Philosophy Discussion Forums | A Humans-Only Philosophy Club

[ShanesGirl]

We've been pushed to be "good" patients and better consumers that don't complain. It's going to take so much to fix this system. We all know that big insurance overcharges for everything. Seeing the ease the hospitals negotiate if necessary, or how the base price for the same procedure if you have medicare is thousands of dollars cheaper shows just how broken the system is. I've had good and bad doctors, but the bad experiences probably would not have been improved by a guide like this. Sometimes it doesn't matter how well you prepare they don't have the time or interest left to truly serve a person's whole health, which would help avoid a lot of catastrophic health situations the author talks about. The fact is if you have medicare many doctors feel it's not worth the money to spend the time. I was told concerning Medicaid a few years ago it didn't cover the specialists gas to work. As long as it's like this we all have that big event coming at some point in our lives to sink us. The focus is wealth not health in too many instances.

[Sushan]

Well, you have a point. In today society many people care about their own gain, and the field of medicine or its service providers are not excluded from that. Many try to gain more by doing less. There are less people who love to work hard and for many hours. I am not much aware about nationwide health insurance systems, but I have seen many specialists who do not have time for patients in the government institutes spend hours for patients in their private channelling centres. But at the same time I have seen specialists as well as general practitioners who care equally to every patient though they are paid consumers or not. So, I think it is not the fault of the system, but mostly of the people and their minds. Though here we discuss about the medical field, this is common to any other field as well.

[ShanesGirl]

You're right! There are many wonderful doctors and surgeons etc out there that go above and beyond in their dedication. I guess I just would like to see the ones that don't held a bit more accountable when a large diagnosis is missed. Not every case, but I've had an issue that I kept telling the doctor I believed was happening, ran rampant in the family, and I was presenting all classic symptoms. After 3 times in the office I went to the er. A simple sonogram showed I had the issue and was rushed to emergency surgery. Having had insurance upon refection I was floored that had I been sent for such a simple thing I could have avoided a lot of the aftermath. I know my experience is not the norm, but it happens enough The system improvement I'd like to see is the price issue I mention. An ingrown toenail will be charged to Humana at 2000$ vs Medicare at 600$. But no change to procedure. I get that medicare is given a discount but it feels a bit extreme. I do know these days the hospitals are working with people on the crazy balances left. Medical debt in itself can feel catastrophic, and the dress from it is definitely adverse to overall health.

[ReaderAisha2020]

I agree that healthcare nowadays is often entered into for financial gain and also due to gain status in the society. Doctors have prestige and earn the praise of people for being doctors and are looked up to as they are thought to be more intelligent and caring. They earn a lot more than other types of professions. Despite of this, there are are many complaints about the treatment of patients in the healthcare system. As the writer of this book has mentioned in some parts, clients are often not recieving the attention and care they deserve a lot of the time. Clients need more than just s diagnosis and some medication. At the same time many important types of treatment are unbelievably expensive and so not available to normal people. There are also discriminatory rules at times and age discrimination, in which people above a certain age are denied access to certain treatments. Therefore, in our time it seems that the essence of healthcare as a caring profession has been corrupted somewhat. It's perhaps not enough that grades determine a profession but also a person's personality and reason for entering it. It would be useful if training taught the younger doctors that they are providing a service and it is a huge responsibility. People's lives are in their hands, so it is not only for financial gsin

[LuckyR]

I agree that healthcare nowadays is often entered into for financial gain and also due to gain status in the society. Doctors have prestige and earn the praise of people for being doctors and are looked up to as they are thought to be more intelligent and caring. They earn a lot more than other types of professions. Despite of this, there are are many complaints about the treatment of patients in the healthcare system. As the writer of this book has mentioned in some parts, clients are often not recieving the attention and care they deserve a lot of the time. Clients need more than just s diagnosis and some medication. At the same time many important types of treatment are unbelievably expensive and so not available to normal people. There are also discriminatory rules at times and age discrimination, in which people above a certain age are denied access to certain treatments. Therefore, in our time it seems that the essence of healthcare as a caring profession has been corrupted somewhat. It's perhaps not enough that grades determine a profession but also a person's personality and reason for entering it. It would be useful if training taught the younger doctors that they are providing a service and it is a huge responsibility. People's lives are in their hands, so it is not only for financial gsin

A couple of things:

Firstly, if someone can get into Med school, they have access to other opportunities that make more money than being a doctor.

Secondly, Med school training spends little to no time and energy training young doctors about the business of medicine.

Lastly, running into a crappy doctor is not evidence of problems with the system of Healthcare delivery. I'm not saying that there aren't problems with the system, just that anecdotes about this or that jerk doctor isn't proof of them.

[Charmaine Cabaron]

I agree that healthcare nowadays is often entered into for financial gain and also due to gain status in the society. Doctors have prestige and earn the praise of people for being doctors and are looked up to as they are thought to be more intelligent and caring. They earn a lot more than other types of professions. Despite of this, there are are many complaints about the treatment of patients in the healthcare system. As the writer of this book has mentioned in some parts, clients are often not recieving the attention and care they deserve a lot of the time. Clients need more than just s diagnosis and some medication. At the same time many important types of treatment are unbelievably expensive and so not available to normal people. There are also discriminatory rules at times and age discrimination, in which people above a certain age are denied access to certain treatments. Therefore, in our time it seems that the essence of healthcare as a caring profession has been corrupted somewhat. It's perhaps not enough that grades determine a profession but also a person's personality and reason for entering it. It would be useful if training taught the younger doctors that they are providing a service and it is a huge responsibility. People's lives are in their hands, so it is not only for financial gsin

A couple of things:

Firstly, if someone can get into Med school, they have access to other opportunities that make more money than being a doctor.

Secondly, Med school training spends little to no time and energy training young doctors about the business of medicine.

Lastly, running into a crappy doctor is not evidence of problems with the system of Healthcare delivery. I'm not saying that there aren't problems with the system, just that anecdotes about this or that jerk doctor isn't proof of them.

I have to agree with this. It really does depend on the doctor's personality and attitude. I know doctors who are very dedicated and compassionate with their work and there are also a few who are indeed just after the wealth. But to think that they have to go through a lot and even spend a lot in becoming a doctor, maybe some are just using their profession to pay the debts they've incurred along the process of becoming a doctor. Trust me, there are a lot of healthcare workers who thinks of their patient more than they think of themselves and that is a very pure emotion from them. The wholesomeness in just the mere thoughts of helping their patients recover and get back with their lives is their vocation that's why even if there are times that it is beyond their capabilities, still they try their best to be there for the needy. We might just have to see from their point of views as to why they are the way they are-- the good and the bad. Afterall, we are all responsible for our actions and there is enough reason to justify the reason behind our actions.

[Sushan]

You're right! There are many wonderful doctors and surgeons etc out there that go above and beyond in their dedication. I guess I just would like to see the ones that don't held a bit more accountable when a large diagnosis is missed. Not every case, but I've had an issue that I kept telling the doctor I believed was happening, ran rampant in the family, and I was presenting all classic symptoms. After 3 times in the office I went to the er. A simple sonogram showed I had the issue and was rushed to emergency surgery. Having had insurance upon refection I was floored that had I been sent for such a simple thing I could have avoided a lot of the aftermath. I know my experience is not the norm, but it happens enough The system improvement I'd like to see is the price issue I mention. An ingrown toenail will be charged to Humana at 2000$ vs Medicare at 600$. But no change to procedure. I get that medicare is given a discount but it feels a bit extreme. I do know these days the hospitals are working with people on the crazy balances left. Medical debt in itself can feel catastrophic, and the dress from it is definitely adverse to overall health.

Indeed, your experiences and reflections shed light on a multifaceted issue within the healthcare realm. It's disheartening to hear about your ordeal which could have been averted with a more attentive approach. Your narrative also unveils a poignant aspect of the healthcare conundrum - the stark discrepancy in charges for the same procedure across different insurance schemes. This financial disparity not only manifests as an undue burden but could potentially deter individuals from seeking timely medical intervention.

You brought up a compelling point about accountability, especially in scenarios where an apparent oversight leads to severe consequences. It opens up a broader dialogue about how the healthcare system could evolve to foster a more transparent and accountable milieu. The variance in charges you pointed out also paves the way for discussing how a more standardized or regulated pricing model might impact both the providers and the recipients of healthcare.

Given your experience, do you envisage a particular mechanism or reform that could better align the interests of healthcare providers with the well-being and financial ease of the patients? Furthermore, how do you think the community and healthcare professionals could collaboratively work towards creating a more patient-centric healthcare ecosystem?

[Sushan]

I agree that healthcare nowadays is often entered into for financial gain and also due to gain status in the society. Doctors have prestige and earn the praise of people for being doctors and are looked up to as they are thought to be more intelligent and caring. They earn a lot more than other types of professions. Despite of this, there are are many complaints about the treatment of patients in the healthcare system. As the writer of this book has mentioned in some parts, clients are often not recieving the attention and care they deserve a lot of the time. Clients need more than just s diagnosis and some medication. At the same time many important types of treatment are unbelievably expensive and so not available to normal people. There are also discriminatory rules at times and age discrimination, in which people above a certain age are denied access to certain treatments. Therefore, in our time it seems that the essence of healthcare as a caring profession has been corrupted somewhat. It's perhaps not enough that grades determine a profession but also a person's personality and reason for entering it. It would be useful if training taught the younger doctors that they are providing a service and it is a huge responsibility. People's lives are in their hands, so it is not only for financial gsin

You've articulated a poignant critique of the current state of healthcare, touching on the dichotomy between the idealized notion of medical practice and the realities that often manifest. The financial aspect, coupled with the societal prestige associated with medical professionals, seems to have eclipsed the core ethos of healthcare – which is care, compassion, and a genuine commitment to alleviating suffering.

Your remarks about the inadequacy of merely having a diagnosis and medication, without a holistic, patient-centric approach, resonate deeply. It underscores the necessity for a paradigm shift in how medical education and healthcare systems are structured. The mention of discriminatory practices based on age or perhaps other demographics further accentuates the systemic flaws that need redress.

Your suggestion about aligning the selection and training of medical professionals more closely with the intrinsic values and responsibilities of the profession is quite compelling. It invokes a broader dialogue about how the healthcare sector could evolve to reincorporate its foundational principles.

Do you envision any specific reforms or initiatives that could help rekindle the essence of care and altruism in healthcare? Additionally, how do you think patients and the community at large can play a role in catalyzing this shift towards a more compassionate and equitable healthcare system?

[Sushan]

I agree that healthcare nowadays is often entered into for financial gain and also due to gain status in the society. Doctors have prestige and earn the praise of people for being doctors and are looked up to as they are thought to be more intelligent and caring. They earn a lot more than other types of professions. Despite of this, there are are many complaints about the treatment of patients in the healthcare system. As the writer of this book has mentioned in some parts, clients are often not recieving the attention and care they deserve a lot of the time. Clients need more than just s diagnosis and some medication. At the same time many important types of treatment are unbelievably expensive and so not available to normal people. There are also discriminatory rules at times and age discrimination, in which people above a certain age are denied access to certain treatments. Therefore, in our time it seems that the essence of healthcare as a caring profession has been corrupted somewhat. It's perhaps not enough that grades determine a profession but also a person's personality and reason for entering it. It would be useful if training taught the younger doctors that they are providing a service and it is a huge responsibility. People's lives are in their hands, so it is not only for financial gsin

A couple of things:

Firstly, if someone can get into Med school, they have access to other opportunities that make more money than being a doctor.

Secondly, Med school training spends little to no time and energy training young doctors about the business of medicine.

Lastly, running into a crappy doctor is not evidence of problems with the system of Healthcare delivery. I'm not saying that there aren't problems with the system, just that anecdotes about this or that jerk doctor isn't proof of them.

Your insights bring a new dimension to this discussion, highlighting the different facets of the healthcare system and the individuals operating within it. The point regarding the financial prospects for those capable of getting into medical school is intriguing. It suggests that there might be deeper motivations for choosing the medical profession beyond financial gain, perhaps a genuine aspiration to contribute to societal well-being.

However, your observation about the lack of training in the business aspects of medicine presents a compelling paradox. On one hand, medical professionals are expected to uphold a noble, caregiving ethos, while on the other hand, they are plunged into a heavily monetized and often bureaucratically complex system without adequate preparation. This could potentially lead to a dissonance between their initial motivations and the practical realities they encounter.

Your final point challenges the use of anecdotal evidence in assessing systemic issues, which is a prudent reminder of the importance of a more comprehensive and data-driven evaluation. It also perhaps hints at the need for a broader, systemic lens to identify and address the roots of the shortcomings in healthcare delivery.

Expanding on your points, do you think there could be structural changes in medical education that could better prepare aspiring doctors for the business and bureaucratic aspects of healthcare, while reinforcing the core humanitarian values of the profession? Also, how might the healthcare system evolve to better align with the altruistic motivations of many medical professionals, creating an environment where both patients and doctors feel valued and fulfilled?

[Sushan]

I agree that healthcare nowadays is often entered into for financial gain and also due to gain status in the society. Doctors have prestige and earn the praise of people for being doctors and are looked up to as they are thought to be more intelligent and caring. They earn a lot more than other types of professions. Despite of this, there are are many complaints about the treatment of patients in the healthcare system. As the writer of this book has mentioned in some parts, clients are often not recieving the attention and care they deserve a lot of the time. Clients need more than just s diagnosis and some medication. At the same time many important types of treatment are unbelievably expensive and so not available to normal people. There are also discriminatory rules at times and age discrimination, in which people above a certain age are denied access to certain treatments. Therefore, in our time it seems that the essence of healthcare as a caring profession has been corrupted somewhat. It's perhaps not enough that grades determine a profession but also a person's personality and reason for entering it. It would be useful if training taught the younger doctors that they are providing a service and it is a huge responsibility. People's lives are in their hands, so it is not only for financial gsin

A couple of things:

Firstly, if someone can get into Med school, they have access to other opportunities that make more money than being a doctor.

Secondly, Med school training spends little to no time and energy training young doctors about the business of medicine.

Lastly, running into a crappy doctor is not evidence of problems with the system of Healthcare delivery. I'm not saying that there aren't problems with the system, just that anecdotes about this or that jerk doctor isn't proof of them.

I have to agree with this. It really does depend on the doctor's personality and attitude. I know doctors who are very dedicated and compassionate with their work and there are also a few who are indeed just after the wealth. But to think that they have to go through a lot and even spend a lot in becoming a doctor, maybe some are just using their profession to pay the debts they've incurred along the process of becoming a doctor. Trust me, there are a lot of healthcare workers who thinks of their patient more than they think of themselves and that is a very pure emotion from them. The wholesomeness in just the mere thoughts of helping their patients recover and get back with their lives is their vocation that's why even if there are times that it is beyond their capabilities, still they try their best to be there for the needy. We might just have to see from their point of views as to why they are the way they are-- the good and the bad. Afterall, we are all responsible for our actions and there is enough reason to justify the reason behind our actions.

Your perspective brings a nuanced understanding to the table, acknowledging the human side of the healthcare profession which often gets eclipsed in discussions about systemic issues. The journey to becoming a doctor is indeed a long and often expensive one, and it’s conceivable that the financial pressures could steer some practitioners toward a more profit-driven approach. However, as you've pointed out, there's a significant number of healthcare workers whose primary drive is the welfare of their patients, embodying the altruistic ethos of the profession.

Your reflection upon the intrinsic motivation of healthcare workers to aid in the healing and wellbeing of their patients shines a light on the potential for empathy, understanding, and human connection even within a system that might have its flaws. This human-centric viewpoint is a refreshing contrast to often depersonalized discussions about healthcare systems.

Your mention of viewing the situation from the doctors' point of view invites a deeper exploration of the individual experiences within the healthcare system. It leads to a question of how the healthcare system could be refined to better support the altruistic motivations of many medical professionals while mitigating circumstances that may push others toward a more profit-oriented approach. How might a revised system better nurture the inherent vocation of helping and healing, and provide a conducive environment for both healthcare providers and patients to thrive? Furthermore, how could the narratives of both ‘good’ and ‘bad’ experiences within the current healthcare system inform such revisions, creating a more holistic and human-centered healthcare experience?

[LuckyR]

I agree that healthcare nowadays is often entered into for financial gain and also due to gain status in the society. Doctors have prestige and earn the praise of people for being doctors and are looked up to as they are thought to be more intelligent and caring. They earn a lot more than other types of professions. Despite of this, there are are many complaints about the treatment of patients in the healthcare system. As the writer of this book has mentioned in some parts, clients are often not recieving the attention and care they deserve a lot of the time. Clients need more than just s diagnosis and some medication. At the same time many important types of treatment are unbelievably expensive and so not available to normal people. There are also discriminatory rules at times and age discrimination, in which people above a certain age are denied access to certain treatments. Therefore, in our time it seems that the essence of healthcare as a caring profession has been corrupted somewhat. It's perhaps not enough that grades determine a profession but also a person's personality and reason for entering it. It would be useful if training taught the younger doctors that they are providing a service and it is a huge responsibility. People's lives are in their hands, so it is not only for financial gsin

A couple of things:

Firstly, if someone can get into Med school, they have access to other opportunities that make more money than being a doctor.

Secondly, Med school training spends little to no time and energy training young doctors about the business of medicine.

Lastly, running into a crappy doctor is not evidence of problems with the system of Healthcare delivery. I'm not saying that there aren't problems with the system, just that anecdotes about this or that jerk doctor isn't proof of them.

Your insights bring a new dimension to this discussion, highlighting the different facets of the healthcare system and the individuals operating within it. The point regarding the financial prospects for those capable of getting into medical school is intriguing. It suggests that there might be deeper motivations for choosing the medical profession beyond financial gain, perhaps a genuine aspiration to contribute to societal well-being.

However, your observation about the lack of training in the business aspects of medicine presents a compelling paradox. On one hand, medical professionals are expected to uphold a noble, caregiving ethos, while on the other hand, they are plunged into a heavily monetized and often bureaucratically complex system without adequate preparation. This could potentially lead to a dissonance between their initial motivations and the practical realities they encounter.

Your final point challenges the use of anecdotal evidence in assessing systemic issues, which is a prudent reminder of the importance of a more comprehensive and data-driven evaluation. It also perhaps hints at the need for a broader, systemic lens to identify and address the roots of the shortcomings in healthcare delivery.

Expanding on your points, do you think there could be structural changes in medical education that could better prepare aspiring doctors for the business and bureaucratic aspects of healthcare, while reinforcing the core humanitarian values of the profession? Also, how might the healthcare system evolve to better align with the altruistic motivations of many medical professionals, creating an environment where both patients and doctors feel valued and fulfilled?

Yes, the two biggest gaps in Medical School education are both absolutely critical to practice satisfaction long-term. The first is assistance in learning the real world practice styles of various specialties and thus whether they are a good personality, style and skill match-up for what the prospective doctor brings to the table. Essentially >90% of the criteria students use to decide specialty are ultimately unhelpful: compensation, hours, community demand, prestige, lawsuit risk and anything other than what you're going to be doing all day for decades. Obviously, residents learn this all first hand, but by then it's too late, they're already committed. The second is what we spoke of, namely the business of medicine, how the same specialty will be very different in rural vs overserved urban practice, likely clientele (and thus compensation and style of practice).

The weird thing is, one can convey this essentials of this information to an individual in a couple of hours, but no one does. Thus why I chose to have those conversations with medical students (rather than going over the nuances of my specialty, that they were never going to use, since they were going into something else).

[Sushan]

I agree that healthcare nowadays is often entered into for financial gain and also due to gain status in the society. Doctors have prestige and earn the praise of people for being doctors and are looked up to as they are thought to be more intelligent and caring. They earn a lot more than other types of professions. Despite of this, there are are many complaints about the treatment of patients in the healthcare system. As the writer of this book has mentioned in some parts, clients are often not recieving the attention and care they deserve a lot of the time. Clients need more than just s diagnosis and some medication. At the same time many important types of treatment are unbelievably expensive and so not available to normal people. There are also discriminatory rules at times and age discrimination, in which people above a certain age are denied access to certain treatments. Therefore, in our time it seems that the essence of healthcare as a caring profession has been corrupted somewhat. It's perhaps not enough that grades determine a profession but also a person's personality and reason for entering it. It would be useful if training taught the younger doctors that they are providing a service and it is a huge responsibility. People's lives are in their hands, so it is not only for financial gsin

A couple of things:

Firstly, if someone can get into Med school, they have access to other opportunities that make more money than being a doctor.

Secondly, Med school training spends little to no time and energy training young doctors about the business of medicine.

Lastly, running into a crappy doctor is not evidence of problems with the system of Healthcare delivery. I'm not saying that there aren't problems with the system, just that anecdotes about this or that jerk doctor isn't proof of them.

Your insights bring a new dimension to this discussion, highlighting the different facets of the healthcare system and the individuals operating within it. The point regarding the financial prospects for those capable of getting into medical school is intriguing. It suggests that there might be deeper motivations for choosing the medical profession beyond financial gain, perhaps a genuine aspiration to contribute to societal well-being.

However, your observation about the lack of training in the business aspects of medicine presents a compelling paradox. On one hand, medical professionals are expected to uphold a noble, caregiving ethos, while on the other hand, they are plunged into a heavily monetized and often bureaucratically complex system without adequate preparation. This could potentially lead to a dissonance between their initial motivations and the practical realities they encounter.

Your final point challenges the use of anecdotal evidence in assessing systemic issues, which is a prudent reminder of the importance of a more comprehensive and data-driven evaluation. It also perhaps hints at the need for a broader, systemic lens to identify and address the roots of the shortcomings in healthcare delivery.

Expanding on your points, do you think there could be structural changes in medical education that could better prepare aspiring doctors for the business and bureaucratic aspects of healthcare, while reinforcing the core humanitarian values of the profession? Also, how might the healthcare system evolve to better align with the altruistic motivations of many medical professionals, creating an environment where both patients and doctors feel valued and fulfilled?

Yes, the two biggest gaps in Medical School education are both absolutely critical to practice satisfaction long-term. The first is assistance in learning the real world practice styles of various specialties and thus whether they are a good personality, style and skill match-up for what the prospective doctor brings to the table. Essentially >90% of the criteria students use to decide specialty are ultimately unhelpful: compensation, hours, community demand, prestige, lawsuit risk and anything other than what you're going to be doing all day for decades. Obviously, residents learn this all first hand, but by then it's too late, they're already committed. The second is what we spoke of, namely the business of medicine, how the same specialty will be very different in rural vs overserved urban practice, likely clientele (and thus compensation and style of practice).

The weird thing is, one can convey this essentials of this information to an individual in a couple of hours, but no one does. Thus why I chose to have those conversations with medical students (rather than going over the nuances of my specialty, that they were never going to use, since they were going into something else).

Your emphasis on the need for more practical and relevant guidance in medical education is an important consideration. It's interesting to see the focus on helping students understand the real-world implications of their specialty choices, beyond the commonly considered factors like compensation or prestige. This approach seems to prioritize a more holistic understanding of the medical profession, considering personal compatibility with the practice style and the realities of different work environments.

The point about the lack of emphasis on the business side of medicine in medical education is particularly striking. This gap suggests that many medical professionals may find themselves unprepared for the practical challenges they face in their careers, which could impact their effectiveness and satisfaction.

Your approach to addressing these issues by directly engaging with medical students is commendable. It seems to offer a more grounded and realistic preparation for their future careers. This kind of mentorship could be instrumental in shaping a more informed, satisfied, and effective medical workforce.

Given your experience and insights, how do you envision the integration of these critical aspects into the medical curriculum? Do you think there should be a systemic shift towards more personalized and practical training that takes into account the diverse realities of medical practice?

[LuckyR]

Given your experience and insights, how do you envision the integration of these critical aspects into the medical curriculum? Do you think there should be a systemic shift towards more personalized and practical training that takes into account the diverse realities of medical practice?

Yes there should be (hence my actions) but I dont really see it happening. Because in order to effectively help students the mentor needs to stick their neck out and criticize verbalized career choices and explain why, plus go out on a limb and make suggestions, again explaining their rationale. Of course educators don't want to accept responsibility and prefer to present facts "and let the student decide" (which of course ultimately they're going to do regardless).

In addition, educators as stewards of the community's overall health do things like promote serving in undeserved areas, rural areas etc, which obviously are good for communities in the short haul but are commonly a poor match for individuals (who then have dissatisfying work lives and leave those areas). Recruitment of rurally inclined docs should be done at acceptance to medical school, not try to turn suburban inclined docs into unhappy rural practitioners.

[Sushan]

Given your experience and insights, how do you envision the integration of these critical aspects into the medical curriculum? Do you think there should be a systemic shift towards more personalized and practical training that takes into account the diverse realities of medical practice?

Yes there should be (hence my actions) but I dont really see it happening. Because in order to effectively help students the mentor needs to stick their neck out and criticize verbalized career choices and explain why, plus go out on a limb and make suggestions, again explaining their rationale. Of course educators don't want to accept responsibility and prefer to present facts "and let the student decide" (which of course ultimately they're going to do regardless).

In addition, educators as stewards of the community's overall health do things like promote serving in undeserved areas, rural areas etc, which obviously are good for communities in the short haul but are commonly a poor match for individuals (who then have dissatisfying work lives and leave those areas). Recruitment of rurally inclined docs should be done at acceptance to medical school, not try to turn suburban inclined docs into unhappy rural practitioners.

Well, I have some different thoughts.

Firstly, it's important to consider the ethical implications of prioritizing recruitment based on rural inclinations at the outset of medical education. This approach could be perceived as a form of social engineering, potentially compromising the autonomy of students. It's essential that students have the opportunity to explore and discover their own interests and aptitudes without being pigeonholed into predetermined career paths from the start.

Secondly, such an approach might inadvertently create a divide within the student body, segregating those with rural inclinations from their urban counterparts. This could foster an environment of inequality and bias within the educational system, potentially leading to stigmatization based on background or perceived career inclinations.

Moreover, the notion of educators steering students toward or away from certain career paths, albeit with good intentions, raises concerns about paternalism in the educational process. While guidance is necessary, it's crucial to respect students' capacity to make informed decisions regarding their careers. Educators' role should be to facilitate this decision-making process, not to dictate it.

Finally, the commendable goal of serving in underserved areas should be pursued with the voluntary and enthusiastic participation of practitioners. Imposing such choices may lead to dissatisfaction and burnout, ultimately affecting the quality of care provided.

I'd appreciate your thoughts on this new answering style. Do you find it more engaging or effective and less formulaic?

[Okoth Omondi]

We've been pushed to be "good" patients and better consumers that don't complain. It's going to take so much to fix this system. We all know that big insurance overcharges for everything. Seeing the ease the hospitals negotiate if necessary, or how the base price for the same procedure if you have medicare is thousands of dollars cheaper shows just how broken the system is. I've had good and bad doctors, but the bad experiences probably would not have been improved by a guide like this. Sometimes it doesn't matter how well you prepare they don't have the time or interest left to truly serve a person's whole health, which would help avoid a lot of catastrophic health situations the author talks about. The fact is if you have medicare many doctors feel it's not worth the money to spend the time. I was told concerning Medicaid a few years ago it didn't cover the specialists gas to work. As long as it's like this we all have that big event coming at some point in our lives to sink us. The focus is wealth not health in too many instances.

When the focus is solely on accumulating wealth without considering its impact on health, individuals may engage in behaviors that compromise their well-being. Long working hours, high stress levels, and neglecting self-care can lead to physical and mental health issues. While financial success is important, it should not come at the expense of one's health. A healthy lifestyle contributes to increased productivity, better decision-making, and overall life satisfaction. Neglecting health can lead to burnout, decreased quality of life, and potential long-term medical expenses. It's essential to recognize that wealth and health are interconnected. Investing time and effort in maintaining good health can enhance one's ability to pursue and enjoy financial success in the long run. Striking a balance between wealth accumulation and health preservation is key to a holistic and sustainable approach to life.