On Feb 12, 2009, at 1:54 AM, David Cake wrote:

>       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.

I think we are agreeing here. They are potentially useful in many  
situations but not actually used very often. Like many people I have  
mild hypertension which is easily controllable with common drugs. I  
monitor my blood pressure and my medical regime has been stable for  
years. I obviously could be served by a nurse practitioner but I am  
not. In fact it is hard to find a GP who is willing to handle my  
situation. I end up going to an internist.

The drugs I take are not subject to abuse. They used to be expensive  
but they have become generic now. I have highly subsidized medical  
care so it is not a personal financial issue with me[1]. It is just  
wasteful though. there is no reason that they are not sold over the  
counter except that the physicians like the easy  money of   
subscription renewal.

>       In Australia, GPs are not particularly well paid, certainly
> not compared to lawyers.

In the US physicians services exhibit the famous backward sloping  
supply curve. When their rates go up their hours  worked go down  
because they can sustain fairly lavish life styles while working fewer  
hours. Lawyers are famously hard working.

[1] I live near enough to the Mexican border that people here who are  
not wealthy can still get good health care. That option isn't  
available to most Americans.

---
Neither a man nor a crowd nor a nation can be trusted to act humanely  
or to think sanely under the influence of a great fear.

-Bertrand Russell, philosopher, mathematician, author, Nobel laureate  
(1872-1970)


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