Always ask questions, it is your right.

>From: James <[log in to unmask]>
>Reply-To: Harpsichords and Related Topics <[log in to unmask]>
>To: [log in to unmask]
>Subject: Expertise etc. (way way off topic)
>Date: Tue, 22 May 2007 22:26:17 -0700
>
>At 09:53 PM 5/22/2007 -0500, Jay wrote:
>
>I can't help asking--does any of this fit any historic paradigm of
>"conservative" or "liberal?"  Near as I can tell, all those stereotypes
>have gone out the window.
>
>Doesn't Wal-Mart epitomize the market economy, which "conservatives" 
>support?
>
>Incidentally, I went to have my eyes checked, and the ophthalmologist says
>I have fairly a fairly advanced cataract in the left eye, and as a
>consequence suddenly the required correction for that eye has changed
>considerably.  Then he whips out a little model of the eye and starts to
>explain to me basic optics, stuff I learned as a physics undergrad.  And
>explained to premeds as a graduate teaching assistant.  Do I play dumb at
>that point, or do I ask a question or two, which will likely piss him
>off?  Looks to me that the cataract has changed the index of refraction of
>the lens.  The thing that puzzles me is that the old prescription still
>seems to work fine in most circumstances.  Is it legitimate for me to be
>curious about this, or do I just accept his authority?
>
>I've run into this problem before, and I still haven't figured out the
>appropriate strategy.  I'm afraid I'll continue to be seen as a smart ass
>as long as I continue breathing.
>
>JB
>
>
> >on 5/22/07 10:51 AM, Stuart Frankel at [log in to unmask] wrote:
> >
> >
> > > James McCarty wrote:
> > >
> > >> I guess the difference between my work and yours is that while I 
>would
> > never
> > >> pretend to understand modes, my patients read something on the
> > internet for
> > >> 15 minutes and think they understand it better than I do :)
> > >
> > > I don't see the problem - if they already understand things,
> > > then they must be consulting you for very high-level help,
> > > and you could charge accordingly.
> >
> >They don't come in to consult. They come in to argue. They really do 
>think
> >they know more than I do.
> >
> >And we can't "charge accordingly." Our fees are set by the insurance
> >company--no negotiating allowed. Even if you are the chairman of the
> >department at the medical school, or if you have a particular expertise 
>in a
> >certain disease, it doesn't matter. You get paid exactly the same for 
>that
> >office visit as the guy fresh out of residency. And you never get a
> >raise--well, actually you get a pay cut, because the cost of operating 
>your
> >office keeps going up while the reimbursement you get stays the same. 
>Some
> >incentive for excellence!
> >
> >Don't worry, though. In a few years you won't have to see us horrible
> >incompetent American doctors. You'll be ushered into a room with a TV
> >camera, where you'll consult with someone in Thailand or India who's 
>willing
> >to do it for a lot less. Hey, price is all that matters, right? It's the
> >Wal-Mart way.
> >
> >--
> >James R. (Jay) McCarty, MD
> >Fort Worth, TX
> >
> >"Sine arte, scientia nihil est"

_________________________________________________________________
PC Magazine’s 2007 editors’ choice for best Web mail—award-winning Windows 
Live Hotmail. 
http://imagine-windowslive.com/hotmail/?locale=en-us&ocid=TXT_TAGHM_migration_HM_mini_pcmag_0507