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PostPosted: Thu May 31, 2012 4:21 am 
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Are you talking about physicians in the US? Where did you get that pie chart from?

The average physician here in the US will ask for your medical insurance card. To which he/she is happy to bill to.
There is a rather large pause if you say you are not covered by insurance. It's like "Ooooh you don't have coverage". You can see the office assistants face cringe.

The patient pays the co-pay anywhere from 10$-35$ per visit.

So here is how a routine check up goes?

Patient presents insurance card?
Patient pays co-pay 10-35$ It's up to $45 for a specialist (anything other than a general doctor)
The nurse checks your vital signs: blood pressure, heart rate etc
The doctor comes in reviews vital signs on sheet or iPad, asks a few questions on your history,
The doctor prescribes a standard blood test for cholesterol, lipids etc.
Then there is the urine test.
All in all the visit is about 10-15 minutes.

Total cost to patient with insurance is 10-45$ plus the lab work another 35$ plus any miscellaneous pills he might prescribe for blood pressure, cholesterol etc. This would be another 10-20$ for the pills which you will take daily with monthly refills.

Now if you did not have coverage this routine visit would easily cost you 300$ plus not counting the pills.

Of which you may or may not need. Or at least you may need temporarily while you get better. To which then you should be off the meds and resume normal life through good diet and exercise. Right?

But here is the clincher. The drug business is really big. And physicians here do get a cut of this business.

It is common for elderly patients to be placed on a drug regimen. Where by medications become an essential part of their life from then on.

I do question this type of standard practice by physicians on every level.

More patients on drug equals more $$$. So then this scenario looks more like a business model and less like a the good physician wanting to make your life better. And if it's a business well then you can bet someone is going to get the short end of the stick.

I don't know if I have a skewed view of what we call "patient care" here in the US but this is the way it looks to me at least here in the good old US of A.

Now getting beck to this topic. Whether you hold a degree or not is irrelevant. It is also irrelevant to the type of profession you are in. Anyone that has the money regardless of how they got it can ride the expensive bike if they choose to do so. Its about your priorities in life. This person might like to spend that 15K on the bike rather than the car. This other person might want to spend that 15K on a entertainment system rather then a bike.

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I never took drugs to improve my performance at any time. I will be willing to stick my finger into a polygraph test if anyone with big media pull wants to take issue. If you buy a signed poster now it will not be tarnished later. --Graeme Obree


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PostPosted: Thu May 31, 2012 5:32 am 
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"Are you talking about physicians in the US? Where did you get that pie chart from?"

Yes I was speaking about physicians in the US, as that is where I live and that is where DJ lives.

The pie chart comes from online. There is a similar chart from the US Department of Labor Bureau of Labor Statistics: http://www.bls.gov/opub/ted/2010/ted_20100325.htm" and the one that I found was from the Department of Justice here: http://www.justice.gov/atr/public/healt ... ec_sum.htm" or from the National Institute of Health here: http://www.nimh.nih.gov/statistics/4DIS ... 2003.shtml". Google US health care expenditures or healthcare spending and you will find more than enough data on this topic.



"And physicians here do get a cut of this business."

I wish that was the case!!! lol No, physicians do not get a cut of "the business." We don't get a paycheck at the end of the month from drug companies if we prescribe their medication more than their competitors. We don't get a paycheck from CVS if we send them more patients than Walgreens. Sorry, we don't get any kick backs. Hell, even government regulations have limited the amount of interaction that physicians and drug companies can have. It is very regulated.



"It is common for elderly patients to be placed on a drug regimen. Where by medications become an essential part of their life from then on. I do question this type of standard practice by physicians on every level."

I would say that anywhere from 50-75% of the patients that I see have medical conditions that are caused by lifestyle issues; smoking, drinking, being overweight, poor diet, lack of physical activity...etc. The most common diseases I see are diabetes, hypertension, heart disease, strokes, cancers, elevated cholesterol...etc. If people would stop sitting on the sofa watching TV, drinking soda, eating crap and instead actually exercise several times per week and make health choices for dinner, they wouldn't have to be on a medication for their high blood pressure or diabetes. The majority of Americans are lazy. They want fast food and want fast medicine. "I want the pill doc," so that they don't need to make corrections to their lifestyle. The vast majority of patients with hypertension, elevated cholesterol or mild diabetes I try to correct with lifestyle changes. I give them a few months to change their diet and start exercising more. A very small proportion of patients do this and are successful. The vast majority come back with the same issue that is worse. At some point, you need to treat the blood pressure so they don't stroke out on you and the diabetes so that they don't develop kidney failure. I don't like putting patients on medication. But sometimes their life decisions leave us (as physicians) with no choice. We need to look out for their overall good.

Btw, we don't get any kick backs/cut of the business! lol


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Posted: Thu May 31, 2012 5:32 am 


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PostPosted: Thu May 31, 2012 5:56 am 
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Ah ha! this is the crux of the entire health care problem: "people are lazy."

The vast array of quick easy patched solutions to problems is what makes our life harder in the end.

So no matter what type of bike you ride they all provide that same benefit.

And now I'd like to close this thread while I am stuffing my face with my mothers baked zitti but not before I did my nightly 50 miles on the bike.

Good night....biotches. :smartass: :lol:

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I never took drugs to improve my performance at any time. I will be willing to stick my finger into a polygraph test if anyone with big media pull wants to take issue. If you buy a signed poster now it will not be tarnished later. --Graeme Obree


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PostPosted: Thu May 31, 2012 11:30 am 
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I started this thread to highlight Portland, Oregon as being cycling friendly, and how a lot of lawyers ride bikes there, not all of which were Parlees or Serottas, and noted how they had a lunch time ride, and wondered how that compared in intensity to the Palo Alto Noon "Engineers" Ride (I suppose there may be some lawyers and Venture Capitalists in there - I'm sure D.J. would know). Maybe we should terminate the discussion about the merits, or lack thereof, of the U.S. health care system and the medical profession, and get back to how the lawyers rides in Portland compare to the hammerfests starting in Palo Alto, and blasting up Old La Honda Road, among other destinations.

I admit to starting this thread down a slippery slope (beyond the slightly provocative thread title) in my subsequent post. From there, the thread acquired a momentum of its own, rapidly descending into a debate about the U.S. healthcare system and the medical profession.

I also never did get a response to my question as to whether lawyers remove the lawyer tabs on their forks. Of course, the very name, slang though it is, "lawyer tabs" is derogatory to the legal profession (at least in the United States), not that I am a lawyer, although per my 6th grade autobiography (written when I was 11 years old), I did not know what I would be when I grew up, but thought I might perhaps become a lawyer, in order to save up money for several years to then start my own business - but by my sophomore year of high school (age 15), I had lost all aspirations of becoming a lawyer.

When I was a kid, we were all "taught" that all (medical doctors) are very smart, and we all believed it. Seeing the pre-meds at a top echelon college, and that they were on balance (but certainly not in every case), well below the intellectual capability and academic performance of math/engineering/graduate school track* science majors, quickly disabused me of that notion - and many of the weak students were getting into top medical schools, yet the courses they took, and their performance in them, was so far below the math/engineering/graduate school track* science majors, that it convinced me that they weren't all that smart. Perhaps, though, they were smart enough, and actually, maybe they had "people and common sense smarts" enough to know what a lucrative gravy train they were getting on compared to the other students, many of whom studied and worked harder than they did for years in school, only to make a fraction of the pay when fully qualified for their professions. Some of the pre-meds were rather ingenious though, as one pre-med student, from said top echelon college, applied to and was rejected for admission to Harvard Medical School (the most prestigious Medical School in the United States, at least at that time) in the early '70s. Somehow, he accepted Harvard's admission offer, even though he had been rejected, and was matriculated into the M.D. program. The error was not discovered until the end of his first year of Medical School, but by then he was at the top of the class, and was allowed to stay, and indeed received his degree 3 years later. He became a very successful doctor, although he didn't ride a bike - that is until he reached the age of 51 (yes, not 50), whereupon he bought a Serotta to ride at 25 kph (o.k., the entire story is true except for the part about the bike). O.k. sorry for violating my own admonition to get back to the original premise of the thread.

* By graduate school track science majors, I really mean as distinguished from pre-med science majors, as not all graduate track science majors actually went on to graduate school in a science. Of course, the pre-med version of Organic Chemistry, which was considered to be by far the hardest class pre-meds took, was viewed as a total joke by graduate school track Chemistry majors, and laughable compared to the introductory Organic Chemistry class they took. The pre-med version required only mindless memorization of some trivial material, and neither required, nor demonstrated on the part of the student, any scientific or intellectual ability or understanding in order to pass. So the pre-meds memorized some stuff which they had to remember only until the exam was over - big deal!

Now :back2topic:


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PostPosted: Wed Jun 06, 2012 5:44 pm 
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All this profession bashing stuff is rather narrow.

What they fail to tell you in the Careers Advice centre is that it's possible to make big money collecting garbage, making sandwiches or providing medical care. It's running a business. This is what the Lawyers and Doctors who are making big money are doing. Simple maths shows that employing 100 junior lawyers and taking home 5% makes much more than defending OJ.

Personally I would rather have movers and shakers participating in my hobby and subtly bringing other powerful people onside, than have them driving fast cars and playing golf. So next time you see a lawyer or doctor or other professional on a bike, give them a push up the next hill and thank them for choosing to ride.


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PostPosted: Wed Jun 06, 2012 6:02 pm 
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.....I am an Accountant and I ride a CAAD10. Does that speak to the stereotypical frugality of the accounting profession?? :noidea:

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PostPosted: Wed Jun 06, 2012 6:58 pm 
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no, but the mere juxtaposition of two multi-syllabic words within the same sentence posits the hypothesis that you are an outlier amongst your bean-counting brethren


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PostPosted: Wed Jun 06, 2012 8:19 pm 
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mrfish wrote:
All this profession bashing stuff is rather narrow.

What they fail to tell you in the Careers Advice centre is that it's possible to make big money collecting garbage, making sandwiches or providing medical care. It's running a business. This is what the Lawyers and Doctors who are making big money are doing. Simple maths shows that employing 100 junior lawyers and taking home 5% makes much more than defending OJ.

Personally I would rather have movers and shakers participating in my hobby and subtly bringing other powerful people onside, than have them driving fast cars and playing golf. So next time you see a lawyer or doctor or other professional on a bike, give them a push up the next hill and thank them for choosing to ride.

Couldn't agree more. All those years spent in school represents a huge opportunity cost- and with today's economy, it's nowhere near certain that you'll make a salary that is better than some occupations that don't even require a bachelor's degree. Running your own business is definitely the way to make it big, but that said, it comes with a lot of risk and plenty of entrepreneurs out there go bust. There are lots more lawyers who make middle-class salaries than those who are lucky enough to be in the top 1%, and also plenty that are making less than working in retail despite having longer hours (some fresh grads have to article for free!)

After riding with some of the big guns at my firm for a charity ride, I was pleasantly surprised. It's easy to poke fun at the stereotypical image of the fat, old doctor going 10km/h on a Serotta/Parlee with aero wheels, but that's definitely not true. A few of these older guys race at the top level here, and will definitely spank those who choose to spend their time online and poke fun instead of riding.

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PostPosted: Sun Jul 22, 2012 7:47 pm 
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In his most recent WW post on May 24, 2012, gumgardner wrote:
There is something to be said about researching the various fields and making a smart decision about what line of work you choose to go into. I'm not saying that it's bad to be a chemist, biologist or whatever, but if you are going into such career thinking you are going to strike it rich, you are ill informed. Some people go into it because it is what they love to do. I really love what I do, but if it was a known poor paying profession, I'd never go into it. I'd find a different career that I loved that paid the bills for a lifestyle that I want.
The formerly prolific poster gumgardner now on extended hiatus, having been almost 2 months since his most recent post? Perhaps he is reprioritizing the place the WW boards hold within his grand vision of life and what he loves?


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PostPosted: Sun Jul 22, 2012 9:58 pm 
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Don't get so butthurt. It's not like the subgroup of dentists gets persecuted in any real way. So what if bikesnobNYC mocks your purchases. 99% of the general public thinks you're a douche for even riding a bike already and will murder you just the same.
quit whining and go ride your bike


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PostPosted: Mon Jul 23, 2012 12:24 am 
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Hey weight weenie, are you an anti-dentite? Click me.


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