BTW I'm not going to continue the stupid argument, but seriously melkerson, it's important to know that this is wrong.

Lol.

You are literally the worst poster. Football spiking your own post plus ridiculous confirmation bias.

OK. Let's go through.

Gdp per capita.

This is completely irrelevant when talking about global wage competition. I concede perhaps more relevant to the general question of "are doctors in the US paid to much", but that's a different argument which just highlights your terribadness.

Call center workers in the Philippines are in the top 5% income earners. That doesn't mean jack when talking about pressure on US call center wages.

Vs global average.

Again this is not the relevant figure. The UK, Netherlands, Australia etc face the same protectionist support. The fact that doctors in China etc are earning a fraction of US wages is the relevant issue, and one you completely hand wave away.

More hours.

This is just lol worthy. Cherry picking one data point completely our of context just to hand wave away the gap is ludicrous. It's very similar to your "something something higher medical insurance costs something " that you embarrassed yourself with on wages before the spin off.

If all you got left is, "we have better training" and our education costs more (this is not a good thing ldo) to stop yourself getting out competed then you are in trouble.

****ing hypocrites the right is. Free trade for everyone except them and their buddies.

What are you talking about? Like I have no idea what the **** you are trying to say. I didn't pick that data point, you did man. I apply it to total earnings and GDP per capita. Shocker, your claim that doctors in the USA are paid too much fell through.

**** man YOU cited that data. The hell are you blabbering about?

As for foreign doctors, you can't cite their wages because they aren't in the USA, and it's not due to protectionist policies. You can't be a doctor without knowing english and be a few thousand miles away. It just does not work that way.

Reading is hard. The fact there was 0.1 second between me posting and you responding that you couldn't understand does not surprise me.

Take a deep breath. Try again. If it helps you can sound out the big words out loud.

No it's still garbage. Your claim relies on doctors in china being able to perform their job in the USA. This is not possible. It's not close to possible. Your claim is invalid.

The confusing part is how you shot down your own data source as invalid.

So close... watching you attempt to follow a logical train of thought is like watching a tramp stumble along the tracks looking for empties.

You know he will probably get there, but he could train crash at any time and he definitely stinks.

Ok.

1. Why can't a Chinese doctor perform medicine in the US?

2.. if we stopped imports of TVs or cars from China... that policy would be called what...?

Because they're in china. I'll obviously agree that there are protectionist policies regarding licensure, but even if you eliminated that barrier, it wouldn't lead to the drop of well over 50% in salary.

For the same reason why Chinese plumbers can't perform plumbing in US.

When rugby gets into an accident and gets rushed to the ER, he's going to be pleased when the only doctor available is the one the hospital has on speed dial in shanghai.

And a boat full of Chinese doctors is not going to be able just start competing once they land, there's too many barriers.

for those wondering, this is what rugby meant... which, lol

fwiw someone mentioned robots and surgeries. Currently these davinci robots gotta be one of the dumbest things in healthcare and can probably be a poster child for why USA healthcare is so damn expensive. Some hospitals are using them to do f-ing hernia repairs. They are expensive as hell, make surgeries take 4x longer and I dont think there is even great evidence their outcomes are much better (could be wrong, im not a surgeon). There is no reason to always have the best/newest/flashiest technology in health care, its just not sustainable.

hahahahah

ikes puttin on a clinic ITT

robot no good now, ergo robot never be good, I am special and unique ergo no robot can ever do what I can do

dude, Watson already has you whooped when it comes to making diagnoses. Robots are going to get better as fast as they are getting better at driving cars. Don't worry, though, legislators will erect plenty of barriers to keep you in a job a while longer, at the low cost of just an untold number of human lives.

You like completely dodged his point. Good show tho.

Actually, "dodged" implies you understood his point in the first place, which is almost certainly not the case.

Anyway. Back to the original point. Now you've conceded you are dependent on protectionism, I assume you'll start campaigning to lower barriers to entry for foreign doctors? Consumers are suffering.

It doesn't need to be as often as you tell unemployed manufacturing folks to suck it up because they are better off in the big scheme of things, but you know, every now and then?

Another point even those arguing against ikes are missing is that you don't need to import doctors from China. DUCY?

We import doctors mostly from India now a days.

AFAIK the data is pretty good that foreign docs perform as well as US trained ones. We have several working in our system, and in my tiny sample they're all fine. I would be more concerned about problems with language barriers in non-English speakers, because I'm uncomfortably aware of my difficulties in getting a good history from non-English speakers even using our new tele-linked translator service, which is really slick.

Robot wise, I'd like to see some data that shows even slight evidence that robots outperform laproscopy in terms of patient outcomes. I think there have been some signs of that in prostrate procedures they do, but otherwise, they seem to generate huge bills and the same or slightly worse outcomes. They may improve. OTOH, they may be like fusion - the answer in five years for the next century.

I think the poster that noted radiologists as a prime candidate for being replaced by computers has a point. Pattern recognition is something that computers are good at, and informally speaking with a couple of my rad colleagues tells me that some of them think that mammograms should be read by machine today.

It doesn't surprise me that Watson would be better than an MD at diagnosis - it's pretty much a skill of managing a lot of information in an organized way. Exactly what computers are good at and people bad at. OTOH, I've been reviewing EKG's with computer reads for decades, and the computer still routinely ****s them up. So I dunno.

You can probably save more money by training more NP/PA types to manage simple problems/patients and save the sicker ones for us high priced types. But for whatever reason that seems to be lower in priority at least for now.

You may now resume your personal attacks.

MM MD

When it comes to the watson stuff, I think people opinion of that sort of technology changes significantly once you actually start practicing medicine. If someone was particularly dedicated Im sure they could find posts about me being super gung ho about it previously.

But now having practiced medicine some, Ive found that the things we really spend our time with are more normative questions that dont have a concrete right or wrong answer. IIRC I read a malcolm gladwell article awhile back talking about Enron or something. There was some tangent in there about the difference between a puzzle and a mystery. He said a puzzle has a clear solution, you just need to gather enough information and you will come to the right answer. However with a mystery you can gather all the information in existence and still be at a loss for an objective solution. I feel like in medicine Im faced with many more mysteries than I am puzzles.

Should grandma be discharged today to a nursing home that she may never leave, or should we keep her in the hospital an extra day to try to give the family time to come to grips with the situation and take her home? Should this person with widely metastatic cancer undergo hip surgery? How should I approach a patient with days to live whose family wants him to come home to die, but he wants to stay in hospital so as to not be a burden? Is this person's pain controlled? Should I use a medication to improve quality of life that also increases risk of death? How do I tell this patient that we don't even know exactly what kind of cancer they have, but that they will die within weeks? Is this person going to kill themselves if they leave my ER? Are the side effects of this treatment worth it? When a patient says they have "X symptom", is it really X symptom or are they just bad at describing Y symptom?

Very rarely are we saying hmm I have X checklist of symptoms and labs, I wish I could interpret and act on them. Dont get me wrong, doctors would love to have watson available to help with those situations and make sure they dont make mistakes in others, but concrete medical decision making seems to be only a minor part of practicing medicine.

This is something that boggles my mind as well, its literally a couple lines to analyze, this should be a computers wheelhouse. I dont understand how they could ever get it wrong, but they do.

hobbes,

I agree with you re: the near future direction of robots (I think, you didn't spell this out exactly), the augmenting of mid-level providers to allow them to do expand their scope of practice.

Your examples revolve more around being a doctor in a hospital than being a GP, which is what I was talking about. Asking about symptoms and diagnosing are a huge part of being a GP. I agree Watson isn't going to replace hospital staff. But just to give one example, my girlfriend went through over a decade of reporting to doctors that she was tired all day and felt like her sleep quality was ****ty and that she dreamt all night and not one of them suggested that she be tested for a condition for which those are exactly the most common symptoms. Try to guess if you want:



In the end she diagnosed herself after I told her about the existence of modafinil, she read about it on Wikipedia out of interest, clicked through in the list of conditions it was used to treat, and was like "this sounds an awful lot like me". When she went to her GP and asked to be referred for a sleep study, he said "oh, you don't have that". And he's a smart guy, it's not like he's a bad doctor. This isn't an isolated incident either, I have a million stories like that. People are horrendously bad at considering all possibilities dispassionately and weighing up probabilities.

Continuing is pointless, because you're wrong, and you won't admit it.

BTW, like much of everything else you posted, your tidbit on extracutaneous manifestations is irrelevant to the point. That's why I specifically said stage I CTCL, which by definition has no extracutaneous manifestations. So my prior statement is correct. It's been fun watching you grasp at straws though. I'm out.

Very stupid tangent. I've already shown that people do (and cited sources one of which is from a peer-reviewed journal) and demonstrated why it is. There's no need to re-hash though. Think of it however you like.

Doctors can move freely within the EU right? I wonder why more of the Portuguese and Italian doctors aren't moving to Germany and Netherlands.

Did you read the AI article I linked in the LC thread? I know you're talking about more than just capability (human acceptance, lawsuits etc), but I'd be curious if reading both parts of this changes your mind: http://waitbutwhy.com/2015/01/artifi...olution-1.html

As I said when I first linked, youve gotta make it through the first half of the first article before it gets good