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Old 04-20-2014, 12:41 PM   #21
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I think it's multifactorial: insurance, malpractice, gov't regulations, declining appreciation, declining incomes, increased workload.

I just informed my practice they need to find my replacement. ER here I come!
Congratulations! It is great!

+1 on the multifactorial nature of motivation. While our health insurance is a large part of what is wrong with US Healthcare Delivery, it is but one of many factors that finally broke my camel's back. Not one of the list of gripes that I had would alone probably have been enough to make me give up my career and its very nice income. Some of the factors were specific to the profession, some just to my workplace, some just to my personal life. The combined weight of all of my issues finally easily tilted my pinball machine enough for the game to be over.
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Old 04-20-2014, 12:56 PM   #22
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I think it's multifactorial: insurance, malpractice, gov't regulations, declining appreciation, declining incomes, increased workload.
Also a Canadian MD who had practice experience in the US I found dealing with insurance companies was pretty crazy but agree that it is multi-factorial. I find that most of my patients are very appreciative and malpractice insurance costs are not a factor in Canada but the threat of action still looms although the frequency of actions is a fraction of that in the US. MD incomes in Canada have increased over the last 20 years so that is not a factor. For me, the single largest factor, by a significant margin, was dealing with hospital bureaucracy and management bordering on incompetence. Happy to be able to ER at this point.
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Old 04-20-2014, 03:30 PM   #23
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Plan to pull trigger in 2016. Agree reasons to fire are multifactorial but #1 for me is just like 6miths said, dealing with incompetent bureaucrats and administrators.
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Old 04-20-2014, 04:33 PM   #24
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Plan to pull trigger in 2016. Agree reasons to fire are multifactorial but #1 for me is just like 6miths said, dealing with incompetent bureaucrats and administrators.
There was a thread Why Did You Retire? -- Poll only for those currently, fully retired a while back and I noticed that's why a lot of people who generally liked or even loved their jobs retire. Yet another cost of poor management.
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Old 05-02-2014, 02:00 AM   #25
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And the hits keep coming...Dishwasher died this week...yes it should be expected- it is 14 years old...but these first 5 months of breakdowns is really skewing the spending higher from what had been our average for the last three years
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Old 05-02-2014, 10:01 AM   #26
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And the hits keep coming...Dishwasher died this week...yes it should be expected- it is 14 years old...but these first 5 months of breakdowns is really skewing the spending higher from what had been our average for the last three years
Sorry 'bout your string of bad luck.
But remember that NOT having to buy a new dishwasher for a long while should help hold down spending in future years
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Old 05-02-2014, 10:36 AM   #27
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I must say ... it must be incredibly frustrating for doctors to see insurance rates skyrocket while their income gets pinched from any and all directions.
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Old 05-02-2014, 12:12 PM   #28
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A sample of reasons behind skyrocketing HI rates- a new drug to treat hepatitis costs US$84,000 (wholesale, so retail will be much higher). The drug cost alone (not inc doc's, tests, etc.) for treating even half of folks in US with this form of hepatitis would be literally BILLIONS$$$$

FAQ: The High Cost of Hepatitis C Drugs

To control HC costs, you need to follow the $$$.
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Old 05-02-2014, 12:52 PM   #29
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And the hits keep coming...Dishwasher died this week...yes it should be expected- it is 14 years old...but these first 5 months of breakdowns is really skewing the spending higher from what had been our average for the last three years

Hang in there Urn, this could be a sign of good fortune heading your way. First 3 years of my retirement, nothing out of ordinary hit me expense wise. Then the past 4th year... 1) outside A/C unit 2) water heater 3) house roof ... Then finally 4) dishwasher a week after roof was replaced. Too cheap to buy dishwasher so for a few months I hand washed then realized I had about $1000 in credit card rewards so I decided I could live with using free money to buy a new one.. 4 months later and no more problems of any type.


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Old 05-02-2014, 01:07 PM   #30
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........and the respect we receive ........
ROFLMAO

Last time I was admitted to the hosp the docs' name tags were identical to the name tags of all other hospital employees- inc their pic & FIRST name only in bold type. And docs, like everyone else, were referred to by first name only by other hosp employees.

Pt: When will Dr. Smith be in to see me?
Nurse: Let's see. George normally comes by around 3 or 4 in the afternoon.
Pt: I meant when will Dr. Smith be in?
Nurse: I told you. George comes by around 3 or 4.

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Old 05-03-2014, 09:27 AM   #31
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Interesting comment about names and respect. As an MD, I have always tried to get other healthcare providers to call me by my first name when talking to me face-to-face but use 'Dr. Smith' when referring to me with patients. I think the big bold first names on name tags is a great idea! These old eyes would have a much easier time and I would know more of my workmates actual names. Is it appropriate that I am 'Dr Smith' and everyone else is 'Chris, Pat, and Kelly'? Patient safety should be paramount and the hierarchical nature of health care has clearly been shown to work against this when 'underlings' are unable/unwilling to speak up when they see that something is being done incorrectly. The practices in Highly Reliable Organizational Systems are being brought slowly to bear in medicine just as they have been in the past in the nuclear industry and the cockpit. Personally, I love it when I am called by my first name.
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Old 05-03-2014, 09:30 AM   #32
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Just on record as having hung them up after 30 years in the trenches. Was a wonderful run but a great feeling to be moving on.
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Old 05-03-2014, 09:32 AM   #33
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Congratulations! Gotta be a great feeling.
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Old 05-03-2014, 09:39 AM   #34
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Yes feels good but I'm sure it will take a while to sink in. So far it could just be a much need vacation!! Looking forward to summer in the garden and at the cottage.
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Old 05-03-2014, 02:50 PM   #35
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.....Patient safety should be paramount and the hierarchical nature of health care has clearly been shown to work against this when 'underlings' are unable/unwilling to speak up when they see that something is being done incorrectly. The practices in Highly Reliable Organizational Systems are being brought slowly to bear in medicine just as they have been in the past in the nuclear industry and the cockpit. ...
Congrats on 30+ yrs & your retirement!

Agree 100% that patient safety is what it's all about, but sharply disagree that hierarchical nature has hurt medicine...or is being abandoned in HROS's. Obviously honest input from all levels is important, but every job description has its limits. Organizations function best when roles are clear, properly integrated, and goal directed. Ultimately clear chain of command remains critical. Particularly in time-critical areas like the airliner cockpit, the ship's wheelhouse, and acute care areas of medicine. The pilot still commands the aircraft and the captain commands the ship. And its the same in less time sensitive areas. In a successful manufacturing business it ain't the 3rd floor janitor making final decisions on a new product launch.

I've got no problems with my docs calling each other by their 1st names or being on a 1st name basis with other hosp employees when in private. But IMHO this 'always 1st name basis' stuff in front of patients seems unprofessional...and possibly dangerous. If I go into cardiac arrest I want all present to IMMEDIATELY know that DOCTOR Smith is running the code, not "George" who turns out to be the food service worker just there delivering my lunch (as in a 'classic' scene from a medical sit com a few yrs ago)
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Old 10-16-2014, 12:59 AM   #36
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Medical professionals

Continued unexpected expenses piling up.....And now we have an expensive roof repair and the printer keeps going offline and will only print after restarting the computer. And to top it all off---today the dryer just died AGAIN! (8 months since replacing the heating element).

This is starting to make me a little paranoid.





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Old 06-14-2015, 02:47 PM   #37
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8 month update- a continued cautionary tale:

Earlier in this thread I recounted all the unexpected and expensive things that have happened to us since I stopped getting a paycheck. Well, things had settled down, and I figured we were past our string of bad luck...until this past week.

I am considered an extremely physically fit 53-resting heart rate in the low 50's, no risk factors for serious illness, exercise regularly - I swam on Monday and did 46 minutes on the elliptical on Tuesday evening...

Early AM-Wednesday stomach ache just would not get better...by Wednesday evening I was in hospital with severe sepsis from what ultimately proved to be pneumococcal pneumonia. Of course, there have been a few complications as well, but I do expect recovery.

All of this is happening while out of town (out of network)... I don't have any idea how much this adventure is going to cost me, and while I realize I am lucky to be alive, I am sharing my UEE (unexpected expense experience) to be an example of why you may want to be sure you have an extra cushion of money.

Stuff happens.
Really, really unexpected stuff.


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Old 06-14-2015, 05:06 PM   #38
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Yikes, urn, that was a shocker! At least you caught something treatable. I hope you're feeling better soon.
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Old 06-14-2015, 05:35 PM   #39
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That really is unexpected! I hope you're going to be ok. Is there no provision for out of network emergencies?


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Old 06-14-2015, 06:07 PM   #40
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Wow...hope you are feeling better soon! I know all too well about the unexpected expenses. This week (first week since my DW came home from having a spinal tumor removed...FUN!) our new roof leaked quite badly, the garage door spring broke trapping the car, AC condensate drain pump failed (and soaked the basement). Granted, these expenses are low...but they are stressful. And this doesn't add in the "extra bills" that are starting to come in from the DW's stay at the hospital. Those fights being tomorrow. So much for looking forward to Mondays!!!
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