Yoshie Furuhashi wrote:
>
>
> Chuck Grimes wrote:
>
> >If you are in military service as a physician, then you depend on
> >the kinds of cases that arrive and that is something you can't
> >control or cherry pick. So if you want certification in some
> >lucrative procedure that is usually elective like a nose job, breast
> >implant, or tummy tuck how would you get such certification as an
> >military surgeon?
Judging by the vigor with which they advertise, I suspect cosmetic surgery is not all that lucrative. This is a wild guess, but the attraction may be the opposite: surgeons who don't make it in more lucrative fields go into cosmetic surgery in desperation, and like other fields in which the stars get tremendous salaries (pro football) the run of the mill do quite poorly.
> >I can't see any way except to have such elective procedures offered
> >for free. This would then be an incentive for recruiting and
> >retaining physicians and surgeons.
My guess is that plain trauma -- auto, household, ice falls, amateur sports accidents, arthritis repair, etc. pays at least as well and (except fo the stars) probably better than cosmetic surgery. Does anyone have concrete figures on this? I haven't gotten the bills yet for the colonoscopy I got July 8, let alone the bills for the EGD & 2d colonoscopy the last week, but I'd place a small bet that those simple procedures bring in more cash than a breast enhancement.
Look, the military is a huge, cruel, unpredictably kind, bumbling
institution. They can screw their personnel on basic services with one
hand and distribute caviar intermittently with the other. We had
plentiful whipped cream about 3 evening meals out of four at the mess
hall of South Post Fort Myer 52 years ago. I suspect the reconstructive
surgery got offered by some random act of generosity by some general
with a couple cocktails in him. Don't try to find a rational (cynical or
otherwise) explanation for at least half of what they do. Fifty years
ago most dentists didn't use novocaine except for extractions. Air Force
dentists more or less insisted on using it for even minor fillings.
>
> That makes sense, as facilitating transition to civilian careers is
> probably much cheaper for the Pentagon than to offer its surgeons
> compensation packages that are more favorable than what the same
> doctors would be able to expect in the civilian world.
>
> >On the other hand how many trauma and restoration cases come along
> >in private practice? Traffic accidents and burns would be the only
> >big sources.
See above. Someone should look it up, but my suspicion is that this kind
of surgery is one of the more lucrative medical specialties. And there
is lots and lots and lots of it to do. Economists have a word to
describe whether a product is price sensitive or not. Salt is not;
people buy about the same amount whether the current price is low or
high. Other products are _very_ price sensitive, and if the price goes
up very much, sales plunge; if the price goes down, sales boom. If you
break a leg, that's like salt. You get it fixed regardless of price. You
pay for breast enhancement only if you can afford it. My bet is that
trauma surgery pays much better than cosmetic surgery.
>
> Industrial accidents in the civilian world (cf. <a
> href="http://stats.bls.gov/iif/home.htm">"Injuries, Illnesses, and
> Fatalities"</a>) probably produce many trauma cases that are very
> similar to military injuries, requiring reconstructive surgery. I
> doubt that they can be a source of lucrative careers, though, as
> working-class patients won't have much money.
> --
What, 45 million or so people do _not_ have insurance. That leaves quite a few million people who DO have insurance and will provide a lot of business for trauma surgery. And of course auto liability insurance pays for a great deal of surgery, regardless of the income or medical insurance of the victim. Workers' compensation on the whole is a criminal enterprise (designed to keep costs down), but it still pays for an immense amount of surgery and hospitalization.
Deborah wrote:
> >Do you think there's a waiting list of amputations being held up by
> >a boob job?
>
> I won't be surprised if there has been a waiting list:
>
> <blockquote>Complaints of "second class treatment" from dozens of
> Army reservists and National Guard personnel are understandable but
> invalid, the garrison commander of this sprawling military base said
> Tuesday.
>
> Col. John Kidd said the reservists' and guard members' complaints
> that they play second fiddle to full-time soldiers are caused not by
> a double standard, but by a severe shortage of physicians and other
> medical personnel.
There have always been immense complaints about medical care _after_ the war. Some veterans hospitals do well; some are at some times perfect horrors. I imagine it's not much different at military hospitals proper, and that it is not much different now than it was before cosmetic surgery became very important.
We know that in general the army is a criminal organization, and that enlisted men and women get it up the ass. We don't have to chase after marginal ills that may or may not be a big deal.
On non-combat injuries. There are bound to be huge numbers of injuries when they call up reservists. E.g., a near thing when my son was activated back for the first gulf war (Marine Reserves). They had a refresher course in grenade throwing. He is left handed. Got confused; threw the grenade the wrong direction. As it happened, someone yelled loose grenade, everyone dove for cover, and no one was hurt. But it could have just as well provided quite a bit of surgical practice for some Navy surgeons. And I bet in the confusion of pulling off Grenada, at least 50 to 100 people got injured who never came near to Grenada itself. :-)
Carrol