They brush over this, but it would be interesting to have a longer discussion on workforce issues, i.e. "physicians who don't want to see patients".
The shift from private practice to employment, the reimbursement structure, malpractice, midlevels, etc. etc. are real things that are largely invisible to people outside of medicine but which most of us feel quite strongly.
And then there's also the shift in culture where people don't want to work 100 hours a week any more and be on call 24/7. The Zoomers have barely started practicing yet. This trend is going to continue. Rapidly.
I think VP's bathroom reno analogy is great. The problem is that you might not just get your clawfoot tub dinged, you might end up with a hole in the wall through which you can see the next room, or even worse, a hole in the floor that will allow the tub to crash through it.
If we're voting (and we are not), I am totally with Adam, re: RFK. He has dangerously warped ideas about drug and vaccine efficacy and associated risks. Yes, he is correct on some issues but so are hundreds of others who don't promote dangerous conspiracy theories.
For once I totally disagree with Adam. RFJ Jr is already getting mothers to worry about what they feed their kids, and to question doctors as to what they prescribe for their kids just by starting the dialogue. It is a good discussion, and it is already changing people's behavior for the good. I think he will do a good job, but we will see. The person I worry about is the Department of Labor nominee. She has voted against small business in the past. But we will see. The one thing in common with Trump's nominees is that they have hope for Americans and their future. Hope in the future can make all the difference.
Agree that NIH is funding studies that are not informative nor we need. My concern is that the Trump administration is halting funding to “review” and then will redirect money to studies that benefit corporations or people that in Trumps back pocket.
I have to disagree on pharma’s intentions at least when it comes to the opiate crisis. I still have a belief that pharma enjoys permanent patients. That being said I still share the belief that the majority of docs are scrupulous. It’s hard for scrupulous docs to believe that there are some bad docs out there, but I’ve seen a lot of them over the decades. A slow burn turned them into pharma shills. That was in pain management of course.
I agree with many of above comments and previous commentaries that it is healthy to ask questions and debate. This was censored previously and encouraging that debate is now invited. Recently the difference in vaccine schedules between US and Denmark was underlined with Denmark offering 1/3 of vaccines. I don’t think Denmark has been shown to be a sicker nation. Vaccine hesitancy was used as a reason to censor discussion of Covid vaccines It is time to end this harmful response to reasonable question and open floor for debate and good studies.
I thought RFK Jr might be the guy to root out corruption and conflicts of interest in the medical industrial complex. But now I see his main source of income is referral fees from plaintiffs lawyers for HPV vaccine litigation. And he refuses to give up the ongoing referral fees. Can’t get more conflicted or ethically compromised than that.
The US healthcare system isn’t “broken”- it is producing the outcome it has been designed for. We need a committed reformer now, not another gray-mouse bureaucrat whose highest aspiration is to tinker at the edges of Medicaid policy. RFK Jr also has a huge political movement behind him. If he goes down, we will likely see no substantive health reform in this administration.
Adam's basis are overwhelming him and he is one of the reasons medicine in the US is broken. He has no scientific argument just ad hominin attacks and a nervous condescending laugh. I think these "doctors" are actually afraid of the pushback they will be getting from now on from their patients. They have enjoyed a question free work environment in which their opinions are rarely challenged. Now, they may actually need to go back to first principles and primary sources and actual science to justify their decision making, instead of just "following guidelines" and having the patient blindly follow their advice. You can tell which of theses doctors is comfortable with their personal level of knowledge. Adam's condescending tone is just a mask for his own insecurity and inability to be challenged.
What a great discussion! You are real role models in that regard, whatever the subject is you are talking about, how emotional and controversial it might be. I would love to see this kind of arguments in all academic settings, involving students. Unfortunately, this is not happening. Either emotional and controversial subjects are avoided, or such debates are not happening at all. If you are not training critical thinking, or the rules of academic debates, future generations of health professionals will be less likely to appreciate the importance, will be less likely to engage. Thanks again, and keep on arguing :-)
We need a fresh look at government "health care." For one thing, why do we need different systems, each with their own administrators? Merge Medicare, Medicaid, CHIPS, and any other separate programs. Charge premiums based on income. Incentives could be offered to encourage people to take good care of themselves, such as discounts for those with a healthy BMI.
I support RFK Jr. for HHS secretary. We need him to clean up the conflicts of interest throughout the bureaucracy. And stop pushing "vaccines for everything."
Vinay Prasad - new CDC director. You heard it here first.
They brush over this, but it would be interesting to have a longer discussion on workforce issues, i.e. "physicians who don't want to see patients".
The shift from private practice to employment, the reimbursement structure, malpractice, midlevels, etc. etc. are real things that are largely invisible to people outside of medicine but which most of us feel quite strongly.
And then there's also the shift in culture where people don't want to work 100 hours a week any more and be on call 24/7. The Zoomers have barely started practicing yet. This trend is going to continue. Rapidly.
I think VP's bathroom reno analogy is great. The problem is that you might not just get your clawfoot tub dinged, you might end up with a hole in the wall through which you can see the next room, or even worse, a hole in the floor that will allow the tub to crash through it.
Love this discussion between y'all. So great to hear people who are friends be able to push back on each other and have a great dialogue.
If we're voting (and we are not), I am totally with Adam, re: RFK. He has dangerously warped ideas about drug and vaccine efficacy and associated risks. Yes, he is correct on some issues but so are hundreds of others who don't promote dangerous conspiracy theories.
For once I totally disagree with Adam. RFJ Jr is already getting mothers to worry about what they feed their kids, and to question doctors as to what they prescribe for their kids just by starting the dialogue. It is a good discussion, and it is already changing people's behavior for the good. I think he will do a good job, but we will see. The person I worry about is the Department of Labor nominee. She has voted against small business in the past. But we will see. The one thing in common with Trump's nominees is that they have hope for Americans and their future. Hope in the future can make all the difference.
extremely IMPORTANT for anyone who DECEIVES us HUMANS:
https://www.brokentruth.tv/p/now-the-fun-begins-2020-records-shows
That was a terrific, insightful discussion. Thank you!
Agree that NIH is funding studies that are not informative nor we need. My concern is that the Trump administration is halting funding to “review” and then will redirect money to studies that benefit corporations or people that in Trumps back pocket.
I have to disagree on pharma’s intentions at least when it comes to the opiate crisis. I still have a belief that pharma enjoys permanent patients. That being said I still share the belief that the majority of docs are scrupulous. It’s hard for scrupulous docs to believe that there are some bad docs out there, but I’ve seen a lot of them over the decades. A slow burn turned them into pharma shills. That was in pain management of course.
I agree with many of above comments and previous commentaries that it is healthy to ask questions and debate. This was censored previously and encouraging that debate is now invited. Recently the difference in vaccine schedules between US and Denmark was underlined with Denmark offering 1/3 of vaccines. I don’t think Denmark has been shown to be a sicker nation. Vaccine hesitancy was used as a reason to censor discussion of Covid vaccines It is time to end this harmful response to reasonable question and open floor for debate and good studies.
I thought RFK Jr might be the guy to root out corruption and conflicts of interest in the medical industrial complex. But now I see his main source of income is referral fees from plaintiffs lawyers for HPV vaccine litigation. And he refuses to give up the ongoing referral fees. Can’t get more conflicted or ethically compromised than that.
Disqualifying.
The US healthcare system isn’t “broken”- it is producing the outcome it has been designed for. We need a committed reformer now, not another gray-mouse bureaucrat whose highest aspiration is to tinker at the edges of Medicaid policy. RFK Jr also has a huge political movement behind him. If he goes down, we will likely see no substantive health reform in this administration.
Adam's basis are overwhelming him and he is one of the reasons medicine in the US is broken. He has no scientific argument just ad hominin attacks and a nervous condescending laugh. I think these "doctors" are actually afraid of the pushback they will be getting from now on from their patients. They have enjoyed a question free work environment in which their opinions are rarely challenged. Now, they may actually need to go back to first principles and primary sources and actual science to justify their decision making, instead of just "following guidelines" and having the patient blindly follow their advice. You can tell which of theses doctors is comfortable with their personal level of knowledge. Adam's condescending tone is just a mask for his own insecurity and inability to be challenged.
You mean my biases, correct?
What a great discussion! You are real role models in that regard, whatever the subject is you are talking about, how emotional and controversial it might be. I would love to see this kind of arguments in all academic settings, involving students. Unfortunately, this is not happening. Either emotional and controversial subjects are avoided, or such debates are not happening at all. If you are not training critical thinking, or the rules of academic debates, future generations of health professionals will be less likely to appreciate the importance, will be less likely to engage. Thanks again, and keep on arguing :-)
We need a fresh look at government "health care." For one thing, why do we need different systems, each with their own administrators? Merge Medicare, Medicaid, CHIPS, and any other separate programs. Charge premiums based on income. Incentives could be offered to encourage people to take good care of themselves, such as discounts for those with a healthy BMI.
I support RFK Jr. for HHS secretary. We need him to clean up the conflicts of interest throughout the bureaucracy. And stop pushing "vaccines for everything."