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The Hidden Epidemic

nytimes.com — An article on how the majority of med students are going into dermatology and plastic surgery instead of general medicine...... "Dermatologists say they enjoy the variety of a specialty that encompasses serious illnesses like skin cancer and psoriasis as well as conditions like uncombable hair syndrome."

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  • CryRightardCry, on 03/20/2008, -16/+5Requires NYT account.
    Why don't people put that in the description?
  • nickrct, on 03/20/2008, -0/+20Doctor? I call you pimple popper M.D.!!
    • Chompy, on 03/20/2008, -1/+5Yeah, that's nice. Here's your bill. Since I'm an elective specialist, you pay me in cash. And my malpractice overhead is almost non-existent. What are you going to sue me for, a wicked blackhead on prom night?
    • jemka, on 03/20/2008, -3/+1esthetician != dermatologist
    • ShooterMcGavin, on 03/20/2008, -0/+4Nice one nickrct.

      Apparently, Seinfeld references just aren't as recognized anymore.
    • dgp1, on 03/20/2008, -1/+1Awesome nickrct! I came here just to post that, and now I don't have to. Thanks for being here posting jokes while I was asleep.
  • sarixe, on 03/20/2008, -1/+21uncombable hair syndrome? wtf? solution: GEL
    • TheSexyGeek, on 03/20/2008, -0/+3Gel doesn't work for us black folk. :) If my hair gets too long, it is IMPOSSIBLE to comb.
    • sholt, on 03/20/2008, -1/+6UHS is a real condition, affecting hundreds of people every day, you insensitive clod!
      • geddon, on 03/20/2008, -0/+2Right up there with Sleepy Leg Syndrome.
      • sarixe, on 03/21/2008, -0/+1i suppose it's just as bad as being emo... you get upset for no reason.
    • zwaldowski, on 03/20/2008, -0/+3My hair, for one, is too thick for gel. Short, but thick.
    • guyincognitoo, on 03/20/2008, -0/+3I wish I had that problem, that would mean I still had hair.
  • N3M3515, on 03/20/2008, -5/+6The real epidemic is inflation to earnings increase - last year the CPI was 4% meaning if you didn't receive over a 4% raise over the last year your now making less money.
  • Pittance, on 03/20/2008, -9/+1These people have $350 grand in debt and they are having ***** KIDS? If they somehow arent able to make enough money at all times to cover their massive debt, expenses and child expenses, who do you think will suffer?
    • Gerz1219, on 03/20/2008, -1/+3You might not realize this, but if you are a graduate of Harvard Medical School, you typically do not have to worry much about your financial security.
      • Pittance, on 03/20/2008, -3/+1I guess its true if your parents can afford to send you to a private ivy league school, you dont ever have to worry about money. Or be borderline genius/insane and spend all your waking hours studying.
  • jonnyboy1544, on 03/20/2008, -7/+14“It is an unfortunate circumstance that you can spend an hour with a patient treating them for diabetes and hypertension and make $100, or you can do Botox and make $2,000 in the same time,"

    Hmmm if our medical system becomes government run, guess who sets the prices and tells doctors what they can and can't do... it's going to scare away doctors to countries where they can actually make a living.
    • lhbaker, on 03/20/2008, -1/+3I'm guessing universal healthcare wouldn't outlaw private practice.
      • diggrnumber1, on 03/20/2008, -0/+0under hillary, it essentially would.
    • KraftDinner101, on 03/20/2008, -1/+2Yes, because every country with socialized health care is starving for doctors.
      • jonnyboy1544, on 03/20/2008, -0/+5For family medicine type doctors, absolutely. There's no money in it for them. I've lived in Scandinavia, it's a problem.
      • diggrnumber1, on 03/20/2008, -0/+0correct
    • DrDigg, on 03/20/2008, -0/+6Our re-imbursement system is based on gov't rates. They already set the price. That is why the visit is $100.
    • ArchiTech, on 03/20/2008, -0/+1I thought people became Doctors to heal people...
      • jonnyboy1544, on 03/20/2008, -0/+2They do, but don't you think they should be compensated for their service? At least to cover the hundreds of thousands of dollars in loans...
        • kreneskyp, on 03/20/2008, -0/+1maybe theres also a problem with how much it costs to goto school. IMO there should be more grants and scholarships for the medical profession
      • scottfarner, on 03/20/2008, -0/+2They do. The problem is that they go into fields such as Plastics and Derm because they don't have to go into a (relatively) underpaid specialty where they have patients who don't follow their advice, are demanding, and often disrespectful. There needs to be an increase in pay for the primary care specialties to attract the best/brightest in the medical field. Everyone thinks that doctor's are overpaid, but a primary care physician may make less than an accountant/banker/dentist/etc... Society needs to start prioritizing their needs. We, as Americans, want it all, but don't want to have to pay for it.
        Of course, the "lifestyle fields" are highly competitive, you have intelligent, highly motivated individuals who actually desire to have a certain quality of life. How dare them?...
    • jnaz343, on 03/20/2008, -0/+1what Dr.'s spend an hour with a patient? I see a Dr. it is a 20 minute wait and a ten minute visit.
  • KaiSe7eN, on 03/20/2008, -17/+1Buried.....Who the ***** cares.
    • smacksaw, on 03/20/2008, -0/+8When you're next to me in the ER waiting are, dying and there's no doctors to help you, when you beg the admitting nurse for help and whine about the pain you're in, I'll be sure to interject "who the ***** cares?"
  • KyleRayner, on 03/20/2008, -3/+9***** everything is a hidden epidemic these days.
  • AlienClown, on 03/20/2008, -2/+1At first I thought it said "uncontrolable hair syndrome." I wonder which is worse.
  • jabbasi, on 03/20/2008, -0/+3That's where the money's at
  • jdavid, on 03/20/2008, -2/+19plastic docs do not bill to insurance companies. universal healthcare will quicken this trend. what we need to do is to pay doctors well, and engineer the BEST tools in the world for them to use that are 75-95% cheaper to use. I have never heard anyone complain about paying doctors, its always about paying medical bills, which are inflated because insurance companies reject more than 50% of the bills that are submitted by doctors.
    • scottfarner, on 03/20/2008, -0/+1While I agree with the sentiment of this post, the fact is for the majority of Plastic surgeons, they do bill insurance/medicare. People forget that most of Plastic and Reconstructive surgery falls under the non-cosmetic part of the field. It isn't all boob jobs and face lifts and botox. Dr. 90210 has damaged the reputation of one of the best fields in medicine. There is a reason plastic surgeons are called the surgeon's surgeon.
  • rumplestiltz, on 03/20/2008, -0/+15My friend who was at the top of her med school class chose dermatology so she could have a somewhat normal lifestyle.
    • Pittance, on 03/20/2008, -0/+7And the money. Don't forget about the money.-
      • dgp1, on 03/20/2008, -0/+3haha, your nick is so relevant to your comment...
    • priegog, on 03/20/2008, -0/+1It's a shame already... a mind like that should go into something like internal medicine... Anyways I guess it's a matter of vocation; it's not like she didn't know where she was getting herself into to say "oh poor her, she HAD to choose derm..."
  • perot9296, on 03/20/2008, -1/+3Supply and Demand will bring about the proper change or should in theory. But given the health system here, who konws.
    • staeiou, on 03/20/2008, -1/+10No, Supply/Demand and the free market caused this to happen: students try to make the most money because of the debt they are in, and the most money is in superficial services to the rich. The only way the supply/demand will "bring about the proper change" and get more doctors into general health fields is if the cost of general medicine goes up to match the costs of plastic surgery (or if old rich people start accepting that they are old, which is unlikely).
    • diggrnumber1, on 03/20/2008, -0/+0medicare doesn't pay well. the govt sets the prices on major medical treatments.
    • RobotCitizen, on 03/21/2008, -0/+1Medicare reimbursement is biased towards procedure-based specialties. That's why more med grads are going into Derm and other specialties that let you do a lot of procedures you can bill for. As the government keeps trying to cut Medicare reimbursment to save money, primary care becomes more and more a high-volume business. The primary care doc has to cram more patients into the average day, with less time per patient. This leads to more stress, longer days, and more disgruntled patients sucking the doc's soul dry. This is why med grads are going into fields that let them see fewer patients, with better reimbursment per patient. Hence the 1-minute botox injection earns the dermatologist a hell of a lot more than the 20-minute complete yearly physical earns the primary care doc.

      The primary care deficit is purely a product of economics and psychological self-preservation.
  • Stopher, on 03/20/2008, -0/+9"These people have $350 grand in debt and they are having ***** KIDS? If they somehow arent able to make enough money at all times to cover their massive debt, expenses and child expenses, who do you think will suffer?" It's because they're both halfway through medical school. You can only put off having kids for so long. That debt will go away once they're working & making 495K each for treating crows feet.
    • Pittance, on 03/20/2008, -1/+4IF they get their residencies. And if they pass through and start a profitable practice/et al. THEN, they may pay it off and earn 500k a year. But what happens to their 2 newborn/toddler children if he gets a residency in NYC and she gets one in LA? They have to take them because they cant afford not to. If you want to go to school and be in serious debt until your 28 or 30, then maybe children arent right for you. Youve got to pick what you want to do in life. Not just do everything at once and pray your book smarts make it work out.
      • TheRedNewt, on 03/20/2008, -0/+7Many hospitals are well aware of those type of situations, which is why they have programs designed specifically for married couples.
    • lhbaker, on 03/20/2008, -1/+3Right. Because people should always pay off their debts before having children. And once they do have children, the shouldn't do anything supid such as finance a car or get a mortgage or go back to school.
    • guyincognitoo, on 03/20/2008, -0/+2They really should have gone to state schools. The only thing that matters is the MCATs to get into med school, and then Step 1 & 2 to get into a good residency. The residency is where you get the good training and make contacts. I have a friend who went to a NYS undergrad and Medical school for about 90k total. Did good on the tests and is now in a hematology oncology fellowship at Brown. All people seem to care about is what school you went to, but that is irrelevant in the long run.
    • diggrnumber1, on 03/20/2008, -0/+0that's what life insurance is for. even if they die, their kids will still get something (assuming they have life insurance. if they don't they're idiots.)
  • stonewaljacksn, on 03/20/2008, -7/+4ITS THE END OF THE WORLD. yea, because being a general medicine doctor is pretty much on par with being an elementary school janitor...nobody wants to do that *****. buried for the weakest attempt at fearmongering ever.
    • Pittance, on 03/20/2008, -0/+8Except that both are extremely necessary and vitally important for life at all? Doh, lets pay them less and make their jobs suck! That way we can die early deaths and our children can be asshats.
  • xienze, on 03/20/2008, -2/+5I've got two friends in med school and thankfully they're in it for the "right" reasons. They indicate that the majority of med school students are looking for specialties that pay the most money and require the least number of hours. Obviously we all are striving to achieve that goal, but it kind of makes me sick to think that doctors are increasingly in it for the money and prestige rather than helping people.
    • gnomemage7, on 03/20/2008, -1/+9Yes, because all of the lawyers in the US go into law because they want to bring about social justice

      People can choose their career for whatever reasons they please. Medicine is a ridiculously difficult career and if someone has the brains then they also have the free will to enter it for whatever reasons they wish. Who are you to decide what the "right" or "wrong" reasons are to enter medicine.
      • xienze, on 03/20/2008, -4/+1Look, I can understand if you're doing some job where people's lives don't hang in the balance if you do a half-assed job just to collect a paycheck... but doctors? They do need to be held to a higher standard.
        • mw113, on 03/20/2008, -0/+3we are held to a higher standard and are there because we have a passion for it. you can't spend 12+ years in school just for the money.. you learn that in the first semester of med school.
    • Pittance, on 03/20/2008, -1/+2Just be happy that being a cop and firefighter/EMT isnt a high paying job. All those horrible corrupt cops that make the other 98% of good cops look like *****? Imagine how many thered be if it paid 120k a year.
      • Skooma714, on 03/20/2008, -0/+198%?

        I've heard former New York City detectives saying that pretty much the entire department was corrupt.
    • blackinthmiddle, on 03/20/2008, -1/+1You're fooling yourself if you don't think people, at least in part, do what they do for the money. When reality hits and you're struggling to pay your bills, you're going to look to the area of your profession that pays the most, unless money is not an object.

      Yes, there are plenty of people who do what they do simply because they love it and the pay is crappy. However, one of two things is usually the case. 1. - They have *someone* footing the bill. A wealthy husband or parents. 2. - They don't have money and that fact eventually forces them to change course and go into an area with more money. They initially said they didn't care about money because they were doing what they loved. Then reality hit them!
      • xienze, on 03/20/2008, -0/+0Notice that I said that we all try to get the most money for the least amount of work in my original comment. My point is that doctors hold the lives of their patients in their hands every day... I would hope that they're not just trying to coast and collect a paycheck.
        • DrDigg, on 03/20/2008, -0/+3I can tell that most don't. To be honest it is too hard to go through the process to become an attending physician if you are just in it for the money. My dad is a doctor too and he try to dissuade me from doing it. He told me if you are in it for the money you will drop out. He also told me you can more money in another field (and with less debt) if money is all you care about.
  • dxgg, on 03/20/2008, -0/+4Uncombable Hair Syndrome? Back in the day, we called that bald.
  • chanop, on 03/20/2008, -2/+3You're a bunch of anti-dentites
  • ilves7, on 03/20/2008, -1/+15It's not surprising that people who've been in school for 4 years, usually with ~200k or more in debt, and facing at least 4-5 more years of residency making only about 40k a year, choose not to go into a profession that will pay 90k out the gate (primary care) instead of something like derm which pays a crap load more. Systems broke... who the hell would want to become a pediatrcian or primary care doc in a situation like that? Bottom of the barrell...
    • Pittance, on 03/20/2008, -1/+3The doctors who get in it to help people, who try for scholarships and grants. Not the ones that want to do what their daddy does, and has him pay for it all so johnny ***** can buy a porche first year of practice.
      • toxicshok, on 03/20/2008, -0/+1welcome to the real world
      • RobotCitizen, on 03/21/2008, -0/+1You seem to expect doctors to be martyrs, like they shouldn't expect out of life what everyone else expects. Things like quality time with the family, downtime to recharge, not having to work themselves endlessly to pay back the half-million dollars in loans they took for med school and starting a practice from scratch, and to cover their 60% office overhead.

        A medical practice is a business.
    • guyincognitoo, on 03/20/2008, -0/+1That is where the foreign grads come in. They can have the highest scores, but preference is given to US grads when placing residencies and fellowships. Since they can't get into anything else, they do primary care or internal medicine. They still make more then they would wherever they are from, so they are happy.
  • slevit1, on 03/20/2008, -0/+17I'm in med school now, and I'm hearing a lot about the effects of managed care on physician reimbursement. Say what you want about doctors wanting to make money, but I will not be in any specialty which requires me to take insurance. I don't know when it became acceptable for an insurance company to just decide what part of a bill they feel like paying.

    I'm confident that universal healthcare will never happen in my lifetime in the US, but if it does, you can kiss primary care and family medicine docs goodbye.
    • dgp1, on 03/20/2008, -0/+5seriously. Insurance companies are the #1 ripoff in my life. And i'm a patient not a doctor.

      And it's all kinds of insurance that are this way. I love how my dental insurance pays for about 30% of my normal freaking dental work. I won't even have a medical procedure done anymore unless they can tell me exactly how much it will cost me up front. Of course they usually can't.
    • kwazyhulk, on 03/20/2008, -0/+1Actually I think it's the other way around. With a multi-payer system like we have now with insurance companies we are effectively kissing primary care docs goodbye. There is less incentive to become a primary care doc with our current system. Universal health care funnels more patients to primary care docs therefore increasing their value. Primary care docs therefore have better salaries in those systems. Socialized medicine has its own set of problems but it places a priority on preventive care therefore it calibrates its pay scale accordingly.
      • slevit1, on 03/20/2008, -0/+2No, I'm afraid you're wrong. Medicare is the closest thing we have to universal healthcare right now, and it's precisely what started the problems we have now with low reimbursement rates. Medicare gets a bill, decides how much of it they feel like paying, and then that's all the physician gets. Then, other companies, like BCBS, decided to do the exact same thing. If universal healthcare were to ever happen,the government would just have more control over reimbursement schedules and primary care physicians would get paid even less than they do now. There are already doctors (many) who take insurance, but not medicare, because they don't pay enough.

        Why do you think you wait forever in the doctor's office just to talk to the doctor for 10 minutes? It's because it does not pay for the doctor to talk to you. He gets paid a small fee for seeing a patient. However, he can make twice as much interpreting an EKG or some lab work, which takes all of about 20 seconds to do.

        As far as other countries with universal healthcare, the doctors still do ok (probably around $100,000 a year), but make nowhere near what they could be making in the US. They certainly are not making more than any doctors here. Government control over healthcare = bad. The sooner the US stops looking at healthcare as an entitlement, the better.
        • Ellipsys, on 03/20/2008, -1/+1I'm afraid you're overlooking the fact that with multiple insurance companies, its harder for physicians to "pin any of them down" to say their fee schedules were wrong etc. In the event there was one, single payer then every physician could get together if there was a problem and say "Hey, this is an issue. We know exactly who to talk to about it, and we all participate." Big business had their chance - in fact, medicare fee schedules are partially based on algorithms invented by insurance company lobbyists in the 50s. Now its time to try something new. In general, doctors /want/ medicine to go back to being medicine, not the business it is now. A single payer system will alleviate this, and give doctors more leverage in financial reimbursement. When you say that doctors elsewhere are making less than doctors here, please consider that for every one plastic guy making 400,000, there's a general surgeon (or GP, or internist) who's barely making $50,000 -70,000 because of insurance. I think between adopting a GOOD, physician driven universal health care system and scaling back payouts for non economic damages in trials, we can get the medical profession back on its feet.
    • Ellipsys, on 03/20/2008, -0/+3I'm a fellow med student (or, at least I was until a chronic, expensive to treat illness forced me to stop) and my father is a general surgeon. Insurance companies screw doctors over, screw patients over and the change that this article details is only the tip of the iceberg. My advice to you would be, if you don't want to "sell out " and take a specialty like plastic or dermatology (and most dermatologists DO accept insurance by the way, and even if you go into plastic, unless you have your own operating theater, you'll need to take some reconstruction cases to keep privileges at hospitals, in many cases), to join a group that pays you a salary, or get hired as a hospitalist (basically a doc that is hired directly by the hospital, again for a flat salary. You will make more money this way than trying to strike out on your own when you're the new guy.
  • niradg, on 03/20/2008, -1/+4this is a great example of the negative consequences in having a society with immense wealth disparity. people are less willing to behave in a manner that benefits anything beyond their own bank account.
    • lhbaker, on 03/20/2008, -0/+1Perfectly stated (except for the caps).
    • slevit1, on 03/20/2008, -0/+3The wealth disparity and people not wanting to work for anything beyond their own bank account is not hardly the problem! The problem is physicians not being payed what they deserve to be paid. After literally a quarter million dollars in debt from medical school, 4 years of undergrad, 4 years of med school, and up to 7 or 8 years of residency, doctors should not be getting paid $10 per patient!
      • billbillbilly, on 03/20/2008, -0/+1you cant have your cake and eat it too, to pay doctors more means your bills go up
    • MatthewDuke, on 03/20/2008, -0/+2Spoken like a poor and/or lazy person...
  • BuDTheDude, on 03/20/2008, -0/+4The summary is blown out of proportion, but two points should be made:

    1) whoever submitted this is into sensationalism. At one of the hospitals associated with my medical school, there were 400+ applicants for 4 available derm residencies -- thats right, only four. With numbers like that, it is impossible to for the majority of medical students to enter the field. And plastics? I would guess that is
    • sq2shooter, on 03/20/2008, -0/+2This is so true. Baylor College of Medicine in Houston gets hundreds of applicants for Derm and also only take around 4 every year. It is a great field to get into. You don't get called late night for emergencies and many derms don't even take insurance so it is a cash business.
  • smacksaw, on 03/20/2008, -1/+11Gotta rein in malpractise insurance for a start. If a doctor is not competent, that is what professional and even criminal punishment is for. Insurance only benefits trial lawyers. If a doctor makes a mistake, forcing all doctors to pay for the care of a person is punitive and stupid. It should either be covered by everyone's health insurance, social insurance or both. You'd solve a ton a problems right there if you did that.

    Secondly, you can't have a multi-tier competition between doctors. You can't dictate to physicians what things cost while letting these dermatologists and plastic surgeons thrive in a free market. Either cover elective surgery and regulate the prices or put huge taxes on the elective procedures and put it into defraying the cost of actual life-and-death medical care.

    This sort of thing is a disaster here in Canada. Doctors get paid nothing, hospitals are closing critical care beds - the system is bankrupt and it's yet more taxes to raise money to pay it. Many doctors don't want to practise here. We tried for 2 years to get a family doctor for our son and we still don't have one and he needed to see a specialist and it took almost two years. Luckily I'm an American, so our family doctor for kid is now in the US, but not everyone has that luxury.

    People need to take back their health care from the bureaucracies who thrive on bilking us.
    • scamper22, on 03/20/2008, -0/+0or maybe...just maybe

      It's unsustainable to think that every ailment you get can/should be covered by your own personal medical specialist.
      Just maybe it's not your right to live your life to the maximum potential covered by medical technology.
      Just maybe there are better ways of having health care (nurse practitioners, use of technology...).

      And we talk about how hard med school is and how many hours they work...well why should society pay high salaries when the medical profession on its own decides to make residency a living hell? Why should society pay more when its the medical profession that decides you need to spend 7 years in school and it costs 200,000 dollars?

      • smacksaw, on 03/20/2008, -0/+1My wife is an acupuncturist, so I know that as well as anyone, but it still comes back to bureaucracy. Doctors, the AMA especially and pharmaceutical concerns make a lot of money by bilking the system.

        We need to get down to what things really cost. That's one of the problems here in Canada - the far left are in love with single-tier medicine which has so many problems I can't get into it, but one of them is that it's corporate welfare. Society pays it because of lack of choice. We carry supplemental Canadian insurance to cover our dental, vision, chiropractic...and acupuncture, which is free for us LOL.

        Canadians have little choice about payment. In fact, one of the biggest eye-openers for me (and something Americans should be careful of) is that nurses here are unionised and they can and do go on strike. Because of that, they have a backdoor into tax policy. They go on strike and medical care slows or even stops. And until gov't gives them money, nothing happens. If you think about it, they are either forcing a tax increase to pay for their wages or they are forcing budget cuts from other areas to pay for their wages.

        That's how the price of things keeps going up. Socialised medicine does some good things in controlling prices, but in areas like this it fails miserably.
  • kwazyhulk, on 03/20/2008, -0/+6It's interesting when you compare physician salaries in America versus countries with socialized medicine. In Canada for example, primary care doctors make more than many specialists.
    • dblespresso, on 03/20/2008, -0/+2but they still leave to where the free market sets a higher wage. Welcome to the global economy.
    • fokov, on 03/20/2008, -0/+1Could that also be related to a country that does have as many Vain people that want to look good as an air-brushed Hollywood model?
    • diggrnumber1, on 03/20/2008, -0/+1but there's still an incredibly dangerous shortage of doctors in Canada, because almost all doctors in canada get paid less than doctors in the u.s.
  • vwvan, on 03/20/2008, -10/+4doctors... greatest entitlement program ever...
    i went to med school and suffered. Now kneel before me, or I will let you die.
    • slevit1, on 03/20/2008, -0/+1You have serious inferiority complex issues.
    • Ellipsys, on 03/20/2008, -0/+4Your ignorance is astounding. Medicine is the only profession that doesn't pay what the practitioner bills, because of insurance. I'm guessing you're too young to work, but lets say your a plumber. You go to someone's house, fix their toilet and hand them a bill. They pay the bill, you go home right? Now we'll try it under the rules physicians face every day. You go to their house, fix their toilet and hand them a bill. They send the bill off to their insurance company (so now you don't have the money right away) and 6-8 weeks later, you get a check in the mail for $10 if you billed for $200 because "Fix toilet" was on the insurance company's books for $10 and that's all you're going to get.
  • rakeoflife, on 03/20/2008, -2/+2welcome...to IDIOCRACY
  • danq99, on 03/20/2008, -0/+0there are a very limited number of derm and plastics residency spots, so while the majority of students would like to go into these fields, it isn't possible. The real hidden epidemic is the lack of medical students entering primary care due to better pay of most specialties.
    • dgp1, on 03/20/2008, -0/+2Isn't that basically what the article is about!
      • danq99, on 03/20/2008, -0/+0this article is billed as "An article on how the majority of med students are going into dermatology and plastic surgery instead of general medicine" which just isn't true/possible.
  • luft, on 03/20/2008, -0/+2First of all, as it has been pointed out, there are very few spots for dermatology residency, so they are getting only like 1% of grads. The thing is, they are getting the absolute top of the applicants. Dermatolgy is attractive because it makes a ton of mondya while requiring minimal hours. There are probably a few people that go into it for the love of skin diseases and how they can help people, but the truth of the matter is most dermatologists are the gold diggers of the medicine world. They want lots of money for little work. Let me tell you, as a med student I did a rotation in dermatology and it is deadly boring stuff. Just lots of weird little (or big) spots on the skin and lots of minor skin biopsies. Boring, boring, boring. I would hate my life as a dermatologist.
    • josephgoro, on 03/21/2008, -0/+0"Top" is a complex term. I wouldn't want most of these derm applicants to be my primary care doc, precisely for values selected for by the process, so perhaps it's for the best.
  • dgp1, on 03/20/2008, -0/+1Awesome the banner I got on this page was for "Tonik" blue cross cheap health insurance.
  • anteyekon4myst, on 03/20/2008, -2/+1I'm not religous or anything but isn't there something in on of those Holy Books that says vanity will be the undoing of mankind? I know this may not be a huge problem right now, but if cosmetic sciences are where the money's at then who.g.a.f about medicine.
  • Cattywampus, on 03/20/2008, -0/+1I guess this will make a reality that old celebrity saying, which goes something like "Live fast, die young, and leave a good-looking corpse."
  • FrancisB, on 03/20/2008, -0/+5Figures. It's one of the few free market specialties left to doctors, where their costs aren't "set" by the government.

    In the last 5 years, I've had 2 primary care doctors quite medicine (both were in their late 30's early 40's.) Think about it. 12+ years of schooling and residency. A mountain of debt when you start your career in your 30's, and you're stuck making $150K as an generalist, and are told by the insurance companies you must see a patient every 8 minutes... Mind numbing, and burns these guys out in a few years...
  • snotrokit, on 03/20/2008, -0/+3the malpractice insurance for those fields is also MUCH lower.
    • diggrnumber1, on 03/20/2008, -0/+0my parents are dermatologists, and they keep talking about how other dermatologists and plastic surgeons that do more cosmetic stuff get sued all the time because all their patients are assholes that don't have a job and have nothing better to do.
  • dblespresso, on 03/20/2008, -1/+1be very care full about what you wish for.
    government control -> lower profit motive -> less/lower quality medical

    elective medical is an example on how all medical should be. Free market competition, consumer aware of cost. What if family doctors competed on price and quality the way that Lasix doctors do. The best rise to the top and efficiency and quality go up.

    • ArchiTech, on 03/20/2008, -1/+2And the poor lose any chance of getting health care.
  • ArchiTech, on 03/20/2008, -1/+2Reading this entire comment section has made me realize why I'm not ready to move to the United States.

    Universal Healthcare, like any system of procedures in any industry, has flaws.

    Yes, I have to wait 45 minutes to see my doctor, my father had to wait a week to get a test done, and my boss had to wait a few weeks to see a specialist...

    But at least we didn't have to worry about a bill when we did get medical attention, I didn't have to worry if I could afford the medication. Instead of worrying about whether or not I could pay the bill, I could focus on healing.

    When did Americans put a dollar value on human health and well-being? How can people even think about which medical practice pays more when the primary reason Doctors take the Hippocratic Oath is to heal people.

    America is a great country, but it seems odd that it's one of the last developed nations to not have Universal Healthcare.
    • ShBm, on 03/24/2008, -0/+1No, you just paid for it slowly in your taxes.
  • stix213, on 03/20/2008, -0/+1At least curing skin cancer will only cost you $50 in 5 years
  • Kenzan, on 03/20/2008, -0/+2With the crushing debt that Medical school imparts on exiting students, and the prospect of being massively overworked as a resident for the next 5 years, can you really blame them?
    • josephgoro, on 03/21/2008, -0/+0As someone graduating with about a 100k in med-school debt, and choosing to not go into dermatology -- yes, I can blame them. It's easy to say "to each his own," and to spin the merits of an open market, but it takes some moral conviction to admit that this is part of the problem, and that individuals share social responsibility.
  • sndream, on 03/20/2008, -0/+1Anyone watched Sicko will realize every lies it told during the movie is the exact reason why this kind of stuff happening, when then society ran on stupid idealism instead of logical thinking, things go haywire.
    I am sorry, but the truth is that top medical care cost money, if the society have some ridiculous idea that people in the health care industrial, should it be doctor, hospital or pharmaceutical company should not earn a profit for their work then no one will continue to do their job. Everyone wants money, except some people want to work as a dermatologists, some just demand a bigger welfare cheque
    • diggrnumber1, on 03/20/2008, -0/+0what the ***** are you talking about?
  • caponumen, on 03/22/2008, -0/+1Where they will probably still kill many unsuspecting clients.....
  •  

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