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As the weather warms up, flowers start to bloom, and allergies kick in (sigh), it’s fair to say that the flu season is (pretty much) behind us. However, it’s important to understand the financial cost of each flu season.
I got an email from someone at FrugalDad (http://frugaldad.com) with a link to an infographic that very clearly lays out the costs of preventing/treating the flu. What stuck out to me was the pretty significant difference in cost between vaccination versus enduring a bout of the flu and all the costs that can come with it. Bottom line: vaccination not only saves you a lot of the physical agony that can come with suffering from the flu, but it can save you a lot of money as well.
Source: FrugalDad.com
Fox’s beacon of all that is true, just, and patriotic was at it again with this gem, dissecting why the American health care system is more expensive than the Indian health care system:
Not only does he insult the quality of the health care system, but he also takes a jab at the Indian lifestyle and Hindu faith. Why this guy is still on the air still boggles my mind.
About 1 in 20 doctors in the United States are of Indian origin. 40,000 Indian doctors practicing in the United States had their training in India. Some of the top doctors in the United States are of Indian origin (some are listed here). What does that say about the Indian medical education system? I’d say it’s doing all right, producing doctors who are both well-versed in their field, and compassionate health care providers. I know this first hand. I almost died as a baby when I visited India, and was revived by Indian doctors. Thank you, Indian health care system.
Seriously though, what do flush toilets have to do with anything? Yea, some Indian households don’t have flush toilets. Flush toilets aren’t a status symbol. In fact, they’re not the most ergonomically friendly pieces of equipment, as far as toilets are concerned. Sorry Glenn, the Western way of doing things isn’t always perfect.
Oh Glenn, insulting the Ganges does not help matters. It must be a shame, living in your little world, and finding anything beyond its borders baleful. Hinduism is the oldest surviving religion on earth, it has endured eons of disparaging remarks like yours, and numerous attempts to stamp us out of existence, and yet we persevere. Oh ye of small mind and even smaller willingness to open aforementioned small mind to new ideas, do not mess with people who are different from you. Also, angering people who make up the second largest group of people in the world in a country that is rising on the world stage with astronomical speed is not a way to attract new viewers to your show. You have never had a viewer in me (I like my neurons intact), and you probably will lose many more after this little stunt you pulled.
I can’t say angering Indian doctors will make much of a difference in the way we deliver care to you. Doctors are bound by the Hippocratic oath to never withhold treatment from anyone, whether it be a rich man, poor man, intellectual, or fool. We (and I mean the current Indian doctors, future Indian doctors, and doctors in general) will never waver from our commitment to providing care.
It’s my hope that the U.S. health care system is reformed and becomes more accessible to people like Caroline, so they don’t have to shell out money for a plane ticket to some far-flung corner of the world (India or anywhere else) for affordable health care. Yes, they may receive equally good health care for a lower price, but is it worth the trip? You, Glenn, should be turning your supposedly analytical eye inward instead of criticizing the world outside of your borders. Our system is hurting, and needs to be fixed. People who live in glass houses should not be throwing stones.
Women doctors have made amazing strides in the field, where only half a century earlier, it was almost exclusively dominated by men. Yet while the doors have opened to women doctors in most aspects, there is one notable exception: motherhood.
My favorite story of women breaking into this, male-dominated field is the one of Agnodice, who disguised herself as a man so that she could study medicine in ancient Greece. Many girls want to grow up to be both well-regarded doctors and wonderful mothers, but it seems that for the most part, they can’t have their cake and eat it too. Men can enter whatever field they want with little consequence, women must make sacrifices. I acknowledge that this seems to be changing, but the pace is still painfully slow.
To paraphrase a professor of mine, the world is still cruel to women. They are encouraged to pursue their career and focus on it with razor sharp focus, while their biological clocks tick away, independent of any aspirations they may develop down the road to start a family. Once the residency and fellowship parade is over (as the case were for aspiring doctors), and a woman is ready to start a family, it may already be too late. I’m all for women being driven and seizing life by the horns, but sometimes the cost is pretty great.
And then, there is me and those like me, who are from immigrant families who insist upon marriage and having at least the first child before age 30. If I am lucky, I will enter medical school at 24, take four years, and enter whatever specialty I can. Depending on what specialty that is, the years devoted to residencies and fellowships may be as low as 3 or as high as 6-7. People can say “Rebel! Blaze your own trail, do what you need to do to get what you want.” Yet in cultures where filial piety is prized and expected, it is far harder to go against the grain, even when your own wishes may be at stake. How does one reconcile cultural and societal obligations with the rigors of medical school/further training?
From what I can gather (and please correct me if I’m wrong) but several residencies tend to not look kindly on women who are pregnant or who have very young children. Each specialty requires a certain number of years of training. It makes sense, of course, that the more high-stakes residencies (for example neurosurgery) would probably require more time to train physicians in that field. Obviously I’d want my neurosurgeon (heaven forbid that I need one) to have had rigorous training. Yet there are 194 certified women neurosurgeons, out of something like 3000 neurosurgeons in total in the U.S. The difference between those numbers is alarming. It’s enough to discourage most women from even entertaining the idea of going down that road, but I’m not like most women. Many women seem to end up vying for the more “family-friendly” positions like family physician or pediatrician, or at least ones that finish up training quickly.
I am not one of those people, I’m aiming for one of the neuro residencies (neurosurgery if I can help it).* I love the complicated nature of the field, and yes, I love the potentially maddening level of stress that’s involved. It’s a field I greatly respect and I want to be a part of, but could potentially be turned away because I want to devote the same kind of attention to my family.
I went to a seminar being conducted at SUNY Downstate, giving advice for medical students as to when they should get married and start families. Literally, the window of opportunity was a few months at best for both, where the birth of a child could potentially set students back a year. Clearly under these restrictions, days-long, traditional Indian weddings are out the window. If I were to get pregnant year 3 or 4, that could be potentially problematic, whereas the first two years were a bit better (but by no means ideal). Heaven forbid you wanted to take care of your child until they were at least more communicative or mobile, and when their fear of strangers was under control (Piagetian child psychology sets this at around 2 years of age). Then perhaps the babysitter could be introduced, if you don’t mind having a babysitter or nanny (I do mind). Children are for many people, a vital part of their lives, and they have the right to get as much time early on with their parents as they can. Yet as far as I can tell, the policy seems to be to leave everything to after you start practicing. That’s great for some people, but others are (still) bound by age-old traditions and (sometimes antiquated though biologically sound) cultural expectations regarding marriage and childbirth.
Hopefully, the domination by men that still seems to be inherent will continue to be addressed, and will encourage more women to live their lives a bit more easily while pursuing their dreams. If any women doctors come across this, I’d love to hear your perspective, given that mine is pretty limited.
*This is all contingent on my getting into medical school. I’m not going to crow about medicine without putting in that little point in there, I’m not in medical school yet. Hopefully I will be soon, gotta take it one step at a time. Even contemplating residencies is a long way off, but it can’t hurt to start contemplating a little now! 
I was reading the New York Times Sunday Magazine, and came across an interview with Joan Rivers. I think it’s fair to say she is the poster-child of plastic surgery, and plastic surgery gone wrong. She justifies her various plastic surgery procedures by citing the fact that she is in an industry where youth is prized. Perhaps. But is it really worth it?
I’ve never been a fan of plastic surgery for cosmetic enhancement, with rare exception. Plastic surgery seems to serve greater purpose in such cases as reconstructing the faces of burn victims, or allowing the patient who has had a mastectomy to retain some sense of womanhood. Filling lips with Restalyne to make them more pouty or increasing someone’s cup size three cup sizes so they look good in a bikini top doesn’t seem worth it.
Or is it?
I guess the main argument for most of the cosmetic procedures is boosting self-confidence. It’s a valid argument in some cases, but not all. Scar removal, for example, is valid. Removing moles and birthmarks, too, is valid (especially when they are suspected of being cancerous). Cheek implants? Butt implants? Not too sure about that.
Most cosmetic procedures are not permanent solutions, and require years of follow-ups, and sometimes repeat treatments. They are painful and potentially dangerous, in some cases. Breast implants, for example, almost always calcify (as is the case with most foreign objects introduced into the body), causing breasts to become hard and distended. In the case of silicone implants, the calcification carries the risk of causing rupture and leaking of the silicone gel into the body. Lip plumping agents are often temporary, and require visits every 6 months for more injections of collagen, Restalyne, or some other compound. Why go through that if you really don’t need to?
To a greater extent, people flock to creams and lotions that promise a reduction of wrinkles and a more youthful appearance. Everyday, we’re bombarded with ads promising youth in a bottle, jar, or a tube. Each has limited success, yet the bottles, jars, and tubes fly off the shelves everyday, in staggering numbers.
Here are a few numbers:
- In 2007 11,701,031 surgical and nonsurgical cosmetic procedures were performed in the United States. A little over 2 million of those were surgical procedures.
- Since 1997, surgical procedures have increased 123%, nonsurgical procedures have increased 749%.
- The 35-50 demographic makes up the most procedures.
- Yes, even men are getting work done, though not at remotely the same rate as women (ex. 300,472 Botox procedures in 2006 for men, versus 3,181,592 for women).
(Source: Cosmetic Plastic Surgery Statistics)
I think the worst part is that, while some procedures do a decent job at mimicking the natural state, when the procedure goes wrong, it goes horribly wrong. I’m not going to cite examples, because I think we can all think of at least one or two that fit the bill.
Why are we forever after this standard of youth and beauty that, after a while, becomes harder and harder to achieve? Why are women invariably the ones that head for the skin cream, Botox injections, and surgeries at greater rates than men?
What are your thoughts?
This seems like the next logical step after that last New York Times article I commented on.
Here are the steps the author proposed:
• Ask permission to enter the room; wait for an answer.
• Introduce yourself; show your ID badge.
• Shake hands.
• Sit down. Smile if appropriate.
• Explain your role on the health care team.
• Ask how the patient feels about being in the hospital.
Sad to say, I can’t think of one doctor that fulfilled even two out of these steps, let alone all six. Usually, this is how most of my appointments go:
1. Doctor barges in. Clothes/hospital gown may or may not be on.
2. I squint to read the name on his badge. The resulting squinting-wrinkles will probably require another doctor’s visit.
3. I don’t like shaking hands, so it’s ok if they don’t with me. I suppose though, as a matter of politeness, it should be encouraged.
4. Actually this one doctors do make an effort to do. I’ll admit that. However, that does not mean that there’s necessarily a friendly personality behind the smile all the time.
5. This one’s sorely lacking. Most doctors either briefly say “I’m your doctor/neurologist/surgeon,” and leave it at that. I don’t know many that go extensively into their role.
6. Thankfully I haven’t had to worry about this one yet, but I’m sure this is something that is sorely lacking among doctors in hospitals. People are skittish about being in hospitals, generally, and at least if a doctor acknowledges that if even tangentially, it makes the experience less harrowing.
How have your experiences with doctors differed, if at all? Anything notably positive or negative?
Tell me something I don’t know, New York Times and Yahoo! News. It seems this is the day for doctor-related articles, one in the New York Times, and the other through Yahoo! News. The rest part is being addressed, and will hopefully be implemented into current training procedures for young doctors. But what about attitude?
Many doctors, unfortunately, tend to assume a higher-than-thou attitude. This is both true for their attitude with patients as well as other healthcare staff. Arrogance and blaming other people for one’s own mistakes never gets anyone anywhere. Of course, this isn’t a trend with all doctors, but it seems to be a trend with many. I’ve had my fair share of experiences with arrogant doctors, both as a patient, and otherwise and it’s not a fun experience. This will be harder to change, and is more the responsibility of the doctor than anyone else. Nonetheless, mandatory seminars emphasizing team effort and good attitude can’t hurt, especially if they’re factored into the continuing education credits all doctors need. Just a thought.
Here is some stuff to justify that last post.
I am doing my MPH as well as my MS. My MPH has given me a lot of insight as to what is wrong with the system, which is a lot. Public health gives people a birds eye view of health dynamics in a population, and for me, I’m doing my MPH at a school that is set in an ethnically-diverse, low SES community. You want to talk about how the healthcare system is failing? Just look there. Everyone’s on Medicaid, but Medicaid does not equal good treatment by doctors. Compare the facilities of a public hospital to a private hospital and you’ll see what I mean. Doctors need to stop worrying about how much they are going to be paid, and the system shouldn’t shortchange hospitals accepting Medicaid patients to begin with. The insurance system is a mess, but that’s for another post.
In an article by Forbes, it says “within the next 15 years, the United States will experience a shortage [of physicians] of between 90,000 to 200,000 physicians,” owing mostly to the problems that the system has now, like health insurance, the ridiculously long training period, and other things like malpractice insurance and the astronomical medical school debt. The shortage probably wouldn’t affect urban areas, given the concentration of doctors per square mile, however given that rural areas are already hard pressed for enough doctors, this will devastate them. I already touched on how long the training period is in the last post. Malpractice insurance is more a function of the fact that doctors have become easy targets for suits, more than anything, though could also be related to the fact that the pressures that they face increase the number of mistakes that they make. Yet why do medical students have to pay through their (insert orefice here) to become doctors?
This relates back to my “why does education cost so much” post. While I could rant myself about how the costs of medical school, like undergraduate institutions, are rapidly outpacing inflation, I found a blog that does a better job at explaining it than I ever could. The point is made that given the insane cost of medical school, and subsequent debt, specialization seems all the more lucrative, not because it is inherently interesting but because one can pay their loans off faster. Thus we are left with a dearth of primary care physicians, and specialists who are not totally vested in what they do. Now, primary care physicians are themselves leaving the profession in droves. So what does that leave us? It leaves us with a huge problem. Yes, they are increasing class sizes at medical schools, yes they are even creating new medical schools, but is it too little too late? Other things need to be addressed, the cost of studying, the time period allotted for medical education, etc.
This is not about me whining about not being in medical school yet, I’m applying soon enough, and I’ll deal with it as it comes. This is not about sour grapes, I haven’t lost anything yet, and even if I have, I’m not going to whine about the fact that other people got there before me. They deserve it, wholeheartedly deserve it. Yet if I can’t be opinionated, if medical students can’t be opinionated, and if doctors can’t be opinionated, we have a problem. This is not about me blowing steam without solid facts. The facts are there. We’re losing doctors, and we’re not replenishing them in areas where they need to be replenished. Above all, though, our healthcare is not equal across region or society. Not remotely.
So getting back to my previous thesis, something’s got to change.
I will tag this with the tags for the aforementioned post. If you want the password, you will have to comment on this post and I will email it to you.
