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USA vs UK healthcare - physician perspective

USA vs UK healthcare - physician perspective

Old Sep 2nd 2019, 4:52 pm
  #16  
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Default Re: USA vs UK healthcare - physician perspective

Originally Posted by civilservant View Post
It doesn't cost that in the UK.
Yes but it costs that in the US and talking about US salaries here not UK so compare like for like. Vast majority of US doctors are US grads strangely enough

Originally Posted by civilservant View Post
Nor will you find physicians in hock to pharmaceutical companies prescribing drugs that they know to be less effective than others but that happen to be more expensive. Let's face it, that's corruption, pure and simple. All in service to the almighty $.
This is complete gibberish as your insurance and drug plan dictates the medications you use and would be prescribed. If they are more expensive your insurance wont approve and they will dictate the alternative.

Originally Posted by civilservant View Post
I happen to work for a non-for profit healthcare system. So you can throw around works like 'fatcat' and I assure you they land wide of the mark.
So you say the system is financially driven yet you work for a non-profit. In fact just about every health system in the US is non-profit so you cant have both, having a financial driven system that is not for profit a complete contradiction in terms
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Old Sep 2nd 2019, 5:00 pm
  #17  
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Default Re: USA vs UK healthcare - physician perspective

Yes but it costs that in the US and talking about US salaries here not UK so compare like for like.
You're missing the point. I'm saying there is an alternative to the ridiculousness of the US system.

​​​​​​This is complete gibberish as your insurance and drug plan dictates the medications you use and would be prescribed.
So you're suggesting that it's ok to prescribe a more expensive medication because the insurance is the gatekeeper? And the administrative costs of that are? A gatekeeper wouldn't be needed if the system didn't exist. A patient should not be able to ask about medications, nor should a MD have anyone other than healthcare motivations when prescribing, it's a complete inversion of the system.

​​​​​​
So you say the system is financially driven yet you work for a non-profit. In fact just about every health system in the US is non-profit so you cant have both, having a financial driven system that is not for profit a complete contradiction in terms
Of course it's a contradiction. Which is why the US system doesn't work. Healthcare with a profit motive doesn't work except for the 'fatcats' (as you put it) I hope that in time opinions will change and that the US will move towards single payor. Yes of course it will reduce MD salaries (oh no) but with no where else to go (with the capital of healthcare greed now gone) they'll like it or go back to law school.
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Old Sep 2nd 2019, 5:03 pm
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Default Re: USA vs UK healthcare - physician perspective

Originally Posted by expatdoc View Post
Given it costs $500k+ to get through med school in the US not sure how you can then somehow begrudge the salary a physician can make especially coming from fatcat finance world!

The finance world has repeatedly raped the Western population for decades then gone to the Government for handouts when they f up with a rinse and repeat phenomenon while coining your 8-9 figure bonuses in the background.
I presume you're accepting a lower salary then given you didn't incur those costs?
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Old Sep 2nd 2019, 5:10 pm
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Default Re: USA vs UK healthcare - physician perspective

Originally Posted by Giantaxe View Post
I presume you're accepting a lower salary then given you didn't incur those costs?
I was also wondering if the OP would care to reimburse the UK for his (almost) free medical education. Probably wouldn't amount to $500K either....
I also think that if some US drs had used even $1 worth of their ever-so-expensive, world class (apparently) education they might not have handed out the bloody opioids like smarties. Seriously, everyone is blaming the pharmacy companies for their marketing etc but the drs had their hands in the jar too.
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Old Sep 2nd 2019, 5:18 pm
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Default Re: USA vs UK healthcare - physician perspective

Originally Posted by expatdoc View Post
As an example I saw last week an individual case of a patient who had a delay of 4 days to find a mental health bed and that made the front page of a national newspaper in the UK. No way period would such a thing be reported in the NY Times for example.

Thats part of the problem this idea that the NHS is the only way healthcare should be done. Its like kafkaesque regime where you cant speak out when things are just so blatantly wrong in it, look at the fate of any whistleblower there - shambolic. It is absolutely true if you dont pay anything out of pocket then there is no sense of responsibility in using the service thats why its overwhelmed.

Given the mass exodus of doctors at the minute out of the UK and the perilous state of the country post brexit its unlikely the NHS can be sustained much longer
Not a fan of the UK NHS model either, but realistically no one is proposing a single provider model for the US. So I would expect the bulk of coverage to be about countries that have systems that have systems more akin to the political possibilities in the US.
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Old Sep 2nd 2019, 5:36 pm
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Default Re: USA vs UK healthcare - physician perspective

Originally Posted by petitefrancaise View Post
I was also wondering if the OP would care to reimburse the UK for his (almost) free medical education. Probably wouldn't amount to $500K either....
I also think that if some US drs had used even $1 worth of their ever-so-expensive, world class (apparently) education they might not have handed out the bloody opioids like smarties. Seriously, everyone is blaming the pharmacy companies for their marketing etc but the drs had their hands in the jar too.
I've been waiting for the other shoe to drop on this opioid stuff. There have been a few doctors convicted in the last decade of various scams involving opioid prescription, but very few compared to the numbers who were handing out prescriptions like candy.
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Old Sep 2nd 2019, 6:14 pm
  #22  
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Default Re: USA vs UK healthcare - physician perspective

Originally Posted by Boiler View Post
I think the USA comments need to be prefaced by if you can afford it and if you live in the right spot.

Our last GP retired and they have been unable to find anyone to replace, has been a few years, Rumour that we may have a Nurse Practitioner starting this year. Anything serious and you are on the Helicopter at $20,000 a pop, the logic of which escapes me. I am no fan of the NHS but on balance would prefer it to the US non system, my real preference would be for something very different to both.
Yep, same here. My old doctor retired and was replaced by a nurse practitioner. I had 2 issues with that, firstly the NP is not as well qualified as a doc who had been practicing for 35 years, and secondly the NP was a woman. Again, nothing against that except I am a bloke and there are several things I'd prefer to talk to a male about, and in addition I was not too comfortable with the though of a female NP sticking her finger up my jacksy. I think most women would not be too happy with a male doc do I don't view this as a men only phobia. I called 5 practices before I found one who was accepting new patients. I theoretically have a male doctor but the last visit was with a female NP. Oh boy...
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Old Sep 2nd 2019, 6:31 pm
  #23  
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Default Re: USA vs UK healthcare - physician perspective

I would like to see more NP's here where I am, we have a shortage of GP's and NP's would fill the void nicely for more minor ailments allowing the GP's to focus on more serious and complicated conditions. Most of my visits to the GP are prescription refills or to get blood work done, an NP is perfectly capable of doing both, the doctor can review the blood work when it comes back from the lab, the doctor when I go for refills isn't doing anything except typing out a prescription and handing it to me.
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Old Sep 2nd 2019, 7:18 pm
  #24  
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Default Re: USA vs UK healthcare - physician perspective

Originally Posted by TimFountain View Post
I think most women would not be too happy with a male doc do I don't view this as a men only phobia. .
I've always been more concerned about my doctors' competence than their sex. My OH and I have seen the same (male) GP for thirty years (there's always a female nurse in the room when I'm being examined), but when he needed hernia surgery this year, the specialist who operated was a woman.
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Old Sep 2nd 2019, 7:50 pm
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Default Re: USA vs UK healthcare - physician perspective

Same. I want a competent doctor, their gender, their ethnicity etc is of no concern to me, I just want a competent, educated doctor. My current GP is female, our last GP was male, my wife had no issue with a male doctor, and again if examining sensitive areas the doctor had a female staff member come in.

I need a prostate exam and doesn't matter to me if its a male or female doctor.

Originally Posted by Nutmegger View Post
I've always been more concerned about my doctors' competence than their sex. My OH and I have seen the same (male) GP for thirty years (there's always a female nurse in the room when I'm being examined), but when he needed hernia surgery this year, the specialist who operated was a woman.
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Old Sep 2nd 2019, 8:03 pm
  #26  
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Default Re: USA vs UK healthcare - physician perspective

Originally Posted by expatdoc View Post
As an example I saw last week an individual case of a patient who had a delay of 4 days to find a mental health bed and that made the front page of a national newspaper in the UK. No way period would such a thing be reported in the NY Times for example.

~
No, because the US sweeps it under the rug!

I know of someone who virtually had to be committed in order to even SEE a psychiatrist. By that, I mean she had to go to the ER and be referred to a hospital, locked in what can only be described as a cell, and put in a locked ward full of complete crazies and addicts - all because she had severe anxiety. Wanna see the bill for THAT one????

There's no way you're going to make me feel any sympathy for US doctors. Especially when all I hear are stories of people having to decide on medications or their next meal!
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Old Sep 2nd 2019, 8:08 pm
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Default Re: USA vs UK healthcare - physician perspective

The health industry has the US government in its pocket which is why, since the 90’s, they have been exempt from anti trust legislation allowing them to collude on pricing, divide up the market, big hospitals buy up clinics and labs in their area to eliminate choice, and allow conflict of interest so that doctors can have financial gains from the labs and other institutions they refer their patients to.

They spend more than twice as much money than the oil and gas industry bribing lobbying politicians.

https://www.investopedia.com/investi...bying-antm-so/

Pharmaceuticals/Health Products: $3,937,356,877

Spending $3.9 billion over the past 20 years, the pharmaceutical and health products industry has far outpaced all other industries in lobbying spending. It's important to note that this industry includes not only drug manufacturers, but also the sellers of medical products and nutritional and dietary supplements. In 2018, spending was topped by the Pharmaceutical Research and Manufacturers of America and Pfizer.


Overall, the industry is primarily concerned with "resisting government-run health care, ensuring a quicker approval process for drugs and products entering the market and strengthening intellectual property protections.” In recent years, lobbying has focused more specifically “on the patent system, research funding and Medicare.” As is to be expected, lobbying efforts reached a fever pitch in 2009, around the drafting of the Affordable Care Act (ACA) and reported a high in 2017 with legislative enactments again focusing on changes to health care.
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Old Sep 2nd 2019, 11:46 pm
  #28  
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Default Re: USA vs UK healthcare - physician perspective

Originally Posted by Giantaxe View Post
I presume you're accepting a lower salary then given you didn't incur those costs?
Paid enough tax during my years in the NHS to more than cover the University fees and what about the taxes both my parents paid for decades also.

This argument is flawed as in the UK all degrees are subsidized by the taxpayer so are you saying that every single graduate that goes to work out of the country has to pay their fees back? No, then why pick on doctors then??
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Old Sep 3rd 2019, 12:13 am
  #29  
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Default Re: USA vs UK healthcare - physician perspective

Originally Posted by expatdoc View Post
Paid enough tax during my years in the NHS to more than cover the University fees and what about the taxes both my parents paid for decades also.

This argument is flawed as in the UK all degrees are subsidized by the taxpayer so are you saying that every single graduate that goes to work out of the country has to pay their fees back? No, then why pick on doctors then??
I was "picking on" someone who not only is an expat but is getting paid mightily in the US despite the fact they don't fall into the $500k med school cost bracket that you claimed as justification for doctors getting paid what you do. Per your comment:

"Given it costs $500k+ to get through med school in the US not sure how you can then somehow begrudge the salary a physician can make especially coming from fatcat finance world!"

Last edited by Giantaxe; Sep 3rd 2019 at 12:15 am.
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Old Sep 3rd 2019, 1:25 am
  #30  
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Default Re: USA vs UK healthcare - physician perspective

Originally Posted by Nutmegger View Post
I've always been more concerned about my doctors' competence than their sex. My OH and I have seen the same (male) GP for thirty years (there's always a female nurse in the room when I'm being examined), but when he needed hernia surgery this year, the specialist who operated was a woman.
Same here NM. The best doctor in the practice I attend is female, so I see her. I usually had a male doctor in previous practices and they were all great.

Scouse wasn't all that happy with the doctor he'd been allocated at another practice (who happened to be male) so I suggested he try my doc. She's so popular that she wasn't accepting new patients, but makes an exception for family members of existing patients. He's a happy chappy now, thinks she's wonderful.
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