How to find a doctor (Sorry, NGC)

[Arizona Wayne]

Some US Dr.s come from other countries and I doubt they have to go thru the same tedious method US trained Dr.s do.  I've had foreign trained Dr.s and some were good and some not.

So why would a young Dr. want to go thru all the time, effort, cost and in the end get paid poorly because of socialized medicine?

[Kev m]

Some US Dr.s come from other countries and I doubt they have to go thru the same tedious method US trained Dr.s do.  I've had foreign trained Dr.s and some were good and some not.

So why would a young Dr. want to go thru all the time, effort, cost and in the end get paid poorly because of socialized medicine?

Actually the term for them (sometimes not kind) is FMGs (Foreign Medical Grads).

There may be exceptions based on country and certifications, but most are required to enter the US system at the point of residency or fellowship, even if they have been practicing in a foreign country for years. And in competing for those residency spots they are often at a disadvantage.

So right or wrong they are forced into the system at what would have been the point of graduation from medical school.

Now here's an interesting difference. Many foreign countries don't require their doctors to waste time in college. I mean Jenn's 27 years of school and training would have been 4 years shorter if she didn't have take two more years of calculus, organic chemistry, biology etc. along with marine bio in Belize, women's studies, English literature, scuba diving and Shotokan karate (though that was an unbelievable opportunity to TA a class with the world leader of our organization). Instead the framework is laid in high school, the academic talents identified earlier, and they basically go straight to medical school.

It's an interesting difference in systems and probably reduces debt too. Although I think Jenn's undergrad only cost her in the $20k range (of the total $200k debt load) thanks to scholarships and grants.

Still, that would have put her at about 30 when she started her post training career instead of closer to 35.

Oh interestingly enough one of her mentors (and close family friend) is a pediatrician who when she was in school got into a rare compressed 5 year undergrad/medical school program at Penn State/Jefferson University Medical School right out of high school.

Being Chinese (many Asians look very young to non-Asians) and 4' 10" she often got the Doogie Hauser comparisons. But it's an interesting alternative approach to education.

[Arizona Wayne]

Most the foreign Dr.s I've encountered are of India, Pakistan type countries.

[Kev m]

Most the foreign Dr.s I've encountered are of India, Pakistan type countries.

Yeah, that would agree with Jenn's experience/observation (I just asked to be sure).

It sounds kinda that a lot of the older doctors of that ethnicity were educated elsewhere and then trained here. But in Jenn's peer age group it's split more 50/50 educated here or even born and educated here.

Bottom line though physicians that practice here have been vetted here. I'd be more worried about the ones that are still being vetted (FMG residency and fellowship).

Speaking of, I've heard some stories of Russian FMGs (while doing residencies here) that just look at things from a different perspective, not ordering certain tests or eliminating certain diagnosis on the seeming basis of acceptable losses for the rare missed diagnosis. Yikes, but they were being supervised (and over ruled) by their attendings.

[TodkaVonic]

Doctors are the only people I know that get paid in full whether their diagnosis/implementation is successful or not.  Even if you(patient) die they still get paid for their effort.

Yes, we get paid for our services. Would you prefer to live in a society where those services were only available to patients with essentially no chance of dying? My job would be a hell of a lot less stressful, I can tell you. Um, heart murmur? Case cancelled. What's that? You once had a "minor stroke." Case cancelled. You're on a blood thinner...cancelled .

Or do you propose that the entire reimbursement structure be based on the subjective interpretation of a treatment or a procedure's success? Can you imagine the difficulty of that? Well, mrs smith, since you're still having occasional groin pain after the repair of your massive and debilitating inguinal hernia six years ago, we here at Massive Profits Insurance see no reason to pay for that procedure and will not raise you premiums (very much) this year, thank you very much. 

I'm happy that MDs and DOs are paid based on their efforts, time, and expertise. There really isn't another way to do it without either a) not paying docs and therefor disincentivizing them (we do live in a world where mortgage payments and college tuition payments are real) or b) accepting that complex or difficult patients go untreated which is manifestly unacceptable and amoral.

[TodkaVonic]

Some US Dr.s come from other countries and I doubt they have to go thru the same tedious method US trained Dr.s do.  I've had foreign trained Dr.s and some were good and some not.

So why would a young Dr. want to go thru all the time, effort, cost and in the end get paid poorly because of socialized medicine?

All MDs and DOs practicing in the U.S. must be either boards certified or boards eligible. In the latter classification they've passed examinations which make them eligible to take the oral boards and thus go onto licensure. In the former, they've done both.
It doesn't matter if the foreign MD is a Pakistani CardioThoracic Surgeon with 15 years experience or if he's a neurologist from Mozambique who once treated the royal family. They all must fit nto one of the two above categories.
And I've met both, by the way.
My favorite was a colorectal guy from Scotland, a full-on consultant specialist surgeon 20 years into practice who decided to marry an American lass. They moved to Arizona and he spent the next 7 years of his life going through all of the steps that American surgical residents and fellows go through. Just to get to the same place, professionally, that he was in Scotland. He was, by the way, a pretty amazing surgical resident.
Anyhow, to get to your second point, the one about socialized medicine. With the possible exception of Venezula, societies with socialized medicine are not doctor-poor. There simple aren't waves of Canadian docs streaming into America to make a killing (ha!) in medicine. People go into medicine for innumerable reasons and money, albeit necessary and important and fun to have, is but one of them.

[wrbix]

I do not play a doctor on TV, did not stay at an Holiday Inn last night, and haven't read all responses to this post, but:

- all the many responses that say something like "the doctor is only given 10 minutes to see me/you" are bullshit! - I just retired from 30 plus years as a physician dedicated to quality of care, and a doctor can and should TAKE AS MUCH TIME AS HE/SHE NEEDS/WANTS to see each patient. There is no regulatory requirement for limitation of time spent.  If the physician gets pressure from Clinic to limit time then he/she needs to push back or move to a better environment.
Doctors blaming some vague system for poor care are rationalizing to their own financial benefit.

Off my soap box now - spent plenty of time there preaching to my feckless younger associates prior to my retirement.

[Muzz]

I had posted to this thread but somehow it went awol.

The best doctor I ever had lost quite a few patients because he dis not have a good bedside manner. Did not worry me a stuff. With both sports injuries and sickness in general he always got it right and I was quickly on the road to recovery. That's all I need. lost him when I shifted towns.

Present doctor is pretty good, and if he is unsure does not guess but will refer me to a specialist who will know. Unfortunately, some issues in the last 5 years have had the specialists buggered. Once in desperation I went to Dr Google (sorry Chuck) and worked out what it was when the experts couldn't. I was able to minimise the effects while they buggarised around.

My best Dr has been a physiotherapist, where I learnt more in two sessions than I did with 5 years of specialists and a helluva lot of money.

My advice would be to find a Dr who does the job and gets it right. Don't be put off by a lack of a good bedside manner.

[TodkaVonic]

I do not play a doctor on TV, did not stay at an Holiday Inn last night, and haven't read all responses to this post, but:

- all the many responses that say something like "the doctor is only given 10 minutes to see me/you" are bullshit! - I just retired from 30 plus years as a physician dedicated to quality of care, and a doctor can and should TAKE AS MUCH TIME AS HE/SHE NEEDS/WANTS to see each patient. There is no regulatory requirement for limitation of time spent.  If the physician gets pressure from Clinic to limit time then he/she needs to push back or move to a better environment.
Doctors blaming some vague system for poor care are rationalizing to their own financial benefit.

Off my soap box now - spent plenty of time there preaching to my feckless younger associates prior to my retirement.

I got through most of this thread, up to this post actually, and I'm sorry, but your ten minutes is up. Maybe we can set something up for 6-8 weeks out and revisit your concerns?

 




 

[redrider90]

How do you all go about finding a good doc and what is your definition of one?
GliderJohn

How do you all go about finding a good doc
Network with friends and medical professionals if you know any.
I know an awful lot of medical professionals after working in a university based medical center and still find it hard to get a good GP. Specialists are easier to parse out.

 and what is your definition of one?
 A good doc (or any medical practitioner) is someone who knows what he/she does not know.

[Arizona Wayne]

I got through most of this thread, up to this post actually, and I'm sorry, but your ten minutes is up. Maybe we can set something up for 6-8 weeks out and revisit your concerns?

 




 

This is how it was when I was with Kaiser Permanente and every visit you saw a different Dr.  Half the time the Dr. you saw didn't have your file so the visit was worthless.    And when you got a prescription there it was only for 3 weeks. 

[ukdavo]

I recently retired from the VA. Overbooked and overregimented is the name of the game in primary care any more. Give the guy a chance.
Make an appointment to review your labs. Write down questions in advance. Ask whether he is going to give you an exam (heart, lungs, abd, prostate). If he is still rude, tell him to think about his bedside manner and look for another doc. The good ones are out there.

[lucian]

I would check the golf course.

[O]

Apologies for interrupting the debate with an on-topic reply,    this is a pretty cool online tool for finding a physician near you: 

https://amino.com/

I've used it successfully to find a new physician when a practice I was using shut down.