The deference shown to those in whose hands one's life, or the lives of their loved ones, sits, means there is even less effort to subject them to accountability than the paltry amount that there would otherwise be.

- Egregious costs just to become any sort of practitioner (medical school, residency, etc.).

- Insurance companies are basically always grifting you as a policy, unless you call them out on it (reasonable things will be denied and not covered, because most people won’t fight).

- Hospitals are basically always grifting you, unless you call them out on it (bills are basically fraudulent).

- Pharmaceutical companies are basically always grifting everyone (you, the FDA, the prescribers, the insurance companies, etc.).

- Doctors are basically grifting themselves (going into medicine, and staying, almost always for the wrong reasons).

This is just to name a few.

https://www.ama-assn.org/education/gme-funding/medical-stude...

This is paradoxical. Class sizes are limited by the school, but not artificially limited?

Medical school class sizes are artificially restricted by outsized requirements for admissions. For example, the requirement of an undergraduate degree in order to enter medical school is not something that exists in Europe. Or that the admissions and exam requirements are much less hyper-competitive in Europe, than the U.S. This is, of course, “to restrict the supply of residents, so each one can find a job.” It’s still artificial restriction, rather than a natural bottleneck.

The same AMA that “Twenty years ago, the AMA lobbied for reducing the number of medical schools, capping federal funding for residencies, and cutting a quarter of all residency positions,”[0] is now asking for support in reversing its schemes? That’s rich. The same AMA that makes hundreds of millions in revenues, by speculating in securities[1].

Like an alma mater asking you to donate to its investment coffers after it’s shackled you with debt.

[0] https://blog.petrieflom.law.harvard.edu/2022/03/15/ama-scope...

[1] https://www.epsilontheory.com/ama-bitfd/

They created the problem. Just because they’re now trying to fix it means nothing

There are also great medical professionals in both Asia and the West. At their worst though, it's like some kind of dystopian horror film.

The doctor that is the subject of this story was over-prescribing heart procedures for patients enrolled in a single payer program.

Seems pretty obvious.

The largest letter writing campaign in history to the US federal government was to prevent the FDA from regulating supplements.

The real problem I see with government fines is they are generally low enough to simply be a cost of doing business. Bad behavior needs to be more expensive than good behavior!

Scum.

https://twitter.com/generalorthomd/status/163207481637850726...

The first doctor he saw at the emergency room told him his only option is open heart surgery. He explicitly told us to not waste time getting second opinions.

Thankfully we did not listen and we were able to consult with two different cardiologists. They both independently said that they could easily treat him with an angioplasty.

Now, I'm not an idiot - I know X wasn't destined to have a long and happy old age - but a bullet's a bullet.

Eh, many years ago now, maybe I should have fought harder - there were signs they botched something pretty badly. Who knows? Proving that something killed X - besides X - would have been a bear, and of course when it comes to opportunity, you're always the prime suspect in your own death. Lesson for you younguns out there: when you're in the hospital and *The Doctor* comes to give you *The News* - one of life's great repeating acts - that is not the time to shut down or cry it out. Put your radar up, stay frosty, lids open, if you see blood or stuff where it's not supposed to be, then lawyer up pronto. Just the initial consult for this kind of thing won't cost you anything but paperwork and phone calls - something I didn't know at the time.

Professions are those guilds that control their own standards and pace, and regulate their own members. The healing and legal professions are supposed to put their clients' interests first, and mostly do when they would otherwise lose business.

But for those working at government piece rates, the only way to get ahead is to do more pieces, which can skew judgment. The bulk of private equity funding flowing into buying practices targets specialties where local monopolies are possible: anaethesia (great b/c no one chooses their anesthesiologist), dermatology (great b/c you can run through old folks' homes and clip every possible mole), etc.

I'd guess the real rate of over-(and under-) treatment is much higher than reported. Even within a practice group not subject to adverse incentives, there are difference of opinion regarding best treatment. Only when the study sizes are very large can you make generalizations. So it's pretty much an unanswerable question.