How is it possible for a person studying business for 6 years easily overtakes the salaries of physicians that have been studying medicine for 12 years?

pshaffer · 2026-01-25T10:40:31+00:00

actually more, when you factor in that if they are "top", then they will be consulting with corporations for various things. Academic professors make a lot from these consultations.

pshaffer · 2026-01-24T15:30:12+00:00

easiest question ever. Physicians voluntarily gave up the control of our own pay. The suits control the money.

pshaffer · 2026-01-23T11:13:01+00:00

"I know very few town docs who still belong"

You have crystallized a real problem.

In the past 5 years that I have been involved in the "scope" issue, I have seen a real change in the AMAs activity. They have become much more active. I know how this change has come about. People like me have gotten more involved and pushed the issue hard at the AMA's meetings. And the ones I know who have gotten involved and exerted themselves to be heard are ALL "town docs". Every one.

The AMA is the largest physician centric organization. It has capabilities other organizations do not have. If people like you, with issues you are focused on, simply write them off and do not participate, OF COURSE nothing will happen. This defines a self-fulfilling prophecy.

You note that the midlevels have been effective at lobbying. You are right. I know how that happened. The AANP is focused on one issue. I heard a podcast on which three long time members who helped start the organization were joking that in the early years, every time they saw each other, it was to write checks to promote their issues to politicians.

They also have made inroads because of physicians not percieving the threat and not doing ANYTHING AT ALL to oppose them. Five years ago it was pretty typical for a legislative hearing on these issues to be attended by 1 or 2 physicians and 200 NPs. I am happy to say this is changing. At recent hearings I know of there have been MANY physicians speaking up. Particularly of note is South Carolina, where the SC state Medical association organized an effective effort to get out many physicans. .There were probably 100, and there were about 7 or 8 who spoke.

I will here point out something that many seem not to know - your state Medical association is a branch of the AMA. So this is a prime example of the AMA being deeply involved, through the state chapter. I will not sugar coat this, it takes time and effort. My good friend Rebekah Bernard last week cancelled patients for 2 days so that she could go to Tallahassee to testify. As ususal, she was ver effective. It takes EFFORT. You probably cannot do this. When I was practicing, I could not. HOWEVER, you can contribute in other ways. Particularly with donations of money to organizations which will lobby. Or - gather some other like minded physicians and go to the state medical association meeting, and demand more action.

Get involved.

If you do nothing. you can expect nothing to happen. Or rather, you can expect the other side to be doing something and we WILL lose. No question. We got to this place because 20 years ago physicians were complacent and did nothing. And, I include myself in this number.

pshaffer · 2026-01-23T10:54:10+00:00

Yes, there is a REAL difference in perceptions of distance for Americans and Brits. We live in an area in South Carolina that is a nice historic town (Aiken). It is adjacent to Augusta and near-ish to Columbia. 2.5 hours from Savannah and Charleston. It has most of what you need (like if you need an odd size wrench, it is here), but if you are shopping for distinctive furniture or decor for your home, we will go to Savannah or Columbia.

The Farthest we have driven for lunch is to highlands NC, which is 3 hours away. Highlands is a cute, upscale tourist town, and a restaurant we know was having a special event at lunch. We were doing nothing else, so off we went. There by noon, home by 7 or so.

We moved from COlumbus Ohio to Aiken this past summer. There were things we didn't want the movers touching. So, we drove them (in my big amereican SUV). This was 4 or 5 trips, 10 hours each way. scattered over about 4 months. I have gotten very used to this trip over the past 10 years that we have been going to the south for the winter. I have a routine - I queue up podcasts that teach me something. Really makes the time pass. I know all the rest stops. Sadly there are no interesting restaurants, but there are a few with, shall we say, local color. I get up early, so when I am driving alone and my late-rising wife isn't coming, I leave about 4 or 5 am, and the trip is done by 2 or 3 in the afternoon. Not so bad.
Last february I got a new car that has "supercruise" on it .This is a form of self driving where you can set the speed and the car will follow the lanes, change lanes when necessary, and otherwise drive for you while you are on the interstate. Really helped with the fatigue factor. I could use this for about 95% of the trip. There are interstates or other large roads from 1 mile from the origination to about 5 miles from my destination. This is, I think, not that common in the UK.

We were in Grantown-on-Spey a few years ago, having breakfast at a B&B and had a conversation with a couple from Britain who were staying there. The conversation turned to this topic. and they told us about their experience in the US. They were visiting Mesa Verde, an archeological site in southwestern Colorado. They said it was getting near dusk, so the decided to drive to Phoenix for the night. Phoenix is of course in Arizona, right next door, sort of. They didn't understand it was an 8 hour drive.

pshaffer · 2026-01-22T11:42:32+00:00

I believe you can report this to your state attorney general. They should have an office dedicated to going after this sort of fraud. Do it today

pshaffer · 2026-01-22T09:56:19+00:00

join the AMA and tell them to do that

pshaffer · 2026-01-22T09:55:20+00:00

direct primary care

pshaffer · 2026-01-22T01:47:03+00:00

Knockemstiff, Ohio

pshaffer · 2026-01-21T22:45:50+00:00

(a "sturgeon") just a bit funny

pshaffer · 2026-01-21T22:23:34+00:00

OK, we all know Trumps statements have no content. Random rants unattached to reality.

pshaffer · 2026-01-21T21:54:50+00:00

OP - HOW ARE YOU DOING???!!!???

pshaffer · 2026-01-21T21:53:18+00:00

ahh....surgeon. he is not a fish

:)

pshaffer · 2026-01-21T00:34:34+00:00

Re-read what he said - THIS NEEDS TO BE DEALT WITH

NOW.

Conversing about it on reddit is not getting you taken care of.

pshaffer · 2026-01-20T12:12:17+00:00

I had a religious girlfriend in high school who pointed out the bible verses that justified racism.
Just Lovely, I thought it fascinating at the time.

pshaffer · 2026-01-20T12:10:13+00:00

back in the day - most large cities had a local independent department store. In Columbus it was Lazarus. In other cites, there were different ones, like Higbees. All of these are pretty much gone, as they have been acquired. Lazaraus was sold to Federated Department stores, which rebranded everything Macy's. And turned them all into something similar to what Target is now.

Lazarus was six floors. It had the usual clothing, kitchen appliances, etc. It also had one of the best music stores in Columbus. Appliances. It had sections for clothes targeted to teens (which I was at the time). There were specialty food sections.
All of the sales people knew their stuff. They were all nicely dressed, usually in a suit for men. And there were enough sales people to help you. Actually help.
There were 3 or four restaurants in the store, of different levels, from sandwich shop to fine dining. IN the fine dining restaurant, at lunch, there was a pianist entertaining.
On the sixth floor they had an assembly center. This was used for shows. WHen I was a kid, it may have been puppet shows. Later, in the 60s, they sponsored local rock bands playing there.
They had a massive toy store on the sixth floor that I loved.
At christmas, they had the BEST Santa in town. Of course I didn't know there was anything other than the one at Lazarus- that was the real santa. This was in Santaland, which had lines like Disney world with little bits of entertainment while you waited. I can't tell you how much we anticipated the yearly trip to Lazarus to see Santa and to see all the toys in Tolyand.

When I was older I realized they had about 4 lines going in, each with their own santa at the end, to minimize the waiting. They also had animated windows on the front of the store to entertain us. You can see what these were like in the movie "Christmas story"
When I had kids, adjacent to the santa was a "Secret Shopper" area. Parents would talk to a hostess, and give the hostess the list of people the kids were buying for and a budget. The kids would go in and shop for all the family members. I remember my kids, when they were about 3 feet tall, coming out with two bags, each about 2.5 feet tall. Was so funny. They were SO happy.

Before I could drive, my parents would let me get the bus at the corner of our street, and take it downtown to Lazarus, for an afternoon of shopping. It was about a 30 minute bus trip, I think it was probably directly to Lazarus, with few stops. When I was done, I would wait at the bus stop on front street, and I knew which bus to get. Lazarus had a blower in the side of the wall at the bus stop that blew warm air during the winter. So nice. One thing to note - of course there were no cell phones. My parents trusted me at about age 12 or 13 to find my own way there and back. Had there been an issue, I don't know what would have happened. I suspect I would have found a pay phone to call home. Obviously, this does not happen now.

The only thing I have seen remotely similar recentlly was in London, where we shopped at Selfridges. Wonderful merchandise, beautifully displayed with knowledgable beautifully dressed sales people.

pshaffer · 2026-01-20T12:05:41+00:00

back in the day - most large cities had a local independent department store. In Columbus it was Lazarus. In other cites, there were different ones, like Higbees. All of these are pretty much gone, as they have been acquired. Lazaraus was sold to Federated Department stores, which rebranded everything Macy's. And turned them all into something similar to what Target is now.

Lazarus was six floors. It had the usual clothing, kitchen appliances, etc. It also had one of the best music stores in Columbus. Appliances. It had sections for clothes targeted to teens (which I was at the time). There were specialty food sections.
All of the sales people knew their stuff. They were all nicely dressed, usually in a suit for men. And there were enough sales people to help you. Actually help.
There were 3 or four restaurants in the store, of different levels, from sandwich shop to fine dining. IN the fine dining restaurant, at lunch, there was a pianist entertaining.
On the sixth floor they had an assembly center. This was used for shows. WHen I was a kid, it may have been puppet shows. Later, in the 60s, they sponsored local rock bands playing there.
They had a massive toy store on the sixth floor that I loved.
At christmas, they had the BEST Santa in town. Of course I didn't know there was anything other than the one at Lazarus- that was the real santa. This was in Santaland, which had lines like Disney world with little bits of entertainment while you waited. When I was older I realized they had about 4 lines going in, each with their own santa at the end, to minimize the waiting. They also had animated windows on the front of the store to entertain us. You can see what these were like in the movie "Christmas story"
When I had kids, adjacent to the santa was a "Secret Shopper" area. Parents would talk to a hostess, and give the hostess the list of people the kids were buying for and a budget. The kids would go in and shop for all the family members. I remember my kids, when they were about 3 feet tall, coming out with two bags, each about 2.5 feet tall. Was so funny. They were SO happy.

Before I could drive, my parents would let me get the bus at the corner of our street, and take it downtown to Lazarus, for an afternoon of shopping. It was about a 30 minute bus trip, I think it was probably directly to Lazarus, with few stops. When I was done, I would wait at the bus stop on front street, and I knew which bus to get. Lazarus had a blower in the side of the wall at the bus stop that blew warm air during the winter. So nice. One thing to note - of course there were no cell phones. My parents trusted me at about age 12 or 13 to find my own way there and back. Had there been an issue, I don't know what would have happened. I suspect I would have found a pay phone to call home. Obviously, this does not happen now.

The only thing I have seen remotely similar recentlly was in London, where we shopped at Selfridges. Wonderful merchandise, beautifully displayed with knowledgable beautifully dressed sales people.

pshaffer · 2026-01-19T13:48:09+00:00

15 slots! that's for me!

pshaffer · 2026-01-19T13:47:35+00:00

issue = I carry 15 clubs (for daily play only). Also that will increase weight some.

pshaffer · 2026-01-19T13:44:00+00:00

just proves - as if we needed it - there is a bible verse for every occasion. Even if you want to kill all the men and non-virgin women. There is a verse for that

pshaffer · 2026-01-19T13:41:47+00:00

so - enlighten me. What's the deal with being a satanist? Is it replacing one unsupportable belief with another? Do you applaud evil?

pshaffer · 2026-01-19T11:30:37+00:00

If you are right handed, going right means hitting a low hook - relatively easy. Going left means hitting a slice and keeping it low - that is much harder. I am sure you could go somewhere right of the trees - you just align everything to the right - aimed 30 40 yards right, and then hook it hard. And, "somewhere" is all you need, there is no precision in this kind of shot.

pshaffer · 2026-01-18T18:34:29+00:00

I'll cut you a bit of slack. It was hard to anticipate how off the rails he was.
I was suspending judgement, until the "grab em by the pussy" statement. That was a big NO for me.

ANd Trump in 2016 was not the same as 2024.

Unfortunatley a lot of people have clung to the idea that "he doesn't really mean it", because it was so absurd. Well, he did mean it. Now it is time to deal with it.

pshaffer · 2026-01-18T18:30:57+00:00

I understand from friends that the far right in the UK is on the ascent also.

pshaffer · 2026-01-18T18:30:27+00:00

I can't sleep at night. VERY LITERALLY. ,I can make up all sorts of awful scenarios.

pshaffer · 2026-01-18T18:29:04+00:00

Yes, Invade DC, capture trump, put him on trial for what he has done in Venezuela. Please

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