Nurses and Internist Are Your Best Friends

I know surgeons usually get all the respect and admiration, but if you find yourself in the hospital for whatever reason, do remember that the nurses (especially the experienced ones) and the internists are your best friends. The hospital is structured with salaried employees that make the same amount of money no matter how many patients they treat (nurses and internist), and doctors who have privledges at the hospital who make money based on how many consults they see (surgeons). The surgeons want to do surgery, because that is what they get paid to do, and the more surgery they do, the more money they make. I was recently following a 98 year old patient who had a rare type of skin cancer, and had already received the maximum amout of radiation. She now had a new outbreak on her skin that may have been the same type of cancer again. The patient was also found to have a small hip fracture. She was bedbound, and never expected to walk much anymore. The orthopedic surgeon who came to consult on her simply saw a money making opportunity. He booked her for a hip replacement, and put in a certain type of joint replacement (because he could get paid more for using this particular type) that is meant for people who are young and need to get back to full activity. A hip replacement in no small surgical procedure, and this surgeon put this old frail woman though the trauma of this surgery unnecessarily in order to make some money. So, getting back to the internist and the nurses..an internist truly wants to diagnose you, treat you, and send you out. They do not get paid per patient, or for the amount of times they see you. The experienced nurses have seen it all, and if you really want a 2nd opinion, you should ask them. If you go to another surgeon, you will probably get the same answer, because they want to make money too. Although I plan on being a surgeon, and I realize that a healthcare system where surgeons do not get paid per patient would mean less money for me after all this schooling and hard work, I think this would be a better system for the patients. On the other hand, this would also mean long waits for surgery for patients..there would be no incentive for surgeons to work long hours if they were not getting paid per patient. So, what is the answer? I am not sure that anyone has come up with a good one yet.

Healthcare for Illegal Immigrants

So, I was in one of the NYC hospitals that we rotate through the other day, and I saw a poster hanging on the wall with the exact words "We don't care about your immigration status, we care about your health...to get health services at little or no cost, call this number.." So, we have millions of uninsured legal citizens in this coutry, but we are providing healthcare at "little or no cost" to illegal immigrants!? Where is this money coming from to pay for this!? Obviously it is not coming from the immigrants themselves..even if they have jobs, they are not paying taxes. I can understand if they have something that is contagious, and is a threat to the larger population, but routine care should not be covered! I see it all the time...families flying in grandma from their home country, and bringing her to the hospital to get free care. They might want to consider this problem when putting together a healthcare reform bill. If it was possible, I would be all for legalizing the hardworking illegal immigrants and having them pay taxes while kicking out all the lazies living off of welfare and Medicaid while finding new excuses not to work..but since this will never be a reality, we need to figure something out. Unfortunately real healthcare reform can not happen overnight. Pushing for something to pass quickly is not the solution. The president and legislators need to do their research to find the real problems and ways to fix them.

It's a Scary Healthcare World

Hello Readers,

At first I created this blog as a place for other residents to come and seek support of their co-residents who are going through a similar experience, but I have recently decided to scrap that idea. I have just completed a year of residency, and I think it's important to share what I have seen and experienced, especially as healthcare has taken front page in recent days with the Obama administration proposing a universal insurance plan.

First, let me start by saying that although I like Obama, I am not sure he knows enough about the ins and out of healthcare to remodel the system. If I could, I would sit down with him and share my personal experiences, but since I can not do that, I will share them here instead in the hope of educating other readers.

This is just my introduction, and what will follow in the days ahead are actual stories of what I am describing above. It's a scary healthcare world out there, and unfortunately there is yet to be a good plan to fix it.