Or maybe it is not -- I expected to read in the Wall Street Journal in in particular are not right in middle of page the most prominent article. Import some of that set. You. In survey. A majority of doctors in this country. So big reduce storage of print or family member from entering the profession. They go back to Serb area of 121000 positions of which. Only 6%. Described their morale was positive 84%. So of their incomes were constant -- deep reaching. And they quoted doctors like that wouldn't do it again. Have not been doing with the money. I get to respect from patients. Position colleagues. Administrators. And on and -- and and and gotten much more than that. -- It's a wall article in the gives economic reason to rock receive resumed his page and read. And the question I immediately. Called the couple months to written in the consumer email -- article and so did you feel that we do it. And both of them -- -- -- -- know we still love what we do. During their seven easily succeed in their. Gingrich get retired. Both that the end of those you but it talks over the younger doctors in particular. Primary care doctors. You're gonna get a whole different story so. Veterans and and we convinced the doctor did talk to who's on the dark Ford spirits a -- of roads and bridges state medical society. And practicing pediatrician doctor. Once again welcome -- sure appreciate it time. To what do you think his message or reaching or did they take. Just a little isolated surveys and blow -- open -- something much bigger. Now it's it's pervasive and it's it's that nationwide. I think it's a great deal of frustration. I think the older physicians feel that. A little more because Madison was. Practiced differently where it was it was the profession. And the position. Less independent most physicians practice independently. And in today's marketplace. It's more you're you're pretty much -- job. He I mean it was a comment. From the state the other day -- at -- and I only pediatricians. To do shots and -- cultures for strep throat when we can get a bunch of nurses do cheaper. And you know I mean from opposition's point is that the ultimate in disrespect. In that. They. I think his work while paying you to do. The fundamental things that that a pediatrician would view which is -- acute for dramatic -- and make sure that they're immunized against all of their diseases so it's an attitude brought on by young -- bureaucrats where. -- out to them we just widgets. And if they can find a widget that'll do the job -- -- they'll do it and says that at that frustrating scenario. By -- think the numbers support June 1970. Average income for a -- Position was 202210. 2010. It was a 161. Though. Sports what's causing the dropped into -- It's it's their party payers. You know once upon -- in the positions that their their own he's scheduled. And now almost follows operate under a reimbursement cable TV take it or leave it. And they have positions up against the wall because it's on ethical reform union strikes though. If who crosses the -- -- -- mean Medicaid Services Washington. Medicare said this is what you gonna pay we're gonna pay you take it or leave it. There's really not in a position to do about it that you need to take it or you quit. Tell me this is correct on this article and -- in -- of academic matters. The return or an educational and business investment. Or primary care positions. Adjusted for differences in number of programs work. Is about six dollars for a. For primary jacket that calculations from around practice and I make about 6000. Six dollars and homework right. -- go out into the calculation for Louisiana Medicaid that. Based on what they pay. In order to get pay the overhead -- the -- the electric BO you know salaries from a staff. After the patient every seven and half minutes. It -- take longer than seven minutes of the patient I go in the hole that take money out of my own pocket just to keep the expense. -- I'd. And we we've got to take a break produce the reading this this and hearing you verified. How does that sustain. How does that keep gore -- -- what does it take you. -- to become a pediatrician. Two -- you open draw that you buy equipment hire the people and you actually start making money twenty years. I'm detecting that. I can carry it. I've done it twice now I get that started practice and I did it again after Katrina because my office was totally destroyed in. And the patients -- -- -- -- -- this was and intently before Katrina. We're just now like nine years out from Katrina. Getting to the point where positive I've got six more loan payments to make. And the money at -- after Katrina we paid off so it takes about ten years he would Somalia. To the point where you actually. How positive in terms of making it. But that center. Four years of college in the in four years of medical school or right right and then how much -- and -- team. It's three years -- surgeries probably five or six and the sergeant had the advantage is -- in high dollar procedures which makes it a little easier for. Would you still take shifting the twenty something years to get started right. Right it take about that long to really establish in. Become pot when he got to the bank to borrow money by hour and up to live on for ten years. Up well a Serbian whole lot nicer to my doctor's. Office it's a -- and we'll come right back. And or you'll -- a few minutes with this they would covered up. Negated celebrity -- five the -- Good to get above what seems to be a lot of unhappy doctors in this country. Usually do so collected -- -- 8%. Of about 2000 positions question. Said that there and -- -- and for medicine is gone down in the previous five years seven pursuant said the overall Morales has declined during that time. Showing that thirty deporting person practicing positions. Would choose to under the medical profession. If they were deciding on the career today that it even higher percentage. Would discourage their children to pursue a medical career where doctor lord -- with the for a student. Louisiana State medical society and practicing pediatrician. What happened -- the ones that seem to be at pre approved reading it correctly the most unhappy with the primary care doctors. What happens if we can't roll -- then we go. As sued to open in the show 101006. By B rules. Every day in this country for the next between years. Well I mean that is the simple solution is that each individual patient at the -- longer. Ticket services I mean as there's only so many patients one to -- today. And once you're booked full year hopeful. He can squeeze in an emergency -- and Ambac on about basic care management. And therein lies a lot of the frustration is that. If so much regulatory burden that adaptation to have insurance or take the pay in Medicare. Have so many forms and papers then. Certificate that apt to be filled out that he's spent so much longer just due in paperwork. Which have to be done about it and I get -- it did a lot the basic information. But at the end of the days you sort of like a medical costs here is that what I'm doing paperwork. The -- Taking care patients. Come on top of that. Offensive mandated and an all -- the electronic medical records. And you know what the med school to treat patients not to be clerk typist yeah that and much more time typing on -- computer. Do you actually taking candidate because I've -- -- let's put some numbers on the the numbers of looking at. Euros doctor's been almost an hour each day which amounts -- 80083000. Dollars a year. Four times they're Canadian counterpart. And this is just dealing with the paperwork of the insurance companies not the federal government. Right at it it's it's the documentation issue and you know we've done. Discussions on things like the IDD ten conversion which is gonna make it work is -- -- quadruple Lima paperwork that -- To be done -- convert on the ICE nine coding system to the united CD and. Code system. I think more importantly it's the paperwork you have to do just to do something really really simple. Like prescribing antibiotics. You know I want a patient to be on a particular antibiotic -- -- call 1800 hey I'm number may I use this antibiotic inspection. Whereas twenty years ago I just pulled out a prescription and wrote prescriptions for that was done. -- Italy Poland some of our Alicia. Yeah Carol collecting insurance companies and you know federal regulation early need to look at it -- -- -- to be more -- maybe. Streamlining and that's. Well my main course it's a producer earlier. Understand how would be unethical for strikes but lies there and cook for your former union enter Jakarta and for -- Positions that we -- we still consider it to be a profession not a trade. In it's not a train -- electrical workers -- -- where you can join -- So from an ethical point of view we're not a trade where profession. And each individual professionals should should treated that way. Secondly it's illegal Sherman antitrust act says that each position that the competitor. With every other positions so you know I get it back to launch with -- another -- -- over lunch we talk about what we charge in the office. With technically violated the Sherman antitrust -- Because where competitors. We're not co workers as would be electricians and trade. A couple of years grows in New England renewed pleas from a heart surgeon. And his daughter have -- images smugglers have we go to get together boy -- here. As said fumble and would go on tomorrow and I knew suborn kin. We're going to prints to -- your -- worked on and and has said while I thought you had. The the government. -- solution here. And so we do but it's really bad industry shall we go to branch there. And it's put to bed in bone so if we have anything more computing we go to Germany. And actionable. How do you afford to do that outside of the government planning to -- I make a lot of money. And then I came back and learn about -- a year and a -- and where doctors. That have skills that are very important lung transplant so orthopedic that kind of thing. A charge those that can -- eight to today and get away from all the bureaucracy. Over -- seeing more of. I don't think so I mean you'd had a certain. Population that has enough money to be able to afford that. But the reality is the average person has health insurance. To protect them from the catastrophe. And the average person. Just couldn't afford them -- typical -- model. You pay a 150 dollars per our bonds. Per person in your family. To have immediate access to your position as much time you want. But -- you also pay charge when you actually see the positions that you basically plan and access the but the thing that that let thousand dollars per person in your family. Just they have accepted the position now granted you get much more time. And you individualized service. And it's great. But I look at it from my point of view where the patients that take care can barely afford the prescriptions that right now. And if they you know they could afford -- tea concierge city. What what were the answers it's these suggestions all the way to. Publicize include cool excellent given award for pigeons it's action. Replacing. Brokered. I think -- fee for service system with. Payments like boom -- pavement or there were any answers yet. -- is that -- put the patient back in charge of their health care. You know I get -- you know they want us to do these studies class. Where you do quality assurance and -- he proved that everybody's got shots and everybody's got. Hemoglobin a one B and he knows the -- patient's satisfaction surveys but you know thirty years ago. You patient's satisfaction survey -- was that the if you did did you the patient came back and individuality. Transferred to somebody else. Patients are not in control of their health care right now you'd have to do it every year insurer. Or your government insured by Medicare Medicaid you've got to do but some 25 year old bureaucrat in Washington -- to do you have a choice about it. But the government ought to do what the insurance can be got to do -- -- out of the business practicing Madison. And get into the business that is an important that the patient be in charge of their own health care. And one of the patient like the position they think they're getting good care. Then then they can decide this is the position that one city. If I'm not satisfied that they don't think they're getting great care station and the freedom to change positions they change planned whenever they want it. You know there is only one Medicare now would be unhappy that Medicare. Is not -- -- go down the street by now that there. It can this be done under obamacare. Not under Obama care. Obama -- it's in attempted to create one single nationalized. Health system. And and and the government like it that way we read these things about bundled payments and affordable accountable care organizations where you know 5000 doctors work under one tax -- -- And the government like that because. Taking control that organization with one person controlling 5000 docs. Guy like me say they treat us like roaches you know with scarring around do our own thing but they can't keep it under control because we practice independent. I'm not responsible to the government I'm responsible to my patient. And I do what's in the best interest of patient not within that system interest of Obama care of the government. And and when they mandate that apt to do that that's where the dissatisfaction comes look at the rule that went out. Now Monday -- the AK they've made it illegal for Adobe adapted to deliver a baby under 39 weeks gestation. A minute here and OB LA in labor and she's 37 weeks but he's supposed to try and stop it and wait to 39 weeks. Just because the government have to rule saying it's cheaper if he delivered babies at 39 weeks. And I am sure the -- attorneys are circling around that rule lecture art. You know waiting for somebody is trying to stop labor. Too late in the thirty now we deadlines. So they can -- the the the damages that are better record to the patient about waiting. That it is going in delivering and the only reason the government wants to do that is cut its cheaper for them at least -- thing. Doctor we can even have this -- usage from without can thank you so much for the talk. Doctor border it's kind of frozen in Louisiana State medical society in practicing pediatrician. We'll continue this conversation when we come back in the doctor's that are nurses. Do you believe this. Sounds like the profession. Is an unhappy one. Two's exit row one Sibley told pre. Anywhere in the country at 866. Indeed none 08 -- Or at any doctors their nurses. To you if you think it's right. It's totally inquiry of this and I called. A couple of doctor front -- which or. Quite a bit older and getting her to retire. They do -- with the oracle bought. The doctor we just have fallen and another Ottawa pediatrician. Doctor. Would terrorists preferably who resisted medical society. Says well this this is basically. Correct. What it is you can look up to walk through journal article and got a couple of them that mirrored the it's a wide doctors or sick. -- there profession. -- it got numbers behind it. Says the -- the leaders. Service. 50%. Of about 2000 positions question. Said their enthusiasm from that person had gone down in the previous five years and eighty sevens. It's 7%. Sad when pars. To the overall more Rahal had declined greatly drew -- that I'm. In the most recent surveys aside from born. Shows that thirty to 40% practicing positions. Would not choose him the medical position. If they had to decide. Career today. Ended even higher percentage. Or discovering there should discouraging their children. From pursuing medical career. And that's one. Thing I don't really interest in. A row in 1970. The average today. For a position in this country it was 250000. Dollars. 2010. A 161. -- Plus. During that time. Are near doubling. Of the number of patients and doctors see. What would go broke if we've got to obamacare. Virtually in place for at least half and please. Where the you know be a whole lot more patients. What happens. When we've got to a category. Of very important people that -- that -- doctors. In this of one -- -- and they have voted they're facing what is it in the Wall Street Journal article was elaborate and pulp paper bureaucracy. In eighty or bureaucracy. -- doctors spent almost an hour. On average Tuesday. Which comes about 83000. Dollars a year -- times that of their Canadian counterpart. And that jolts. Dealing with the paperwork of insurance companies. Not the government just insurance companies. To our office that spent more than seven hours -- -- Judge on a year. Ancient. -- And then of course regular -- a lawsuit. For malpractice liability premiums. And according beautiful Lotta physicians today. Where is we -- as severe -- profession that every wounded bird problem today. The view themselves Paul Owens and a battle between the insurance companies in the government. The temperature take good -- or Euro and governor bill appreciate the call. I Arlen I practice managers -- the position that while adding that it. Everything that article that this great position that they declining reimbursement. But it'll take the electronic medical record forces that it. Take longer and they're really and then. I'm still within that you particularly in the -- and take care education and develop that relationship. I'm making and then -- -- time after. Think he is feeling where. You buy insurance companies that they need this -- but it's something I'm. The debt service. Gone up and everybody. -- you are. You know where and when I have is so big grouping of about that I have very little knowledge at all. But I hear things like word you're saying you -- and everything. One of the articles and reading. -- from the journal of medicine. Medical journals. National college of physicians. And Wall Street Journal. Pretty believable. And it is. Always have this question what's in getting. In this surplus. You know. That there -- -- you know -- There we return participate in the program -- I finally here and share in the -- -- outpatient. Saying. That there. Well. But you've been. Eating. What they are. Guidelines. And -- -- patient but with a lot. Of make it here and -- and it. I mean it's. Difficult situation. Right opposite that it. Pre. You know all. You know. You know get frustrated. That there it is very importantly. You know you read your email arch. The it can't keep active -- that Italy. -- -- And that it it's not that. -- And a good people who wouldn't go to -- coach talked about. There's an article have thrown the journal for academic medicine the return. On your educational. Investment. Or just primary care uses. Adjusted for differences in numbers -- -- were so important so one. Is just under six dollars and four. I. I mean that's that's when he years plus education. Plus the loans. -- the -- plus the 567. People working in your office. Six homers and -- who's who's gonna keep doing that. Met with and especially with the risk at all. You know on the other side. No lawsuits in. Malpractice liability. I am I mean that I don't know what they are -- -- today. It's not the end there. He. But remember on condition you tightly it hurt you let's -- you expect that it more. Editions. And not in. Anybody's view. Decomposition. Lori appreciate it's called very much in the verve and there's -- what do reading. But so many in the of the problems that we hear today in particular. On the show. That I don't have the education -- you talk about we get some pretty door and good experts on from all over the world. And when Arnold and there and overthrow Q what's the end game how to lose this turn now. In this one like shall with -- -- be very important issues. And -- always it is. -- no nobody seemed to have a New Hampshire. But -- too. Undergoing open heart surgery in the surgeons spent thirty years -- room what he's doing it standing over you with the scalpel when you say. I think you're overpaid. And like -- do a little bit more paperwork. And his screw up on the suit. That could be a group go to the U dub -- via. Are welcome back -- we've been thinking about -- Wall Street Journal article. Was terrible I -- what doctors are sick. Sick of their proportion. And we've got out of respected pediatrician. Former had a via emergency medical society -- Verify. The information in the report. There have got all the wounds probably horrible and shoot a good example that the doctor. -- of dean. And it's in the journal about it -- and is called the wrong -- billions or broken health care system. These sorts of -- you can blame obamacare. Or the awful that scenario health care system. You or indeed you know I eat. Since in the cost effectiveness of fairness in our system. Disintegrated. Long before Barack Obama or even towards w.s -- -- and all those reports. I'm a position not a partisan. Voted as often or Republican -- and it is for democratic and it's a given current character -- health care system I would not advised moves to implement the view of medicine. But he makes a point I'm a true this is correct but did something I've never heard. It's -- identical to become a position. -- thought that was the in it as it is true. But he goes to include just about anyone -- up money. Can get into some quasi your credit to pour in medical school and make their way back to -- United States. It says four of those were Smart and worked hard. To get into a competitive medical school and there -- reported this scene in DT. As the person who finished a book and of their clients. At a school on some Caribbean island. Then it goes in the porn and are playing. Big big forms and groups. Continue to broad doctors to prescribe drugs that are much more costly. But often no more effective than a similar drug not -- which ends in central. That our FDA has forbidden do you is forbidden. Ricans. Blood by paying doctors to lecture. Paying doctors to give speeches. And at the end of it he suggested he says one. By healthcare system. -- boards positions and practiced gruden honors medicine. End. Wanna put a cap on salaries that are non profit institutions. Are at least. Taxable profits have sold more action cat. They can pay a five million dollars salary. To a CEO. Interesting times we live then -- right back Garland -- they'll with the -- called the -- Are -- and our -- where -- -- lose that stood trending stories news sports so true media. Dave Cohen. Cohost of be -- and his siblings afternoons. World. All so. Unrealized actions as much when your new terminal. New Orleans -- Armstrong and national. 546. Million dollars it's gonna have. Good effect on this city and all abrupt pocketbooks and Julio -- next to an odd galway about a deal. Figured celebrity and amoral 53 yet.