Posts by Susan Rodriguez4

If we're talking tiny adjustments, you can just sand them down. But if you need any real leveling, you’ll have to go with the wood filler.

It’s totally possible, especially if those broken teeth have sharp edges that keep catching your tongue.
Go get them fixed or pulled if you can—once those edges are gone, that annoying tongue irritation should stop right up.

Betty Collins45 said:I read somewhere that certain antibiotics can actually stain your teeth... I was wondering if Sumamed is one of those?

Betty Collins45 said:Temporary coloring???

Tetracycline antibiotics can cause permanent tooth discoloration if they are taken during the mineralization stage—basically anytime between ages 5 and 12, depending on the specific tooth. These stains aren't just on the surface, either; they actually become embedded within the mineral structure of the tooth itself. (Just a heads up, Augmentin isn't one of them.)
Temporary antibiotic staining just isn't a thing.

Maria Gomez4Hey! I'm not sure if it's actually worth it, but hey, there's something there.

They aren't worth much. They basically just boil down to basic accounting stuff like tax payments and such. Half the time, someone from Medicare shows up, and their entire argument just circles back to the rights and obligations under health insurance... It has absolutely nothing to do with actual management or running a business.

Ugh, I'm honestly just curious—what kind of business is the Holy Spirit actually running?

I’ve been saying it from the start: running a hospital is a business. Period. So, what kind of business model is the Holy Spirit running right now? It's managing itself, and honestly, that's one of the few institutions that actually understands the need for that kind of approach.

About a year ago, he did this great deep dive on the Mayo Clinic during his morning segment. Honestly, even though the journalist was leaning pretty hard into the populist angle, it’s totally worth your time. There are about six or seven follow-up pieces that came out day after day right after.
I found this bit about the Holy Spirit. Take a look—it’s actually pretty interesting:

You missed the point there. I just quickly threw in names like Piech, Jobs, and Ballmer—plus, Bayer is basically running the whole chemical industry.

I didn't say that. I was just saying that Bill Gates is the one and only.

Do you work in healthcare?

Yes.

Don't get me wrong—I truly believe we can, and absolutely must, manage our money more effectively. But I don't think money is the actual reason the system is broken (which is why some people obsess over the American model or private healthcare). To me, the real culprit is the policy. I’d compare it to running a major U.S. city. Sure, you could argue that if we managed our funds better, we’d have a healthier budget and steady growth, and that makes sense. But what our cities are actually missing is a strong urban planning strategy, a clear idea, and a real vision. Right now, all we have is haphazard, chaotic development paired with overpriced, poorly designed infrastructure.

Of course, everything boils down to politics. It’s politics that decides to put incompetent, underqualified people into positions they have no business holding. It all happens because there's an open invitation to line their own pockets through shady deals or to consolidate power by exploiting the system rather than actually earning it through merit.

If Bandić's buddies hadn't spent so much time getting hitched, the city budget might actually have some money left in it. That's my personal way of describing all that insane spending in Washington, D.C.—you know how it goes. It’s always "hey, I need to throw a massive wedding for my godson," followed by "let me land a sweet contract." Then Bandić swoops in and says, "Sure, just build a public restroom over in Dubrava and I'll hand you a million bucks for it." Is that enough? Probably. But it’s a fact: if those connections weren't being cashed in through weddings and favors, the city would be a lot richer.
If our political system wasn't built on cronyism and backroom deals, we wouldn't even be having this conversation.
Look, we live in a country where it doesn't matter how rock-solid the urban planning is—whether it’s for healthcare, the economy, or education—and it doesn't matter how brilliant the vision or the idea might be. Nothing actually gets built or realized until the political cronies have married off all their buddies and secured every single relative down to the third generation. And let's be real: that's never going to happen.
Regardless of which political party is in power, we have to find a way to fix this system from the inside.
I’m still sticking to my guns on this: the healthcare system actually has enough funding. The real issues are that doctors are generally underpaid and overworked (though some definitely get overpaid because there's zero oversight), nurses have been stripped of their professional standing due to inadequate training, and the bureaucracy is just massive. People aren't dying because of poor medical treatment—let's not make exceptions there—they're dying because of red tape and terrible organization. On top of that, preventative care and palliative care are virtually non-existent. A huge chunk of these problems could be solved simply by managing the money the healthcare system already has much more effectively.

Maria Gomez4
I’m not saying the healthcare crisis is solely about a lack of funding. What I am saying is that mismanagement of those funds throttles the entire profession and creates a mountain of unnecessary headaches. The systemic crisis runs much deeper than just a thin wallet.
From an economic standpoint, healthcare is one of the most demanding and complex industries out there, specifically because we are dealing with human lives.
That’s why, in the US, hospitals are typically run by people who are economists with a Master’s in medical economics, or physicians who have earned that same degree. We're talking about at least 3 to 4 years of specialized postgraduate training just to gain the competency required for the role.
Of course, hospital boards include a medical council to provide clinical guidance. And sure, you can't just cut the power to a non-profit department, but it’s the economist who manages the budget to ensure that never happens. They have the specific know-how to navigate those waters; a doctor doesn't.

We don't really have those specific programs here yet. I know a brilliant, driven young woman trying to pave the way in this field, and people in the hospitals actually laughed at her. They mocked her—as if a Master of Economics wouldn't know anything compared to a Professor with a PhD who’s spent 38 years doing organ transplants.🙄
There aren't even any courses available.
Nothing.
Anyway, my point is this: we need to let specialists manage the money. That way, doctors actually have the headspace, the time, and the resources to advance their expertise and improve patient care, which ultimately makes everyone happier. Look at the Holy Spirit example—where a physician with actual business savvy took over as director. It’s a rare exception that proves the rule, but even within this dysfunctional system, that person worked miracles in a very short time.

As for Milinović, you couldn't be more wrong. He chose a model that is more expensive, detrimental to women's health, strains the system with repeated attempts, and has a lower success rate. It is a total failure, both medically and economically.

Bill Gates is one of a kind. A man with a 170 IQ can do whatever he wants in life. Honestly, if he were running the Department of Health and Human Services, things would be waaaaay better for all of us. Both sides.

What you're calling "sweeping generalizations" actually come from 15 years of experience running a private practice with eight employees. Believe me, I know exactly what this job entails. I know exactly what it feels like when the doctor in me, who cares about the patients, goes head-to-head with the economist in me, who has to make sure everyone gets paid and the vendors are taken care of.😉

fadedmarlin402 said:Maria Gomez4 hit the nail on the head when she pointed out that we are facing a profound crisis in primary care. It’s been reduced to nothing more than endless paperwork, which is exactly why patients have lost so much faith in the system. Even their own colleagues—specialists—tend to mock them, dismissively calling them mere bureaucrats. In reality, family medicine specialists should arguably possess a deeper, more comprehensive knowledge base than any other specialist. Their training covers the fundamental pillars of every single medical field. Instead, we see this ridiculous trend where people are being funneled toward specialists for the most trivial ailments. It's absurd. Honestly, if it's that minor, just deal with it yourself or find someone else.

That’s exactly where the issue lies—with the people who absolutely insist on demanding a referral or a specific prescription, otherwise they just threaten to switch to another doctor. They always think they know better. Look, I’m not saying there aren't doctors out there who make mistakes, but if you don't trust your physician, then change them. Just make sure you actually take a moment to reflect before you jump ship; ask yourself if the problem is truly the doctor or if it's actually you. We have a serious problem with patients essentially holding doctors hostage. Honestly, I think we need to implement health education in our elementary and high schools. We could accomplish so much more if people actually understood the basics of their own bodies, rather than running to the clinic for every minor inconvenience just to demand a referral or a script. Of course, basic knowledge isn't a substitute for medical expertise, but everyone should understand certain fundamentals. At the very least, people should be taught that you don't need a doctor's visit for a 99.5°F fever, that swollen tonsils don't automatically mean you have strep throat, and that you shouldn't go in demanding antibiotics for every little sore throat or case of the flu. It sounds ridiculous, but it’s the truth. It would make a massive difference.

The next issue is the chronic shortage of specialists and high-end equipment in certain facilities, while other institutions are sitting around with absolutely nothing to do. When you combine that inefficiency with everything I mentioned previously, you get one of the primary reasons why the waiting lists are so damn long.

Then there’s the issue of arrogance and sheer disrespect among the staff. It’s a systemic problem. Some doctors—and unfortunately, this isn't an isolated case—take their personal frustrations out on patients and even their own colleagues. I see nurses being rude to patients on a daily basis, and more often than not, they’re overstepping by meddling in the doctors' work. Then you have the doctors who treat patients like commodities. Unless there's a payoff, they aren't interested. Some make it crystal clear that nothing happens without an envelope under the table; others are just passive about it, neither asking for a bribe nor refusing one when it's offered. I’ve personally witnessed elderly patients being written off entirely. There’s this cynical attitude that since they don't have much time left anyway, there's no point in putting in the effort, even when it comes to palliative care. It goes both ways, too. You see older physicians being incredibly condescending toward younger ones and residents. There’s constant shouting, chaos during procedures, laziness, and a general lack of care... I could go on. On the flip side, you have the younger doctors who think they know everything, constantly belittling those with actual experience. Just like any other profession, medicine is increasingly filled with people who completely missed the mark on what this job actually entails. We are seeing far too many "nepo babies"—kids whose parents pushed them into this—as well as straight-up nerds. To be a truly great doctor, specifically when it comes to diagnosis, you need a certain amount of innate talent and intuition. You can't just cram your head full of disconnected facts that don't help you explain anything. There is also an absurd amount of jealousy among the physicians. They literally compete over who has the flashier car, which is hard to do if you aren't taking bribes. So, what exactly are we supposed to expect from people like that? None of the individuals I've mentioned belong in this profession. It is meant to be noble, but they have no business being part of it.

The issue really boils down to doctors who juggle hospital shifts alongside their own private practices. It’s a frustrating pattern: when they're on the clock at the hospital, their bedside manner is nonexistent and they couldn't care less about the patient in front of them. But the second you walk into their private clinic? Suddenly, they're all smiles and attentive care. To make matters worse, I see way too many of them moonlighting privately during their actual hospital hours. We have far too many cases like this happening right now.

Finally, we get to one of the biggest issues out there: bribery. Honestly, both sides are to blame here. If you want to find the root cause, you have to look all the way back to the very beginning of how our healthcare system was built. Historically, people have always brought gifts to doctors as a way of saying thanks—a reward for helping someone, curing an illness, or quite literally saving a life. But really, a doctor should be the kind of person whose greatest reward and sense of fulfillment comes simply from the fact that they helped someone. That is their job. It’s what they get paid for, and it’s what your employer—and by extension, you—are paying them to do. A simple "thank you" should be more than enough. But, as we all know, that’s not how reality works. If someone enters the profession with those kinds of ideals, it’s only a matter of time before things go sideways. And let me tell you, this is a massive burden on the honest, decent professionals in the field. Even the most upright doctors deal with people showing up with envelopes or gifts every single day, and sometimes it is genuinely difficult to shake them off. There are times when people will literally show up at a doctor's front door just to hand them something.

There is still so much more to uncover that you could easily write a massive book about it—and honestly, it would probably be a bestseller. We aren't just looking at a minor hiccup here; we are facing a total systemic collapse, the kind that isn't going to be fixed overnight. Given the sheer scale of these issues and, frankly, the caliber of people currently running this country, it’s likely going to take several decades to sort through the mess.

As long as doctors—not economists—are the ones calling the shots on the financial side of healthcare, the system is going to remain a bottomless money pit. This constant lack of funding will inevitably stifle medical innovation and service quality, which only fuels more frustration for patients. It's a vicious cycle.
The American healthcare system is bleeding cash through a million different holes. It’s exactly like any other massive corporation suffering under incompetent leadership.
Look, I’ve never heard anyone claim that a pharmacist runs the entire pharmaceutical industry. You don't see a software engineer calling the shots at a massive tech firm, and you certainly don't have an auto mechanic running an entire car factory. So why on earth do we insist that hospitals have to be managed by doctors? Most of them aren't even trained for administration, and honestly, they don't know how to do the job. It isn't even their primary career—it’s just an extra burden tacked onto their actual medical duties.😲😲😲
And let's not even get started on how much harder this is than running any corporation or massive conglomerate. When you factor in that human life is an immeasurable economic variable, the whole job becomes infinitely more complex and demanding.

The way our healthcare system works is backwards: it actually rewards laziness. It doesn't matter if you're looking at primary care, specialists, or major hospitals—it’s the same broken logic everywhere. The Department of Health and Human Services gets a set budget, and most of that just goes straight to payroll. But the rest? If you actually step up and do your job, you're viewed as a liability. In this system, being productive is treated like a loss on the balance sheet. Basically, if you want to get ahead, just don't do anything.
It all starts with primary care being funded through this broken fee-for-service model. It basically creates a system where the harder a doctor actually works, the less they make. So, to ensure they can actually pay their bills and survive, they end up writing prescriptions that don't cost them a dime.
Secondary care has basically vanished now that they've dismantled the community health center system.
Hospitals are a whole different story.
While surgeons around the world are pivoting toward minimally invasive procedures—designed to get patients out of the hospital quickly and back to work in six days instead of six weeks—our system is stuck in the past. Here, they admit you five days before the surgery, keep you an extra five days after, and then toss you onto long-term disability for weeks. To make matters worse, Medicare gets billed for fifteen days of hospital stays, even if the actual procedure only required three. It’s a massive waste of resources. That surplus cash could be used in a million different ways—upgrading equipment, advanced training, or better patient care—but instead, it just vanishes into the bureaucracy.
Of course, this also brings up the issue of staffing shortages in certain facilities—not to mention how much easier it would be if we could actually speed up patient turnover.
It’s actually pretty fascinating to watch private clinics like State Farm or Sunce thrive. They aren't just getting by; they are absolutely killing it, and everyone—from the patients to the doctors—seems genuinely happy with how things run. I wonder, do any of them have a director who is also a practicing physician? You know, someone who handles the clinical work in their own office while simultaneously running the whole show?

All at All, my take is this: if we actually put some competent people in charge of our healthcare system, they could—and honestly, they should—get everything back on track pretty quickly. If that happened, life would be a whole lot better for everyone.
The Secretary of Health and Human Services has zero business deciding which women are allowed to have children. That’s not his job. His actual job should be making sure the budget is handled properly so that anyone who wants to start a family can access the highest possible standards of medical care. Period.

Kate Collins67 said:Look, I don't know about you, but if you finished your specialty and then worked, fine—but I will absolutely put in the work. If you're pulling 88 hours of overtime a month in an ER where you're basically running the whole show solo, then honestly, the hospital shouldn't even bother paying me, since the hospital is the one educating me...

To work in hospitals, specialization is mandatory—it’s just a built-in part of continuing your medical education. Therefore, the government—not individual hospitals—has to fund these specialties if they want anyone to actually staff the system. Since the system doesn't return anywhere near the amount of money invested, self-funding isn't an option unless you come from a family with deep pockets.

Besides, the government funded all our high school workers to meet its own needs, right? So, are those people somehow obligated to repay the state? Are they bound by contracts or any other college degree paid for by the Department of the Treasury, or are these people tied down by contracts to federal agencies? I wouldn't say so.

Well, go ahead and do it. Go above and beyond, sure, but don't do it at the very facility paying for your residency. Unless you're specializing at Mayo Clinic specifically to stay at Mayo Clinic, but then you're just part of the "chosen ones."
I'm not talking about the workload; I'm talking about working for one employer while someone else picks up the tab. And that second party expects you to deliver exactly what they paid for.
Usually, the specialty training is covered by the government—meaning Medicare handles the costs (if they aren't private)—while the actual employer (the institution that sent you for training) covers salaries and benefits, which is a much bigger expense.

As for contracts, yeah, anyone receiving scholarships during school—whether it's high school or college—is typically required to work for the organization sponsoring them. Residencies fall into that category, though it's a bit of a win for you since you still earn seniority credits while you learn.
Don't even get me started on the quality of the training. It really boils down to what you said earlier: as a young doctor, you're being worked to the bone for 88 hours a week because, to the institution where you're learning, you're nothing more than free labor. They couldn't care less about your actual knowledge or whether you even have the time or the mentors to learn from.

Kate Collins67 said:

Susan Rodriguez4 I can't even begin to wrap my head around what they’re saying here. Seriously, how does anyone look at this situation and think it makes any sense? It’s like we’re living in some kind of alternate reality where logic just went out the window—is that what we've become? Just accepting whatever nonsense gets pushed our way without a second thought? It's frustrating, honestly. You try to make a point, you try to point out the obvious flaws in the system, and then you get met with this level of sheer, unadulterated stupidity. It's enough to make you want to scream into a pillow. We need to be asking better questions—real questions—instead of just nodding along like everything is fine. Because it isn't fine. Not by a long shot.
Of course they’re going to tie you down for ten years. It’s a total racket. You’ve got a hospital or a medical center sponsoring your residency, right? They’re covering your salary, paying for your entire medical school tuition, and even handling your pension and health insurance contributions. And then what? After three, four, or maybe five years of them footing the bill, they expect you to stay in their grip. It's basically a gilded cage—they pay for everything upfront just to make sure they own your career for the next decade. Makes sense from their perspective, I guess, but isn't it just a way to manufacture indentured servitude under the guise of "professional development"? Honestly, what’s even the point of having that doctor around during residency? It feels like a complete waste of time—seriously, why bother? Most of the specialists are already out working at different hospitals or private practices anyway, so they aren't even physically there to actually help. It's just one more layer of useless bureaucracy when you're trying to get things done.
It’s honestly ridiculous how the system is set up—even after you finish all that grueling medical school and residency, there's this binding contract hanging over your head. Basically, you're forced to sign an agreement where you owe the hospital or university that funded your training twice the length of your actual schooling. You're essentially indentured to them! And if you decide you want some actual freedom or a better opportunity elsewhere? They come after you for every cent of the tuition plus massive penalties. How is that even remotely fair? Is this supposed to be "serving the community," or is it just a way for big healthcare systems to trap talent? It feels less like a career path and more like a debt trap designed to keep doctors on a leash. Look, let’s be real here—does anyone actually believe they have to pay back every single cent of their wages and taxes? Because I certainly don't. It’s all just a giant, circular game of musical chairs played by people who think they can control every penny we earn. Why should we be expected to play by these rigid, suffocating rules when the system itself feels like it's constantly shifting under our feet? Is it even necessary to settle every little discrepancy, or is that just more bureaucratic nonsense designed to keep us running in circles? Honestly, it feels like a massive waste of energy. For most specializations, the money just moves around in circles—it’s all just shifting from one pocket to another without actually changing anything. We’re talking about a range of $30,000 to $50,000—and honestly, let’s be real for a second—is that even enough anymore? When you look at the numbers, it feels like we're just spinning our wheels. Is anyone actually seeing that kind of money go as far as it used to? It feels like a drop in the bucket when you consider how much everything costs these days.Honestly, it’s about time we started looking at this logically—the amount should be scaling down proportionally with every single year that passes. Why wouldn't it? It just makes sense to have it decrease steadily as the years go by.
So, let me get this straight—even after all that, the doctor decides to just pull the plug on the contract early? And what happens next? They sit down with the facility and hammer out some convenient little deal for a 7 or 10-year repayment plan—no late fees, no interest, nothing—and then they just walk right out the door into private practice, pocketing $2,000 in the process? Are you kidding me? Is that really how the system works now?$1000 So, let me get this straight—we’re actually talking about monthly interest-free loans now? Are you kidding me? Is this some kind of joke or a fever dream? I mean, seriously, where does the math even work out on that? You can't just pull these things out of thin air without someone, somewhere, footing the bill. It sounds great on paper—doesn't it? It sounds like a total lifesaver when you're staring down a stack of bills—but there's always a catch. There is *always* a catch. Who is actually providing this? Some massive bank looking to lure people in with a shiny carrot before they hit them with hidden fees? Or is it some government program that’s going to evaporate the second the political wind shifts? Honestly, it feels too good to be true, which usually means it's a trap. What’s the fine print actually saying? Because I guarantee you, once you dig past the headline, there's a mountain of strings attached.
Honestly, if you ask me, these contracts are way too soft. We need much heavier penalties and significantly longer repayment terms if we actually want to see any real accountability. Why are we even settling for these weak terms? It’s ridiculous.

Are you living in some kind of parallel universe? Seriously, what are we even doing here?

Look, it’s just one piece of the puzzle—it isn't the whole damn specialization. What’s even the point? In that first phase, you basically pour your entire soul into the job, breaking every rule in the book just to satisfy this institution that—as much as they love telling me—is supposedly "providing for me." But let's be real: they aren't actually fulfilling their end of the bargain when it comes to education. Instead of getting actual training, you just end up becoming a self-taught doctor. Is that really what we're calling professional development these days? It's ridiculous.

Look, they basically have to pay back every cent of those salaries and taxes—money they didn't even actually earn. Think about the math here: they’re paying out specialist-level gross salaries when all they're actually receiving are specialist-trainee rates. So, they take that money, pay themselves for the work they did for the institution, and then what? You end up in this absurd loop where you're essentially working a job only to rack up a massive debt in the process. It’s madness. Every single paycheck that hits your account ends up being treated like a personal loan you owe back to the system. Can you even wrap your head around that level of stupidity? Imagine working your tail off just to realize you actually owe the employer money for the privilege of working there. It's completely backwards.

Look, let’s get real about the numbers here—we're talking roughly $200,000 to $350,000 just for the specialization itself. That’s the ballpark figure. And keep in mind, that price tag is specifically for the folks who aren't going under a formal contract—you know, the ones who choose to pay their own way out of pocket. But there's a massive catch that people seem to gloss over: you aren't pulling in a salary, and you aren't paying into any benefits or social security during those four grueling years. It's a massive gamble, isn't it?

1. The issue of self-taught doctors is unfortunately everywhere in the medical field. Our education system is pathetic; knowledge isn't valued during training or afterward. But that's how it is in all government agencies. Doctors are no exception here.
Likewise, doctors who get their white coats and specialize for a specific institution often feel neither gratitude nor any moral responsibility toward the entity that enabled them to train and acquire the knowledge that stays with them for life, rather than staying with the institution. That is exactly why these restrictive contracts were created.

2. Yes, you have to pay back the salary (my mistake), and in some hospitals, you even have to pay back the specialist's salary that was covering your position while you were learning.
You aren't creating debt because you aren't performing your full job. In reality, you're getting paid upfront. I wonder what your stance would be if you only started receiving a paycheck after you actually began working for the institution you specialized for? How would you survive during your training? That’s why I say the institution is feeding you. They are paying you in advance for future work. (A gross salary of $4000 comes to 432 $0.00 over 3 years).

3. Residency costs $5000 per year. Knowledge is the cheapest commodity we have.
People who "refuse" to sign a contract pay for their own training, but no one gives them a paycheck during that time; they have to find another way to earn money to eat and live. On top of that, they still have to pay for Social Security and Medicare. During that same period, for those under "contract," the institution pays out that 432 $0.00.

Therefore, a contract is the most normal way for an employer to protect themselves and their investment. You see this in every private corporation and business. The government is the only entity with enough cash to not care if they train someone only for that person to jump ship to another job. A private employer can't and won't allow that.
Look, medicine might be the only field where the government has actually adopted a market-based approach. Unfortunately, the contracts vary wildly, drafted under vague regulations and unclear criteria, which makes them a constant source of frustration and confusion. But if they are needed, they are. They just need clear criteria and parameters. But Milinović doesn't have the guts to implement that, because then the "chosen ones" wouldn't be able to dodge the contracts.

jadesailor14 said:And they really lock you in for 10 years? That feels like a bit much!
But hey, knowledge is expensive, and everywhere you go, people get tied down when there's a huge investment involved.

At least you'll have the chance to make some extra cash on the side
if our Secretary's wild idea to scrap this actually happens.
I'm really not a fan of that plan!
And honestly, those on-call shifts are just awful—it's totally not right.

It makes sense that they tie you down for 10 years. A hospital paying for a resident's pension, health insurance, salary, and tuition—all while they're training for 3, 4, or 5 years—is a huge commitment. Most of the time, the hospital doesn't even see much benefit from that doctor during residency because specialists are usually working outside their home institution anyway.
Once training is done, there’s a contract where the doctor agrees to work for the institution that funded them for twice the length of their training. If they break it, they have to pay back the tuition plus penalties. They don't have to pay back salaries or benefits. For most specialties, we're talking about $30,000 to $50,000, though that amount decreases proportionally for every year served.
Even then, if a doctor decides to walk away early, they just negotiate a 7 or 10-year repayment plan with the hospital, interest-free, jump over to private practice, and pay back an interest-free loan of maybe $250-$300$1000 a month.
These contracts should actually have much higher penalties and longer repayment terms.

bluehawk37 said:A pharmacist's job description includes giving advice; if they don't do that, it's their own fault.
Yet, nobody blames them.

Kindness is always extended to a kind patient. But there is nothing in the manual
stating I have to kiss the feet of a patient who is arrogant or rude.
As my namesake colleague would put it: arrogance must be earned. 😁

Pure nonsense!
I refuse to let some snobby, ill-mannered, arrogant person drag me down to their level. This is about professional standards. In a doctor-patient relationship, nothing should be "earned"—neither kindness nor rudeness. It's all about basic decency and maintaining a professional distance from your personal feelings.

Jacob Fox6 said:Oh yeah... now that you mention it, you just reminded me... I heard that general practitioners make their biggest bucks from Medicare specifically by targeting older patients, so they try to stack their schedules with as many seniors as possible...

True, but they’re also the ones spending the most of it. On average, older folks definitely need medical care way more often than younger people do.

Jacob Fox6 said:Man, that really is a tiny amount...😲
I had no clue.
And I mentioned someone more informed could jump in to clarify, but honestly, I thought we were talking about some serious cash... this is just straight-up pathetic, just like you said. It's honestly embarrassing...

Yeah, exactly.
Generally speaking, principal amounts vary depending on the age group. For the 18 to 65 demographic, the figure sits at approximately... $67 Maybe bump up the annual coverage slightly for the older crowd.
OB-GYNs have some nerve. $29 Annual cost per patient: 86 / 12 = 7.17$2.50 Every single month!
Big Pharma is basically running the ultimate scam against hardworking primary care doctors. It’s a brilliant setup for anyone looking to dodge work—the less you actually do, the more money stays in your pocket.
It’s a joke, really. Nurses have their salaries locked in by collective bargaining agreements, yet I’ve walked into more than one clinic where the doctor’s paycheck at the end of the month is nowhere near what the nursing staff is pulling in.

Jacob Fox6 said:Honestly, better that way.🙂

The only thing is that dentist you used was still getting paid by Medicare, and man, that's not exactly pocket change...

$45 for the whole year, or $3.75every single month.
That amount isn't just large—it's pathetic.

Angela Wright said:They have a right to know while there's still time to hunt for other options! Are you really so numb from being in that profession that you can't grasp basic logic or follow a simple analogy after reading through this thread? Every single day at our foundation, we take in medical records from people who have been written off, and we send them abroad to get second opinions at top-tier clinics. And don't even get me started on rare tumors that nobody in our local medical establishment has the expertise to handle. We're talking about kids suffering from things like sarcomas. When we look overseas, we get a massive influx of options and different ways to approach treatment. You wouldn't believe it—many people who were essentially given up on here end up seeing results that blow your mind, once the protocols actually manage to fight their way through our healthcare system.
You won't get that kind of honesty from the doctors here. They won't say, "I don't know, I haven't seen this before, but you should talk to Dr. Smith." It's all about ego and prestige. They'd rather rob a patient of a chance to extend their life—a chance that might mean the entire world to someone—just so they don't look "weak" in front of their colleagues.

I couldn't agree more.
If our doctors actually had knowledge that was even half as big as their egos, we'd hear the truth more often.
To tell someone, "Hey, you need to go to Mayo Clinic for this," you actually have to be smart enough to know that's the move. But knowledge doesn't pay the bills, it doesn't add hours to your shift, and it doesn't boost your status. The only thing that should matter is whether the patient gets better, period.

Kate Collins67 said:Giving a patient a choice... based on what exactly? Heaven forbid I have to pick which wire to cross in an electrical circuit when someone's life is hanging in the balance—and let's be honest, wiring isn't exactly my specialty.

What you're describing is just modern medicine—or more accurately, "alibi medicine." It's a convenient way to shift all the responsibility onto the patient's shoulders because, hey, it makes your job easier, right? But honestly, it surprises me that you—someone who claims to actually care about patient outcomes—would advocate for such a cowardly approach to medicine.

I'm not talking about any kind of alternative medicine.
The approach I’m talking about requires a hell of a lot more expertise and accountability than just blindly following some basic one-dimensional protocol. It’s not like those surface-level steps 1, 2, or 3 actually worked for you—it’s a shame, really. Goodbye.
Most of the time, we just get it done without all that "we're so sorry" nonsense.
As a patient, I have a fundamental right to be cured as effectively and quickly as possible. On your end, as a doctor, you have a duty to lay everything out on the table—tell me exactly what my options are, including your limitations. That part about what you can and can't do? It’s usually the first thing people skip, and honestly, that's where I have zero tolerance.
That’s exactly my point. It isn't about shifting the blame.

Jacob Fox6 said:I mean, this whole thing just doesn't add up at all... judging a doctor's actual medical expertise based on whether they happen to be having a good day or if they're just in a bad mood is totally baseless... like, seriously, that is just straight-up nonsense...🙄🤣☕

There’s no such thing as a "bad day."
Basic professionalism dictates that anyone working with people should stay smiling and polite.
I would never let a stranger—a patient—see that I'm having a rough time or feeling grumpy. Even if I were screaming on the inside.
Plus, you're giving people way too little credit. Not everyone without a medical degree is clueless.
People can tell pretty quickly if you're actually a competent doctor or not.
swiftbear86 was only talking about first impressions.

Jacob Fox6 said:I'm with you on that. But let's be real, some things are just way easier to explain than others... If someone has a fracture, but it's complicated or open and stuff, it gets so much harder to walk them through why they need surgery, or antibiotics, or why they might have trouble walking later on... Some things are simple, some aren't, but if you can simplify something without losing the actual point, then you definitely should... But try explaining a brain tumor that completely changes someone's personality! From what I've seen so far, the issue isn't usually that doctors don't tell patients what's wrong—honestly, I haven't met a single doctor who hasn't told a patient their diagnosis unless the patient couldn't understand it—it's more that people suddenly want to know every single tiny detail right away. I honestly find it hard to believe anyone expects a doctor to give them a full lecture on their medication... that's just "too much"🙄... And if they get a diagnosis but have no idea what comes next, that's not on the doctor, it's on the healthcare system and how weirdly it splits up responsibilities between specialists and primary care docs, where nobody is allowed to step outside their own lane...

Look, nobody is asking you to give them a PhD-level lecture; they are asking for options. If you have a patient with an open fracture (since we're talking about that), it's your job as the doctor to say: "You can go into surgery; here are the recovery odds, here are the potential issues, and here are the possible complications." If you don't lay out those chances, risks, and complications, then the patient feels like the path you suggested is the *only* path. They expect a cure because they think they had no choice. If they don't get better, they'll come after you with everything they've got.
And the idea that patients wanting to know everything is somehow shameful? Give me a break. When I take my car to a mechanic, I want to know exactly what he did to it, so imagine when it comes to my own body! It is their right to know!!!!!! I will say it a million times if I have to.
Thank God we have the internet and patient advocacy groups nowadays. All you really need to do is point the patient toward where and how they can research the condition they're dealing with. That's really not that hard.

Kate Collins67 said:So, what I’m trying to get at here is—does a backup protocol actually exist if the first one falls through? Or better yet, is there some kind of third, fail-safe protocol waiting in the wings if the second one fails too? I mean, seriously, how is this even structured?
In some perfect, utopian fantasy world, "personalized medicine" supposedly leads to better patient outcomes. But let’s get real for a second—in the actual, messy world we live in? It’s nothing more than a convenient smokescreen used to mask incompetence and sheer ignorance. It’s the ultimate loophole, isn't it? If you follow standard protocols and screw up, there’s a paper trail and accountability. But if you decide to just wing it because you want to be "individualized," suddenly you have the perfect excuse ready to go. When things inevitably go south, what’s the defense? "Oh, I wasn't being careless; I was simply tailoring my approach to this specific patient's unique needs!" It gives anyone the freedom to do whatever they feel like without any oversight or control. How can you regulate someone when they can hide behind the vague label of "personalization" every time they make a mistake? It’s a total disaster waiting to happen.

Thanks for pointing out that I'm not some kind of god—I guess I must have been acting pretty high and mighty somewhere along the line if you felt the need to take me down a notch... clearly, I needed the reality check.

I don't even need to sit here and play judge regarding who’s got enough sense and who doesn't—I can tell the second I start talking to them. Honestly, I have to wonder... do you actually work with people in the real world, or are you just sitting there putting them on this ridiculous pedestal?

It's clear we see our profession through completely different lenses.
I've been working with patients every single day for 15 years, and my philosophy hasn't changed: as a doctor, my duty is to provide the diagnosis, explain the treatment options, and lay out the expected outcomes for each path. After that, the patient has every right to decide which direction they want to take.
My role is to provide the expertise; the patient makes the choice regarding their own health.
That’s how I’ve practiced for 15 years, and that’s how I’ll practice for the rest of my career.
I know plenty of colleagues who operate this way—people with massive experience and deep knowledge who stay calm, collected, and never burn out.
And their patients are thrilled...
For those of us treating actual human beings rather than just managing symptoms, seeing satisfied patients makes all the stress worth it. That's just being human.
And honestly, a smile costs absolutely nothing. Nothing at all.
I would never dream of labeling someone as "unintelligent" just because they don't grasp something outside their field of expertise. By that logic, you'd be considered "unintelligent" by a lawyer because you don't understand legal jargon... at least according to lawyers with your mindset.
Also, categorizing doctors into "grumpy experts" versus "nice amateurs" is frankly ridiculous.
Being kind is about being a decent, cultured person. It has zero correlation with clinical knowledge; it's strictly about how you carry yourself.

Jacob Fox6 said:That's exactly what I was trying to say...🤷
I said I had nothing to do with that department and I had no clue where his labs were, and I only said that maybe five times total... 🤷

I totally agree that working with people is never easy. And I get that patients are going through it too the second they walk into a doctor's office. But the kind of patient you described sounds like a perfectly rational person, and honestly, not everyone is like that. Some people are just... well, they're a handful in general, and then they get sick and just spiral into this total panic, which makes everything so much harder. They become completely irrational, you can't explain anything to them or get through to them, and for someone like me who's still young and doesn't have the years of experience the older doctors have, it feels like absolute hell... so when I'm looking at it from my perspective, I'll admit there are plenty of reasonable, chill patients, but man, there are also the ones who drive you absolutely insane—like when they lie right to your face during an intake, or "accidentally" forget to mention they have diabetes even after you've asked them four different ways before you've even seen their charts. That's probably like 40% of the patients I've dealt with during my studies. It feels like there's no such thing as a "typical" patient because every single one is as different as night and day...🤷

Unfortunately, everything you wrote is spot on.
As doctors, it isn't our job to play God or act like prophets by judging people based on how they react when they're terrified, panicking, or acting irrational.
Our job is to explain what happened, why it happened, and how we’re going to help using simple language. We can save the Latin terminology for our own professional chats; if we say "broken shinbone" instead of "fractura tibiae," the patient actually understands us, and it's the same thing. If we can't help, we need to explain why and point them toward someone who can.
Any reasonable, relatively normal person will get the information they need if it's explained this way.
But it’s not our place to decide in advance who is capable of understanding and who isn't. And we should never, ever view it as a waste of time just because we had to explain something twice to a patient who didn't catch it the first time.

Jacob Fox6 said:Spot on—that is exactly it, period. 🙏

It’s like patients expect their doctors to be full-on psychotherapists. I had a situation just today where someone in the hospital kept asking me for test results, even though I told him at least four times that I was just a student passing through that unit... and the guy just wouldn't listen or process what I was saying. It was such an exhausting day already, and then having to deal with someone who literally can't communicate or understand a simple sentence was just the icing on the cake. In the end, I just repeated myself for the fifth time, turned around, and walked away. And then you have people like that writing posts about how doctors are "so-and-so." These situations are just everyday life for medical pros, but people just don't get it. They don't realize that working with people is hands down the hardest part of the job. If doctors actually tried to meet every single demand people have, they’d all just burn out, and then we’d genuinely have no one left to take care of us... and I also totally agree with your post about how under certain conditions, doctors are just going to pack up and leave... and honestly, the European Union being involved might actually help since it would mean removing the Schengen border. Anyone choosing to head out isn't wrong for doing what they've always done, now or in the future...

Medicine is just one of many professions where you're constantly dealing with people. Doctors aren't some special exception to that rule. And yes, working with people is the toughest part, especially when they're sick. But being sick doesn't make someone stupid; they're just unwell. Regardless of how rough your day was as a student, believe me, the patient who just found out they have a serious illness is having a much worse day than you are. And they came to you for help.
As for those colleagues who decided to quit the profession, ask them how long it really takes to learn how to translate medical jargon into plain English. In your case, "plain English" should have been: "I don't know," instead of "I'm just a student passing through." To say that, you need a massive amount of confidence and deep knowledge. Once you reach that level, no patient is going to respect you any less for it.