal

Really good.

It’s nice not going bankrupt over medical bills and only paying $20 to see a doctor

Glad I’m not your slave.

There are very few people in the world who can do the things I do.

Keep your 20 dollars. I’m staying home.

It's unfortunate that it needs to be one extreme or the other. Without insurance, a single significant incident would bankrupt most people because hospitals charge a shitload of money for a couple of Advil.

The orange pillers will tell you to skip insurance and go bankrupt out of principle. Otherwise you’re just a slave owner or some other larp

Don’t quite get the whole slave thing. Yet to meet a doctor forced to work for free in America anyway.

Good for you, I guess?

Lucky for me there are plenty of doctors out there that want to help people in need. So yeah stay at home feeling self important

In Canada lots of docs are closing shop, retiring early, and/or locuming.

Smart to pivot when the market tells you to. More ppl should do that

Imagine spending 14 years in school, giving up your life for a 4-6 years of residency, then a fellowship and then having the stress and responsibility of someone’s life in your hands, then you’re asked to run your own business, and you’re constantly worried about getting a sued.

You can’t just pivot.

Everyone thinks that doctors are overpaid until they’re the ones laying on the table.

Yes, people should learn about the profitability of their chosen careers before going down that path.

They are not asked to run their own business, they can work for hospitals and clinics. Having a private practice is a choice that comes with potential rewards and risks.

Lots of entrepreneurs fail every day. Being in school for a decade doesn’t magically remove the possibility of failure. People of all professions that can’t pivot or adapt are NGMI. This is not new

Do you not see the problem if doctors are not paid for what they do?

Good luck finding a doctor the next time your sick. Or, if you do find one, it will most likely be an IMG that isn’t properly trained to perform your surgery.

If we want proper care, we need to pay for it. Doctors are not the problem. The litigations, bureaucracy and administration are.

You have no idea what they sacrifice, unless you are one, are the child of one, or are married to one.

Sorry if I’m wrong, but I’m guessing you’re none of these.

Lots of people sacrifice. That people don’t romanticize the guys going on boats to fish for months in the freezing ocean or go work at oil fields is another thing.

No one is saying doctors as a whole are the problem. They however are not immune to markets and failure in the business world should they try to start their own practice.

Health care is just another market good. No need to get in our feelings. If red tape is an issue for some doctors in some jurisdictions then they should react accordingly and that will create the necessary political pressure to change the regulatory environment that caused the problem.

I’m assuming in the United States šŸ˜‚

I dropped insurance last year because the costs didnt make sense to shell out thousands a year and then have a massive deductible. Insurance is a gravy plan that benefits the insurers, not the insured (except chronically ill needing meds or regular ops) or service providers (except those who take kickbacks at low level)

Now I pay 100% out of pocket and only work with businesses that know and can tell me what something will cost. I no longer goto a GP to have basic vitals done or routine stuff and instead requisition it online.

Are you angry at people that pay for insurance? or at the insurance business itself? cause the people that pay for insurance are doing their best to be able to afford health care, medical care in the USA is ridiculously expensive

I use Christian Healthcare Ministries, the OG CrowdHealth. Insurance is a scam.

Interesting conversation, eye opening for me and i love that this happens on nostr. Can you IMAGINE the equivalent 'convo' from this post on twitter or facebook ? šŸ˜­šŸ˜‚šŸ˜­

nostr:nevent1qqsvwwvweyr3nx6z7t5kxvhpx30q52ekkt94ccjz5tt022uc8609yxspr3mhxue69uhkummnw3ezucnfw33k76twv4ezuum0vd5kzmqzypha5k7w9zppw6lm40at2qapk55px22c94cuf05yhw6k0ejurfu37qcyqqqqqqg0rk66t

Your post is getting a lot of positive feedback.

Added to the https://nostraco.in/hot feed

As an employee of a large corporation in the US and someone who isn't from a medical background, what are my options? I'm a high earner and would gladly pay for my healthcare if there was an economical option. The way I see it, my company offers 3 tiers of insurance, am I supposed to opt out totally and just pay cash at the doctor's office?