I love your breakdowns. You make it so simple to understand and sound so easy to do…then the real world smacks us in the face and says “HA!” I’m going to add a bunch of bureaucratic nonsense to make things interesting. Unfortunately, not many people want to wade through the nonsense. (I guess that is what gives those of us in consulting a purpose?!)
"Also, consider that these people literally save lives everyday, so the value tradeoff definitely seems to be there."
Uh, no. Whitecoat fuckups are the second leading cause of inpatient death. Many different jobs save lives every day: Mold remediation techs save lives ..wastewater treatment operators save lives ..nannies save kids' lives all day long. Also, many people save lives for free just because they saw someone in mortal danger and leapt to help them. They don't expect pay and they typically don't expect special treatment either. They certainly don't develop an embarrassingly unwieldy god-complex and the need to wear a stolen lab coat about it. And let's not get started on the nurse's martyr delusion. "Hard job" ..right. Like the majority of full-timers don't have that. Most of these scrub grubs couldn't last a day in tech. They'd just go red-faced and scream and cry that they just want to go back to taking blood pressure and handing out $30 Tylenol caps.
The Rockefeller-hijacked healthcare system intentionally creates an occupational honeytrap for those who have serious psychological issues. The money and pReSTiGeEe is a siren song for ego-driven fools who just want to feel superior to everyone they graduated high school with. They want "money and girls and a Porche" (and full access to "pussy" all day, if aiming for OBGYN - please do attempt the "but some pussy is gross" angle and we can talk about how plenty of it isn't, friend..) as they openly state in undergrad before they realize people are starting to give that talk the side-eye.
Real medicine is the kind where people train by apprenticeship. It's the kind where boards don't lord over physicians and tell them what they can and can't do. The kind where the state child traffickers known as CPS aren't stalking parents to steal babies from families whose only crime was being poor. The kind where physician popularity is built by word of mouth and clients are gained by assessing portfolios of past work.
So physicians "aren't taught business in school" ..ok? Are the people expected to pay exorbitant amounts for their poor-quality "care" taught finance in school? Never expect to be let off the hook for something you yourself won't let other off the hook for. Oh, but remember! dOnT gO tO pRoFeSsoR GoOgLe for your business information! You didn't go to school for that so looking it up would be so over the LINE of you!
Commenter Vein Doc hit the nail on the head when he/she said that the state is working to break healthcare so that they will be begged to take it over and "fix it", thereby creating a far more socialized system. This would be the death knell of any semblance of a medical industry we have left.
Luckily, independent (portfolio!) physicians are quietly becoming more popular choice, and people are educating themselves in the *real* traditional medicine as well. Even the people still in the system are learning to scrap "health" insurance to get way lower cash pay prices and to give fake names/addresses with "no ID" in the ER, etc.
Socialism has caused this mess and the brainwashed crying for more government intervention just aren't going to get their way. It's done. We've had it. Bring back the 100% free market, total capitalism, where anyone with the chops can roll in and give better care for better prices and force everyone to compete over clients again. Will whitecoats be taken down a notch or two off their unwarranted pedestal? Of course. Will they have to work evenings and weekends in many specialties? Sure, at first, until they make good names for themselves. Will they need to have the humility to learn from clients who are experts in Condition X because they've been dealing intensively with it for years or decades? You betcha.
There's your brighter future! Whitecoats can either join reality and ditch their pissy misery for a deep satisfaction in life ..or not! But the rest of us are moving on.
I'm finding more of my clients are actually going back to private practice in the Concierge space. Even hybrid where they offer the concierge fee and also accept insurance.
The more you own, the more it owns you. I have owned my healthcare practices for 32years. I love creative control on how best to serve the patient and to care for my second family(employees) . The money can be better but the responsibility can be great and that can erode some joys of having more money. There is a concerted effort to collapse the system to a universal basic system like the UK and Canada. Best for you to have your pricing at a level that ‘self pay’ Will bite at. The government wants to control healthcare and they are capturing it through over regulating it and breaking it so people will come to them asking for them to take it over. Learn how to keep your costs down by comparing what other countries do. In the USA , it’s all about using expensive devices and drugs. Medical technology is great and some things are worth the investment and some slightly older and more affordable technologies may still be worth using as they will improve your ROI and patents expire allowing some competitors to provide price improvements. Medicare and Medicaid prices have been imploding for 30years. Be careful not to hitch your wagon to a ‘falling star’.
I think you'll appreciate this highly related post https://substack.com/home/post/p-172872769
Thanks for sharing
I love your breakdowns. You make it so simple to understand and sound so easy to do…then the real world smacks us in the face and says “HA!” I’m going to add a bunch of bureaucratic nonsense to make things interesting. Unfortunately, not many people want to wade through the nonsense. (I guess that is what gives those of us in consulting a purpose?!)
Thank you, as always, for your words of wisdom.
Appreciate you reading and the kind words!
It’s the healthcare equivalent of enshittification. As always Preston, keep beating this drum.
Yessir!
Great analysis as always Preston.
Thanks so much!
"Also, consider that these people literally save lives everyday, so the value tradeoff definitely seems to be there."
Uh, no. Whitecoat fuckups are the second leading cause of inpatient death. Many different jobs save lives every day: Mold remediation techs save lives ..wastewater treatment operators save lives ..nannies save kids' lives all day long. Also, many people save lives for free just because they saw someone in mortal danger and leapt to help them. They don't expect pay and they typically don't expect special treatment either. They certainly don't develop an embarrassingly unwieldy god-complex and the need to wear a stolen lab coat about it. And let's not get started on the nurse's martyr delusion. "Hard job" ..right. Like the majority of full-timers don't have that. Most of these scrub grubs couldn't last a day in tech. They'd just go red-faced and scream and cry that they just want to go back to taking blood pressure and handing out $30 Tylenol caps.
The Rockefeller-hijacked healthcare system intentionally creates an occupational honeytrap for those who have serious psychological issues. The money and pReSTiGeEe is a siren song for ego-driven fools who just want to feel superior to everyone they graduated high school with. They want "money and girls and a Porche" (and full access to "pussy" all day, if aiming for OBGYN - please do attempt the "but some pussy is gross" angle and we can talk about how plenty of it isn't, friend..) as they openly state in undergrad before they realize people are starting to give that talk the side-eye.
Real medicine is the kind where people train by apprenticeship. It's the kind where boards don't lord over physicians and tell them what they can and can't do. The kind where the state child traffickers known as CPS aren't stalking parents to steal babies from families whose only crime was being poor. The kind where physician popularity is built by word of mouth and clients are gained by assessing portfolios of past work.
So physicians "aren't taught business in school" ..ok? Are the people expected to pay exorbitant amounts for their poor-quality "care" taught finance in school? Never expect to be let off the hook for something you yourself won't let other off the hook for. Oh, but remember! dOnT gO tO pRoFeSsoR GoOgLe for your business information! You didn't go to school for that so looking it up would be so over the LINE of you!
Commenter Vein Doc hit the nail on the head when he/she said that the state is working to break healthcare so that they will be begged to take it over and "fix it", thereby creating a far more socialized system. This would be the death knell of any semblance of a medical industry we have left.
Luckily, independent (portfolio!) physicians are quietly becoming more popular choice, and people are educating themselves in the *real* traditional medicine as well. Even the people still in the system are learning to scrap "health" insurance to get way lower cash pay prices and to give fake names/addresses with "no ID" in the ER, etc.
Socialism has caused this mess and the brainwashed crying for more government intervention just aren't going to get their way. It's done. We've had it. Bring back the 100% free market, total capitalism, where anyone with the chops can roll in and give better care for better prices and force everyone to compete over clients again. Will whitecoats be taken down a notch or two off their unwarranted pedestal? Of course. Will they have to work evenings and weekends in many specialties? Sure, at first, until they make good names for themselves. Will they need to have the humility to learn from clients who are experts in Condition X because they've been dealing intensively with it for years or decades? You betcha.
There's your brighter future! Whitecoats can either join reality and ditch their pissy misery for a deep satisfaction in life ..or not! But the rest of us are moving on.
My wife and I just joined an alternative to all this mess called CrowdHealth.
It was a scary decision to become uninsured, but here’s a post about how we came to that decision!
https://nicholaswestfall.substack.com/p/why-i-got-rid-of-health-insurance?r=61w2ip&utm_campaign=post-expanded-share&utm_medium=web
I'm finding more of my clients are actually going back to private practice in the Concierge space. Even hybrid where they offer the concierge fee and also accept insurance.
The more you own, the more it owns you. I have owned my healthcare practices for 32years. I love creative control on how best to serve the patient and to care for my second family(employees) . The money can be better but the responsibility can be great and that can erode some joys of having more money. There is a concerted effort to collapse the system to a universal basic system like the UK and Canada. Best for you to have your pricing at a level that ‘self pay’ Will bite at. The government wants to control healthcare and they are capturing it through over regulating it and breaking it so people will come to them asking for them to take it over. Learn how to keep your costs down by comparing what other countries do. In the USA , it’s all about using expensive devices and drugs. Medical technology is great and some things are worth the investment and some slightly older and more affordable technologies may still be worth using as they will improve your ROI and patents expire allowing some competitors to provide price improvements. Medicare and Medicaid prices have been imploding for 30years. Be careful not to hitch your wagon to a ‘falling star’.