At 9:27 PM -0700 11/2/09, Chris Gehlker wrote:
>On Feb 11, 2009, at 3:14 PM, Mark Smith wrote:
>
>> On Wed, Feb 11, 2009 at 10:21 PM, Chris Gehlker <[email protected]>
>> wrote:
>>> I'm not sure about finance but this has actually been extensively
>>> studied as between law and medicine and the problem is much greater
>>> in
>>> medicine. The problem is actually diminishing in the realm of legal
>>> services.
>>
>> I can believe that the problem is *diminishing* in the world of law,
>> but I'd still argue that, at least in my two reference nations (UK and
>> Germany) and according to my frame of values, that lawyers are
>> generally more overpaid than medical doctors.
>
>
>That's certainly not the case in the US but then my understanding is
>that doctors are paid a lot less relatively in those two countries. In
>at least some US states, nurse practitioners are legally allowed to
>write prescriptions but they aren't allowed to practice independently
>so practically they aren't allowed to do it.
In most Australian states it is the same. It makes them
potentially useful in large hospital departments for starters, and
many GPs work in largish multi-doctor practices, into which nurse
practitioners can fit fairly comfortably and see those with routine
complaints.
The role of nurse practitioners is evolving, but just because
they can't straight out replace doctors entirely doesn't mean they
can't have a significant role.
> LuKreme is exactly
>right. Doctors in the US make an incredible amount of money writing
>routine prescriptions. It is well documented that for things like
>routine hypertension medication doctors who bill by the visit don't
>tend to write prescriptions for longer than a month while doctors on
>salary tend to write the same prescriptions for three months.
In Australia, GPs are not particularly well paid, certainly
not compared to lawyers.
Now, specialists can be pretty damn well off, especially
surgeons in private practice etc. But General Practitioners, who
generally have to take out rent in premises, payment for admin staff,
etc before they get their take home pay? Actually, it turns out not
that rich. Well off, but not crazily so.
One of the reasons why is, even for doctors in private
practice, the MediCare payment (what the government 'sociaiized
medicine' system is willing to pay doctors for a consultation) is an
effective price setter (GPs can charge more, but patients are quite
likely to change doctors if they charge a LOT more), and sets the
value of a GP consultation fairly low. The government focusses on GP
charges as a way to keep costs down (perhaps a bit more than they
should, IMO).
The US system is broken in more ways than one. And a public
system can reduce costs in many ways.
Another aspect of the Australian system is that, while the
system does not tell them what drugs they should prescribe, it makes
it a lot easier for them to prescribe the cheap, well-established,
treatments rather than new expensive ones. Some drugs are on the
Pharmaceutical Benefit Scheme - if prescribed, they get suppplied at
a standard cheap price (with the government subsidizing the cost).
Want to prescribe an expensive one? There is a good chance it will be
'on authority' - you have to ring up a bureaucrat and explain why you
feel it is justified for this particular patient (often, this means
they'll want to know a particular test has been performed, or the
will allow a drug to be on the PBS for some conditions, but not
others). Want to prescribe a drug that isn't on the PBS? Sure, but
you patient pays the full cost (unless they can convince private
insurance to do so).
Cheers
David
_______________________________________________
OSX-Nutters mailing list | [email protected]
http://lists.tit-wank.com/mailman/listinfo/osx-nutters
List hosted at http://cat5.org/
