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Where Have All The Doctors Gone?

Posted by Herb7734 6 years, 10 months ago to Science
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I have done no research on this topic other than personal experience. Being an old geezer, I regularly visit a number of doctors who specialize in various branches of medicine. Other than my G.P. doctor, I attend a cardiologist, an endocrinologist, a neurologist, and an urologist. Within the past year, the following has occurred: The endocrinologist sold his practice to another practice which has three locations in the area. The other three M.D.'s have retired. The endocrinologist's practice has been taken over by a group of Indian and Syrian doctors, who were educated overseas but got their board certifications and residencies in the USA. I have yet to find a replacement neurologist, however, my G.P. is doing a good job as a substitute. I have interviewed several urologists and so far, have I have not been satisfied. I did find a cardiologist. He is a young local man educated in Florida. He's not a M.D. but a D.O. However, his references are A1..

As my wife and I searched we had a revelation. There were in our area, hardly any American educated M.D.'s practicing in my here. As you all know, the internet is the mighty Wizard of Information who puts the whole world into my computer.At first, mainly out of curiosity, I tried to find American educated M.D.'s or at the very least a doctor who spoke English in a way that I could easily understand. I searched within my town, then adjacent towns, then cities further away. Finally, I wound up at the largest city in the area, but it was over 30 miles away.

Has anyone had a similar experience?Has becoming a M.D. lost its prestige or ability to produce income? Was Obamacare a contributing factor? What, if anything, is going on?


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    Posted by DoctorObvious 6 years, 10 months ago
    I can answer that. I retired from my solo neurosurgical practice of 20.5 years three years ago with a hand injury and now live off my private disability benefits. Many have asked my why I have not switched to a non-surgical practice or go to teach a the university. My reputation, outcomes and experience are extremely valuable, many believe. I don't disagree with them, but the obstacles to taking care of patients have become insurmountable for physicians. There are so many regulatory requirements that have raised the cost of providing health care to an unaffordable level. You have Obamacare rules, Medicare rules, mandates from state and local bureaucrats, and then there is license and "MOC:" Maintenance of certification is another racket dumped on doctors to perpetually spend thousands on special mandated training courses provided by the very entities that issue the certificates. None of this makes one a better physician, but it does make a bunch of crony capitalist organizations rich. The barnacles of bureaucracy on the belly of the ship of independent physicican practice have gotten so heavy the ship has sunk. Productive, intelligent, compassionate, independent thinking Americans have become more rare with progressive indoctrination in schools, and the few remaining have the common sense to not go a quarter to a half million dollars in debt to end up paying to provide care to patients, while also paying for malpractice insurance to protect the physician from litigation and obscenely greedy trial lawyers. I closed my solo 20.5 year professionally successful practice, with $200,000 of debt thanks to these bureaucratic barricades to patient care. It cost more to provide service than one could offset by insurance and Medicare payments that are supposed to reimburse for the care. No one seems to be aware of the massive burden physicians face to comply with all of this parasitic bureaucracy. More staff must be hired than are needed for patient care just to chase the paper tsunami around the office and hopefully avoid a SWAT raid by Medicare, Medicaid, or their hired guns RUC. I loved my patients and I loved performing surgery that got them back to their lives and jobs, and out of pain. Sometimes while sleeping, I still have extremely realistic dreams that I am performing spine surgery in the operating room. My career was my life, but it is something I can never contemplate returning to in any manner, knowing what I know now. Even though the career is no longer active, I still have the state law requirement to maintain my medical records for seven years after closing my practice. That means seven years of paying for a liability policy to cover medical record archiving, a part time office manager to chase old invoices and pay the ongoing bills for accountants, attorneys, electronic health record software maintenance, computer server I.T. maintenance, etc. So, the answers to your four questions are YES,YES,YES, and YES. Now more than ever, people need to learn how to stay healthy, avoid toxic processed foods, and educate themselves about their health issues so they can make informed decisions on what limited care they will have access to. Since Medicare reimbursed my services at 10-15 cents on the dollar billed, you can see why more doctors just walk away, drop Medicare, drop Medicaid, and are going to cash only practices where they can. The cash model works well for veterinarians, and would definitely cut costs for people if more would just cut the insurance cord. The biggest problem is hospital costs that are hard to reduce in the current system. The way that socialized medicine nations save money on health care is to not provide it through rationing and delays to access to treatment. Even so, these programs are bankrupting those nations. It would destroy the USA prosperity if permitted here. Choose carefully, and stay well.
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    • Posted by wiggys 6 years, 10 months ago
      doctorobvious,

      I saw all of this going on in the mid 80's because of government interference in their businesses. it certainly has gotten worse, much worse and it is going to get even "worser" as time goes by. socialized medicine may ultimately be the weight on the camel that breaks its back.
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    • Posted by straightlinelogic 6 years, 10 months ago
      Doctor Obvious,
      I am going to post your reply on Straight Line Logic later today if you have no objections.
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      • Posted by DoctorObvious 6 years, 10 months ago
        Go right ahead. It seems only those who are physicians are aware of what is happening. The more the people know, the better. Physicians are also patients in their own lives, so we are all on the same side, and all are suffering thanks to Big Brother and their corporate cronies.
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    • Posted by $ Abaco 6 years, 10 months ago
      Thanks for sharing, DoctorObvious.

      I'm good friends with our doctor and he and I talk often of this - usually him sharing related stories. He is fighting to keep his own practice but it seems "the system" is fighting him tooth-and-nail.

      "Now more than ever, people need to learn how to stay healthy, avoid toxic processed foods, and educate themselves about their health issues so they can make informed decisions on what limited care they will have access to." Exactly my take. I'm an engineer working in the healthcare industry. The general public has no idea how this system works. If they did, they'd all be saying what you're saying in those quotes. I tell people, "If you find yourself in a hospital, get the hell out as fast as you can."
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    • Posted by Ed75 6 years, 10 months ago
      Hear, hear.
      Why would an honorable person volunteer to work as a slave?
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      • Posted by DoctorObvious 6 years, 10 months ago
        That's the whole insanity of those who claim "health care is a right". I dropped Medicaid participation in 2003 and when the state asked me why, I claimed that working for no money was in violation of the 13th amendment since slavery is illegal in the USA.
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    • Posted by kddr22 6 years, 10 months ago
      I agree. At 51 yo trying to hold on long enough to get all finances in order and that will be it. Many of my friends doing the same. Looking for alternative areas to work or completely different field. have discouraged my children from going into medicine as well. I am one of the few independent doctors in my area, and am not sure I can maintain. Doing the work, not getting paid esp here in Illinois.
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    • Posted by 6 years, 10 months ago
      I asked the questions because I wanted to hear what the Gulch and it's doctors had to say. You confirmed what I suspected. A doctor's practice is pretty much the same as any small service business. Patients = customers. Question the owners of these enterprises and the answers you get almost duplicate yours. I don't know if Trump can do what he claims to remedy this situation, but if he can't you can pretty much say bye-bye to private practice and family owned and operated business.
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    • Posted by CircuitGuy 6 years, 10 months ago
      "avoid toxic processed foods"
      I imagined paying cash to fix together the damage from Mountain Dew, Taco Bell, and Xanax. I've given up Mountain Dew and Taco Bell, so two out of three.... I'm 42 y/o and still feel great. I need to start looking to some neighboring country (Canada or Mexico?) in case my youthful bad habits catch up with me.
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  • Posted by wiggys 6 years, 10 months ago
    0care IS a contributing factor!!!!!!!!!!!!!!!!!!!!!!!!!!!
    We have as bad an educational system as can be achieved, so how many will want to be doctors since it is necessary to study for a long time even after graduation. the younger generation has no time to put in the time to actually learn. you may find a foreign person who is a doctor that is committed to the profession and if so hug him.
    just think how bad our situation (I am 75) is if we are 20 years old now. If the 20 year olds make it to our age I will be very surprised, if I am here.
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  • Posted by GaryL 6 years, 10 months ago
    What we are witnessing is the "Gutting of the American Health care System". Between politicians and lawyers, One in the same, getting their filthy hands into the medical needs of their constituents there is little hope. When have we ever seen this government ever run any business anywhere but in to the ground.
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    • Posted by DoctorObvious 6 years, 10 months ago
      What happened with the passing of Obamacare, and the Supreme Court idiocy of upholding it (because it was a tax bill after all, JUST LIKE SOCIAL SECURITY...), was meant to be another nail in the Constitutional republic.
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  • Posted by $ blarman 6 years, 10 months ago
    In a previous location, I was personally acquainted with several doctors and they saw Obamacare coming and decided that it was time to get out of medicine. The liability for doctors - especially in ObGyn - is astronomical and the ACA is essentially price fixing without lowering the liability. So doctors wouldn't be seeing different patients or taking fewer risks but they will be making less money for their efforts. It isn't rocket science - just simply risk/return economics.
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  • Posted by ycandrea 6 years, 10 months ago
    What we have here in our small town are mostly Nurse Practioners that do everything. There are no MD's of any kind. The Nurse Practioners are even in the specialized fields such as gastroenterologist.
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  • Posted by DrZarkov99 6 years, 10 months ago
    I'm one of the lucky ones, I guess. Oklahoma City and surrounding communities have become a huge medical research environment. No problem finding a good GP, and the only specialist that has a waiting list is the neurologist (3-4 months).

    Most physicians here have no problem prescribing opiods. The only restriction is no more than a 30 day supply at one time, and pharmacies readily dispense the drugs (with a view of the driver's license or other government ID). Opiod abuse is a problem, but law enforcement and targeting distributors, rather than denying the meds to patients have been the chosen methods to reduce the problem.

    We're seeing concierge doctor practice grow, as well as doctor co-ops with subscriptions that cover all non-emergency care. We also have the Surgery Center, that does not accept insurance, and advertises its charges for operations online. The state is becoming an experimental ground for returning the relationship to a doctor-patient connection.
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  • Posted by $ pixelate 6 years, 10 months ago
    My long time (17 year) provider (Family Practice) finally sold out to a larger practice...

    For the first 15 years of our relationship, he ran a private practice and was a very happy and sociable person. Since I am quite healthy, our discussions were on Ayn Rand and Atlas Shrugged during my periodic visits. During my last visit, when he still owned his practice, he asked if I had noticed the nice two ladies just outside the exam room. He then told me "those nice ladies are Obamacare." They were hired, to the tune of ~100k in annual compensation packages, just to administer the red-tape of the PPACA. It would be the equivalent of injecting cancer cells into a healthy patient and then insisting, with the height of conceit, that 'cancer has needs too.' He lasted a year after the cancer injection. During my most recent visit, he did not smile ... he had visibly changed. The exam rooms had also changed. Instead of each room having a Theme... such as the American Southwest, or Ancient Egypt, etc ... all the photos and mementos from his travels were gone. Without blinking, he explained that the hospital demanded the removal of all objects that could be the harbor for the transmission of disease. The place had all the appeal of a 1960's Soviet-Era exam room. He is now just a paid employee of the hospital.

    I share this anecdotal story with people that I meet, typically 'captive audiences' while on travel (flights). Most people have absolutely no clue how physicians, and their needs, play into the PPACA. When I conclude my story, their eyes light up a bit, having been exposed to another perspective.

    To repeat DoctorObvious -- stay healthy. You do not want to become party to this broken and further deliberately destroyed health care system.
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    • Posted by DoctorObvious 6 years, 10 months ago
      It is up to us to keep shining light on the reality of this situation. Everyone must be resourceful and continue to seek alternative options. Primary care physicians, dermatologists, opthalmologists, dentists, cosmetic surgeons can all go to cash only concierge practices. By severing the contractual ties with the government and insurance companies, they are free to work directly with their patients for the patient's benefit, without the regulatory and tort guns to their heads. Folks are cutting the cords to their cable bills, and will need to start cutting the cords to this false idea that government is needed to make their lives better. Those you can't convince need to take a vacation to the barrios of Caracas, Venezuela.
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  • Posted by $ Olduglycarl 6 years, 10 months ago
    Yes, my wife's doctor, friend and fellow boater, which I sometimes allowed him to do a general check up on me over the past 25 years, has up and moved to another state that is more friendly to GP's and less restrictive insurance practices. He stated, that he just could no longer do business, no longer do a good job in connecticut any more...have no idea where he moved to.

    Health care has become such a hoax in the present paradigm that many doctors have just given up and gone on to something else.
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    • Posted by DoctorObvious 6 years, 10 months ago
      My nickname is DoctorObvious for a reason. These truths are truly obvious to those who think critically and remain perpetually skeptical of the propaganda heaped upon them continuously in the media.
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  • Posted by $ allosaur 6 years, 10 months ago
    My 30-year-old son has an articulated disk that causes a lot of pain and he will hopefully have a successful surgery on June 6.
    He has asked for a specific opoid medication. Instead of a yes or a no, all he hears is that "the doctor has to write a prescription" and this has dragged on for days. "Yes" or "no" my son could understand.
    If the doctor ever does write one, I'm to present my son's driver's license both to receive it and to have it filled at a pharmacy.
    Yesterday, I had mid-afternoon business a half an hour away on the other side of Birmingham. Before I left, my son requested that I carry his license so in case he gets "the call," I could be advised on my cell phone to go straight to the hospital where the doctor is at.
    Of course, "the call" never came.
    Earlier, my son asked the doctor about crutches and was told that would have to be cleared by the insurance company.
    Me the dino told my son "Screw that!" and bought him crutches at Walmart.
    Those under the armpit crutches relieved a lot of pain and made it possible him walk a short way to the bathroom on the same day when he found he could not and all but panicked.
    Later we went to see his doctor, who visibly viewed the crutches with some discomfort.
    Oh, yeah, about that opoid medication, the doc said he had to write the prescription, whatever the hell that really means.
    All this led to my son saying that doctors no longer make decisions. Insurance companies tell them what to do.
    Even about stupid damn crutches . . .
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    • Posted by DoctorObvious 6 years, 10 months ago
      The entire point the media refuses to report is that so-called health insurance is NOT HEALTH CARE. Insurance is merely a debt transfer to the carrier. You pay them to cover your health expenses, but they will only cover the ones mandated by Obamacare. That means tons of red tape to get the damn crutches. I suggest everyone scour local yard sales and craigs list for crutches and walkers. Also estate auctions will have these items. They take up space, but when you need them you have them, period. Save your receipts and so far can still deduct as a health care expense but not count toward deductible. Insurance has all but been rendered useless by Obamacare. Go back to high deductible catastrophic policies and back up the large out of pocket with health savings accounts. Premiums will drop drastically, and those that can pay the high deductible out of pocket costs will be able to deduct them from their taxable income. Those who are too poor to benefit will need to look to charity and Medicaid to get what they can. That is the safety net. Those who can work will need to work to cover their own expenses. It's called personal responsibility; something progressives deny exists in their bubble world view of the masses. IF DC sunk into the mud, most Americans wouldn't miss it. We'd help those around us who could end up suffering. Meanwhile, keep those medical assistive devices you inherit from your grandparents. You might just need them. Hope your son gets better soon. Make sure he walks every 15 minutes after surgery to heal faster. Don't sit more than 15 minutes at a time. Don't use tobacco; it rots the spine and discs and prevents wound healing, thus speeding up the aging process. Tobacco use truly worsens health and increases health costs, so that's another place to save money for those who smoke.
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      • Posted by 6 years, 10 months ago
        Exactly.
        You tell 'em, doc.
        We fail to realize that Health Insurance is in no way the responsibility of government. Other than relatively small volunteer organizations, there is no way that one size fits all can accomodate all the variations in healthcare without excluding preexisting conditions without charging huge fees or having huge deductibles.Now that the stupids in Washington have committed us to this type of unfeasable insurance, the genie cannot be stuffed back into the bottle if the politicians desire re-election.
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      • Posted by $ allosaur 6 years, 10 months ago
        I told my son what you wrote and he was nodding while I spoke. Then he said to ask you why he can't use an opiate but then answered his own question pertaining to the current so-called opiate epidemic.
        I remember being prescribed stuff like that for an arthritis flare-up. That was four or fiver years ago and other times further back, but I never became a druggie.
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        • Posted by DoctorObvious 6 years, 10 months ago
          Certainly there are a number of contributing variables, genetics and age of exposure to addictive substances play a huge role. Anyone younger than age 22 to 26 have incompletely matured brains. Exposure to alcohol, marijuana, tobacco, and narcotics prior to full brain development are the greatest risks for adult and teenage addiction that curses them for the remainder of their lives. Parents do need to protect their children from exposure as much as possible.
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          • Posted by $ allosaur 6 years, 10 months ago
            This is one of the most interesting posts ever! I refer to your anyone younger than age 22 to 26 having incompletely matured brains.
            I long ago recall noticing that at about the age of 30 that I was maturely different upstairs than during my mid-20s.
            I'm also a lifelong tobacco addict but I haven't smoked for five years thanks to a Chantix prescription. Couldn't' quit on my own.
            As a kid I could buy a pack with chump change from a vending machine placed outside of a gas station back when someone filled the tank, checked the oil and cleaned the windshield without asking for a tip.
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            • Posted by 6 years, 10 months ago
              I started smoking at age 10. I quit in 1974 when I ran out of smokes at 2:00 am in a thunderstorm, and was about to run out to the all night convenience store for a pack..I also loved to smoke My son once told me that I would fire off one of my guns so I could suck on the smoking barrel.
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              • Posted by $ allosaur 6 years, 10 months ago
                Winstons were good time delay fuses for cherry bombs. Marlboros would burn out.
                I should know. By 16 I was bad to the bone.
                During the 60s in Dothan, Alabama, smokers liked to say that Marlboros would make you sterile.
                Marlboro TV commercials played The Magnificent Seven music at that time.
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    • Posted by $ Abaco 6 years, 10 months ago
      So sorry your son is suffering with this, at 30, even. Dangit...
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      • Posted by $ allosaur 6 years, 10 months ago
        You'd have no idea for looking at me now, but I could jog four miles when I was 30.
        A little later I joined the Alabama Department of Corrections for 21 years. Back problems do run in my family, though.
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        • Posted by $ Abaco 6 years, 10 months ago
          It's tough. I actually started really boxing at 41, which means I'm crazy, of course. At that time I often ran 5 or 6 miles (I'm a heavyweight). Now, ten years later I'm in decent shape but my joints are really starting to rebel. Of all things, the latest is golfer's elbow...what a strange injury. Knock on wood...my back has been holding up. But, when it has flared a couple times I felt sincere pity for those who have chronic back problems. It's miserable as hell...
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          • Posted by $ allosaur 6 years, 10 months ago
            I first noticed my back had gone bad when I kicked a body bag, pretending it was an inmate during the mid-90s..
            My health has been going south ever since.
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          • Posted by 6 years, 10 months ago
            I was never much for exercise. There was a time when I got pretty good at raquetball and had to get in shape for that. However, for most of my life I did nothing. But then, I found most of my friends coming up with various illnesses like you are. at around the same time I did. Secretly, it makes me smile.
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        • Posted by DoctorObvious 6 years, 10 months ago
          I never could run four miles. Never even tried. Back trouble is common and was most of what I saw in my practice. Much can be controlled with exercise, avoiding tobacco, and maintaining a normal weight. The human skeleton was designed to carry only one person at a time. We gain weight but our skeletons don't get bigger to accommodate the increased size.
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    • Posted by term2 6 years, 10 months ago
      My other half had hernia surgery in Las Vegas a year ago. It was successful (so far) and the dr wrote a prescription for one of the hated "opiod" drugs. I was UNABLE to find any pharmacy that would fill the prescription. If found ONE some distance away, but I found that no matter if I had the persons drivers license or not, I could not pay for it with cash or MY credit card. I finally gave up, and he had several days of pain. This war on drugs HAS TO STOP. I had a knee replacement and got 90 of the dreaded pain pills at Mayo Clinic Hospital pharmacy, which I will retain for any future needs for me and my friends. We are all on our own with medical care nowadays.
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      • Posted by DoctorObvious 6 years, 10 months ago
        Don't forget the legal gun to the heads of the pharmacies. They could go to jail for filling narcotic prescriptions, as well as risk getting shot by carrying narcotics and becoming robbery victims. If the criminals know a pharmacy won't fill narcotic prescriptions, they are unlikely to attempt a robbery.
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      • Posted by DoctorObvious 6 years, 10 months ago
        Another example of how the few ruin things for the many. If dentists were not writing narcotic prescriptions like they were giving out halloween candy, the opioid addiction epidemic would not have gotten so bad. I don't want to blame dentists, the pharmaceutical companies pushed hard for expanding indications for narcotic use decades ago, which led to this addiction problem. It was just as bad as when tobacco companies advertised that smoking was good for you. Hope your wife used ice packs. Sorry you had such a struggle.
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    • Posted by rbunce 6 years, 10 months ago
      Go down to the local street corner... an enterprising young business man will hook your son up.
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      • Posted by $ allosaur 6 years, 10 months ago
        I know you're just kidding around but~
        I used to supervise such enterprising young men and would send them to their cells by shouting, "Lock down!"
        Unfortunately, hooked up users were doing time in that prison too.
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        • Posted by rbunce 6 years, 10 months ago
          More wasted lives due to the government War On Drugs... while the FDA makes it impossible to get them legally... that's messed up.
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          • Posted by $ allosaur 6 years, 10 months ago
            Three strikes you're out equals a life sentence for felonies in Alabama.
            So if you #1 badly beat someone up for sleeping with your wife, #2 got scared and plea bargained a reduced sentence guilty for a burglary you're falsely accused of and then #3 got caught as a druggie because your life sucks--you get free room and board for the rest of your life! But no steak, baked potato or fried chicken.
            I had a reputation for treating inmates fairly even though there was times I was forced to use force and I also fired three warning shots from towers.
            As for that last warning shot, I would have shot the inmate if he had not stopped trying to escape.
            That was the only time I took aim at a human being's center mass. But he decided that he was done that day.
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            • Posted by 6 years, 10 months ago
              I could not o your job, but I'm glad that you were able to.
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              • Posted by $ allosaur 6 years, 10 months ago
                I couldn't do it now for health reasons.
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                • Posted by 6 years, 10 months ago
                  Father time gets us all.
                  "You can evade life, but Death you cannot evade. -- T.S. Elliot
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                  • Posted by DoctorObvious 6 years, 10 months ago
                    Ecclesiastes Chapter 3:

                    "3:1 All things have their season, and in their times all things pass under heaven.

                    3:2 A time to be born and a time to die. A time to plant, and a time to pluck up that which is planted.

                    3:3 A time to kill, and a time to heal. A time to destroy, and a time to build.

                    3:4 A time to weep, and a time to laugh. A time to mourn, and a time to dance.

                    3:5 A time to scatter stones, and a time to gather. A time to embrace, and a time to be far from embraces.

                    3:6 A time to get, and a time to lose. A time to keep, and a time to cast away.

                    3:7 A time to rend, and a time to sew. A time to keep silence, and a time to speak.

                    3:8 A time of love, and a time of hatred. A time of war, and a time of peace.

                    3:9 What hath man more of his labour?

                    3:10 I have seen the trouble, which God hath given the sons of men to be exercised in it.

                    3:11 He hath made all things good in their time, and hath delivered the world to their consideration, so that man cannot flnd out the work which God hath made from the beginning to the end.

                    3:12 And I have known that there was no better thing than to rejoice, and to do well in this life.

                    3:13 For every man that eateth and drinketh, and seeth good of his labour, this is the gift of God.

                    3:14 I have learned that all the works which God hath made, continue for ever: we cannot add any thing, nor take away from those things which God hath made that he may be feared.

                    3:15 That which hath been made, the same continueth: the things that shall be, have already been: and God restoreth that which is past.

                    3:16 I saw under the sun in the place of judgment wickedness, and in the place of justice iniquity.

                    3:17 And I said in my heart: God shall judge both the just and the wicked, and then shall be the time of every thing.

                    3:18 I said in my heart concerning the sons of men, that God would prove them, and shew them to be like beasts.

                    3:19 Therefore the death of man, and of beasts is one, and the condition of them both is equal: as man dieth, so they also die: all things breathe alike, and man hath nothing more than beast: all things are subject to vanity.

                    3:20 And all things go to one place: of earth they were made, and into earth they return together.

                    3:21 Who knoweth if the spirit of the children of Adam ascend upward, and if the spirit of the beasts descend downward?

                    3:22 And I have found that nothing is better than for a man to rejoice in his work, and that this is his portion. For who shall bring him to know the things that shall be after him? "
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            • Posted by Dobrien 6 years, 10 months ago
              Career criminals will unlikely be reformed by the modern prison systems IMHO. the punishment should not be cruel unless the criminal has acted cruel , plenty of bad bad actors who only deserve the worst. Others should be humanly kept very uncomfortable . They should never want to return to a hell hole . Non violent criminals should be treated differently from the violent.
              My thoughts on the examples you gave for the three strike law #1 that's like smashing your thumb and then sticking your hand in a meat grinder.
              #2 maybe a burglar who is caught and another burglary is attributed wrongly, oh well. Kind of like a known liar who tells the truth about something and complains cause they are not believed.
              #3 Huge business because of its illegalization.
              Both on the trafficking and enforcement. It is obviously a war that is unwinable. They don't belong with murderers or rapists .
              Just my thoughts.
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              • Posted by $ allosaur 6 years, 10 months ago
                Corrections training taught me that inmates are sent to prison AS punishment--not FOR punishment.
                So I strove to treat them all the same. I was not the judge, I was not the jury and almost all of those inmates could not wait to tell me how innocent they were.
                Funny how you begin to nurse a special respect for the ones who admit they were guilty as charged.
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                • Posted by Dobrien 6 years, 10 months ago
                  You certainly have more knowledge as to what prison is all about than I do. Just seems like the do gooders are hell bent on making sure the prisoners are treated well when the cons have no concern for the well being of their victims.
                  I have never understood why anyone would want to compound the pain of rejection in a relationship by resorting to violence.
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                  • Posted by $ allosaur 6 years, 10 months ago
                    When I when assigned as "rover" was summer time sweating in cell blocks during the 80s, an Alabama politician trying to get elected on TV criticized prisons for being air conditioned.
                    The only place an inmate on a usual day had air conditioning was in the infirmary. Come to think of it, that was not a usual day.
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                    • Posted by Dobrien 6 years, 10 months ago
                      This fair skinned Irishman doesn't like the heat, glad I'm on the outside.
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                      • Posted by $ allosaur 6 years, 10 months ago
                        I was known for not complaining. One hot summer day I went to work, looked at the roster and thought,"Good, I'm assigned to the infirmary."
                        But the air conditioning was not working.
                        The next day I was assigned to the infirmary.
                        The air conditioning was still not working.
                        The next day I was assigned as rover to a cell block.
                        During that shift I stepped inside the infirmary to discover that the air conditioner was fixed and working.
                        And I was working for my least favorite supervisor. The day he transferred to another prison was a really good day.
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            • Posted by CircuitGuy 6 years, 10 months ago
              "he decided that he was done that"
              Thank God. That's messed up.
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              • Posted by $ allosaur 6 years, 10 months ago
                No psychological problems or nightmares for me dino.
                It is legal for an Alabama corrections officer to shoot an escaping convicted felon in the back.
                That's what I was aiming at and I swore to do my duty. Was mentally prepared to do.
                There's also what a felon I allowed to escape may do to encountered innocents to consider.
                Retired, I don't have to worry about that anymore.
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                • Posted by CircuitGuy 6 years, 10 months ago
                  Somebody's got to do it, either a corrections officer, a police officer, or some random armed citizen facing down a bad guy, but it's still majorly mess up.
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                  • Posted by $ allosaur 6 years, 10 months ago
                    A week of annual training at corrections consisted of becoming NRA qualified with a rifle, a shotgun and a revolver. We are trained to tell courtrooms and to put in report writing that we "shoot to stop."
                    To shoot to stop we are trained to aim at center mass. That way if you miss the center, you still might hit the target anyway.
                    You may really think is really messed up is how I was trained to be a killer when drafted into the Marines in 1969. I'll never forget the first time I fired a M1911 semiautomatic pistol. My target was rolled away like a running man. As ordered, I shouted "Halt!" twice and then shot the target seven times. That was the only time I fired a pistol in the USMC.
                    That's NOT at all how one becomes NRA qualified to shoot anything..
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          • Posted by CircuitGuy 6 years, 10 months ago
            "that's messed up."
            Yes. Just disgraceful. It cheapens the law, furthers the idea that laws are just a fig leaf for arbitrary power.
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            • Posted by DoctorObvious 6 years, 10 months ago
              Sadly abuse of power is a temptation weak souls are vulnerable to. Those in public service must stay grounded in morality not to lose their way.
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              • Posted by $ allosaur 6 years, 10 months ago
                Ain't that that truth! During my 21 years, every two-to-three years a freshly fired corrections officer was handcuffed by notified deputies and escorted to the county jail for due process. The most common crime was smuggling in drugs for inmates. Who usually paid for this to happen? Inmate relatives!
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  • Posted by Eyecu2 6 years, 10 months ago
    Herb, I have seen and experienced similar things. To make matters even worse. My daughter who has dreamed of becoming a doctor since she was 7 (she is currently 17 and very politically aware) has recently decided that it is simply not worth it and is considering other avenues. She will be a senior next year and started reading Anthem a couple years ago after my suggestion. Not sure what direction she is going to go but looking like she will be avoiding medicine, mostly due to all the Governmental interference in health care.
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    • Posted by 6 years, 10 months ago
      It is a terrible loss if she doesn't pursue her heart's desire.Tell her not to decide too soon. Life's road is not a paved superhighway, lots of bumps ahead no matter what she decides.
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    • Posted by DoctorObvious 6 years, 10 months ago
      Look to a pharmacist degree. It is still possible to make a decent living with only six to 7 years of college. I thought I was too ambitious to count pills for the rest of my life, so I went into medicine and became a neurosurgeon. However, my Pharmacist and MD licenses are still active. Keep all doors open and always have something to fall back on!
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      • Posted by Eyecu2 6 years, 10 months ago
        Thank you for the suggestion. She has been considering that. The high school she goes to has a Pharmacist Tech program and she has been in that 3 years now. She was thinking it would be good money while going to college, plus it is in the field. I try to let her come to her own choices, but I will offer this guidance. Thank you again.
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        • Posted by DoctorObvious 6 years, 10 months ago
          I worked as a pharmacy technician in high school just before starting pharmacy school at Purdue. I then worked part time at Eli Lilly in the envivronmental control lab on weekends to help pay for pharmacy school. Once I graduated pharmacy school, I got my pharmacist's license 10 days before starting medical school, and worked as a hospital pharmacist part time while getting my MD degree. Not only does working part time generate cash to minimize debt, but it was a huge reassurance to be able to be in charge of a pharmacy department on weekends and not panic over every medical school exam. I always knew that I had a career if med school didn't work out, and that ability to be in charge kept the challenges of med school from intimidating me. Being able to carry that 60 hour per week school and work load also gave me the confidence to take on neurosurgery residency training, and subsequently solo neurosurgical practice in an underserved area. Granted, I didn't opt for being a Mom since my career was my baby; now two Basset Hounds are my babies!https://www.facebook.com/Baron-Von-Bl...
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  • Posted by ChuckyBob 6 years, 10 months ago
    When O'Bozocare was first introduced I had two friends who were MDs. One said outright he would retire rather than deal with the paperwork overhead. He would rather treat patients than fill out paperwork. The other was an ER Doc who worked about a week a month. That gave him more than enough to live on and the hospital covered most of the overhead and liability. Last I heard he is also considering retirement.
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  • Posted by term2 6 years, 10 months ago
    The MDs have taken their marbles and ran. First of all it costs too much to get the MD classification. I have heard $400k. Then family doctors seem to be hated by the establishment (my family doctor who I can see via MDVIP charges me $125 per moth for access privieges and when i go to see him, medicare pays him $26. He told me that if he didnt join MDVIP, he would have had to close. I think this decision just delayed the inevitable. Single payer is coming.
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    • Posted by DoctorObvious 6 years, 10 months ago
      https://www.i2i.org/single-payer-sing...

      Medicare is single payer
      Medicaid is single payer
      VA is single payer

      Robert Reich was honest when he declared:
      " -Older people should just die- they're "too expensive"

      -There should be "less innovation" in medical technology

      -You should not expect to live longer than your parents."

      Again, look for market options and solutions. If you give up and go with what the government gets you, then you are chatting in the wrong web site. Italy has socialized medicine but allows for cash health care. There is no way to have equal access for all unless everyone gets denied access equally. Those who can afford it will never settle for that.
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  • Posted by Arminius 6 years, 10 months ago
    Indians are thick of the ground being bled into the practices in Providence, RI. It's not their education but their top down attitude, ignoring the 20 year ongoing model of patient contribution to the diagnosis and treatment processes. Not helpful,
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  • Posted by rbunce 6 years, 10 months ago
    Low reimbursement rates from government healthcare payment systems like Medicaid and Medicare. Government regulation of healthcare about what can be provided when and where and to whom. Surprised any of them still in business here... at least in medical care covered by Medicare/Medicaid. Most providers closely monitor their government patient. Some do not accept one or both programs at all and that number is increasing.

    Some tech guy will take his billions and buy up old cruise ships and Navy ships, refit them as medical facilities, and operate them just outside US territorial waters to avoid all this nonsense.
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  • Posted by Ben_C 6 years, 10 months ago
    Ditto all the comments. I am a veterinarian and am thankful I chose this path rather than human medicine. We have regulations - but about a 10th of that of human medicine. We provide nearly the same services as human medicine (I am a specialist - board certified oral surgeon) at about a tenth of the cost - hmmm, wonder why. At 71 I am on Medicare - no choice. I have Blue Care Network for my family. My medical financial obligation per year is 34,000 dollars. Thank you Obama. I cannot sustain this for much longer.
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