Well I guess I'm the idealist now. I'd like to believe that there are SOME women here who are looking at more than just how much money they're going to make, who are really interested in making a difference in the lives of someone other than themselves and people related to them. For single parents I understand the money consideration but for those of you with with husbands who work, really how much money is enough????
And BTW, what's WRONG with providing care to all medicaid patients? Ok, so instaed of a 5000 square foot home, you have a 3000 square foot home. Instead of a new 7-series BMW every year, it's one ever 5 years. Having volunteered at a public health clinic and once considered becoming a FP to practice there, I guess I MUST be missing the point. Finally, I found it quite enjoyable to work in the inner-city. Working around professionals including nurses, techs, and other support staff who were truly committed to the health of the poor was quite inspiring. And the patients were NOT the type you see on TV either. There wasn't a week that went by that I wasn't inspirired by the patients at the clinic and but more importanly, made to feel more appreciatve of all the advantages God has blessed me with because I was there. No, I can't buy a pair of Jimmy Choo's with that, but thank goodness there's more to life than that.

This has been an interesting thread to follow - there was a discussion some time ago like this on a physician only board that I read with some regularity. Someone had brought up treating Elizabeth Edwards for breast cancer. Most of the physicians on that site graduated medical school from a little over 15 years ago (like me) to over 30 years ago. Interestingly, while many did discuss some of the frivolous manners in which they were named (but usually dropped) from a malpractice suit (and the associated costs), there were no statements to the effect that they would not treat Elizabeth Edwards, the wife of probably now the most well-known malpractice attorney. Many on the site discuss their frustrations with the economics of medicine, the inability to care for their patients in the way they'd like and how increasing regulation is overwhelming them (especially those in primary care).
I found the direction of the thread here and over there to have taken on a "different lives", so to speak...

Well, that's my one cent -

CaliMD - who drives a 13 year-old car (japanese sedan), lives in an average home and has worked in inner city areas and spanish speaking only clinics (surprisingly, the suburban and insured patients are often much more difficult and I was able to work in the city due to being employed rather than running my own office). But yes, student loan issues are often HUGE now - I owed a lot for school and endured DOUBLE DIGIT interest rates but I can't even imagine the debt some are incurring right now!
I agree with what pathdr2B says about the community or inner city clinics -
btw, what are Jimmy Choo's?

And BTW, what's WRONG with providing care to all medicaid patients? Ok, so instaed of a 5000 square foot home, you have a 3000 square foot home. Instead of a new 7-series BMW every year, it's one ever 5 years. [/QUOTE]

Your practice would be bankrupt if you saw only medicaid patients. The above poster was *not* exaggerating when she said "pennies to the dollar". It's not the difference between a huge house and "just" a big house. A doc who took only medicaid would be lucky if they could afford a used honda let alone a bmw - even if it's the cheapie 3-series. We pay more in property taxes each year - 98% which funds 25% of the county's medicaid costs than my husband collects from ALL of his medicaid patients.

BTW, we live and work in a rural, underserved area.

Jimmy Choos - veddy sexy shoes. (and ones that no human could walk in)

Once again, I should have been more clear. Public Health Physicians (FP's, Peds)see "medicaid" patients with a starting salary of ~90K. Is there anyone other than me that CAN live off that???

I'm NOT specifically referring to setting up shop, but it's a lovely thought to believe that one day someone would want to apply for a grant to supplement their income and START a clinic for medicaid patients.

And what's wrong with a used Honda? Nevermind, Jimmy Choos in a used Honda probably wouldn't go over too well!!! :no:

NO sacrasm intended, but I think this is great!!!!

Perhaps I am misunderstanding, but there is no way a solo doc could support themselves seeing *exclusively* medicaid patients. Their income would not be 90K a year.

Nothing is wrong with a used honda. I bought myself a 3 yr old '98 Nissan Altima for 9K and DH bought himself a 3 yr old Saab. Can we afford new cars, yep, but see it as a waste.

BTW the 90K is *before* taxes then take off taxes then take off loans and you will see that there is some left but not this huge amount that folks are thinking....I busted my arse this is so long and hard....that I do want to live comfortably and have a couple of D&G if the need arises....I mean do not get me wrong one of my major roles is to be actively involved with the Hispanic community wherever I end up to include providing clinic days whenever I can pro bono for those that have no healthcare. ..

i may have posted elsewhere that i have a contract to see medicaid "HMO" patients, a pilot program in our state to look at care in private settings. its been great seeing this different group of patients. I made my own contract, i played hardball on the $, so they pay near what other insurances pay me....the main downside has been the ridiculously stupid admin side of things...

spend more time (after my billing person hits a roadblock as she NEVER has done with any other insurance) trying to get the $ owed me, much less in a timely fashion. I've told them i will stop seeing new medicaid patients if i'm not paid up by the end of Feb...they owe me thousands of dollars from the last half of 2004, AND they kicked a PREGNANT patient off their services for no good reason (I'm still seeing her occasionally and will push them for the $)...she's been stable for almost 2 years and might just need some help managing her bipolar disorder while off meds for her pregnancy.....if she doesn't qualify for this program then WHO does.... her finances hadn't changed....she and i have gotten many different answers about why she was disqualified, none of them make any sense...

don't get me started...like most jobs i've had in medicine, it isn't the patients who are the problem, but the paperwork and admin/systems issues.

As an attorney who is now also a pre-med, this is a stunning thread to me. First and foremost, I'd like to extend an olive branch from the lawyers to the doctors. I think it is so sad that two professions that actually have so much in common (having people's wellfare in your hands, handling access to the deepest most personal parts of their lives and handling that in a responsible manner, a desire to make people's lives better, etc.) should be so alienated from one another.

I can certainly understand why many doctors are so sensative about the topic of malpractice attorneys, and I appreciate the fact that many who have posted here have noted that not all attorneys are evil ambulance chasers.

But I bring a different perspective to this debate because I have personally experienced the devestation of being refused care because I was married to a lawyer.

Since I always assure doctors up front that I do not do medical malpractice (I'm a corporate, criminal, and civil rights attorney), I haven't had any problems because of my own profession. But my husband, who is a lawyer, was the Genearl Counsel to our Governor while I was pregnant, and that caused un-expected repercussions.

Our state was in the middle of a medical malpracice crises. The Governor eventually sponsored legislation to adress it, and that legislation largely won the support of the medical community. But while I was expecting, the legislation was still being hammered out, and the debate was ugly. The Governor had not yet given into all of the doctor's demands, and their lobbying group was livid.

One day in my first trimester, after my obstetrician recognized my husband's name in the paper, she summarily dumped me and would not even give me a referral to another doctor. Her official reason? "I'm on strike against you people until your husband's boss does something about this mess!"

During this same period I went to another doctor for my 16 week ultrasound. I was a high risk pregnancy, so I was naturally very nervous. When the doctor came in, just as a matter of polite conversation, I asked him how he was. He replied that he would be doing a lot better if my husband would get the Governor to do something about the medical malpracice situtation. He then proceeded to haraunge us through the entire course of the ultrasound, pausing only occassionaly to inform us that every thing looked fine.

Yet another obstetrician to whom I went left a 15 minute diatribe on our answering machine about the malpractice crisis before telling us that some test results were in.

Finally I found a wonderful, caring obstetrician who never breathed a word about the situation, and never expected me to reassure her that I was not a malpractice attorney. Only once my healthy baby was safely in my arms did she say quietly that she hoped my husband could do some good. We both knew just what she meant without her having to elaborate.

As a pleasant post script, my husband later arranged for her to receive an award for distinuished service to the community at a reception at the Governor's mansion in her honor.

If a doctor is so filled with venom against the entire legal profession that she honestly believes that she can't bring herself to deliver adequate care in a non-emmergent situation, then I suppose that it would be ethical, albeit sad and ill-informed, to refer the patient elsehwere.

But I certainly wish that there were better communications between the two professions to eliminate this kind of broad based ill-will, and I certainly think that if a physician feels she simply must refuse to handle a patient that she could at least swallow her bile long enough to treat that patient with a smattering of dignity before kicking that patient to the curb.

And as for a lawyer's ability to pick and chose, to which someone on this thread alluded, we are allowed to pick and chose based ONLY things such as on our evaluation of the mertis of the case, our ability to take on the client due to our current case laod, or conflict of interest. The oaths that lawyers in most states take forbid them from refusing a case based on anything having to do with any prejudice against the person bringing a case.

And in a situation analogous to emmergent care, when we are appointed to take criminal cases, we can't refuse them at all unless we have a direct conflict of interest. Also, when a lawyer does wish to be removed from a case, she has to go before the judge and make a very specific showing as to why she cannot handle it. The court will NOT allow a lawyer to dump a client simply because she doesn't like him or thinks he will sue her for malpractie.