What is "The Bush Doctrine"?

[sumi]

so a private plastic surgeon in a suburban area would probably make bank?

[Jaysh]

Khairan said

My understanding is that doctors at big academic centers actually make substantially less money. The positions are more prestigious and they have access to better resources, and that itself comes at a premium in payscale. Also, doctors who live in big cities make less than doctors elsewhere; medical income is actually frequently inversely proportional to cost of living.

Private practice in wealthy (and preferably more suburban/rural) areas is where the major money in medicine is at.

I think she is talking about someone who graduates from UCLA Med school.

sumiyia said

idunno.. thought it mattered for doctors the way it sometimes matters for lawyers?

It's much different than lawyers actually. It doesn't matter where you graduated from. More than that is where you did your residency...although honestly, I don't think that makes much difference either.

[Khairan]

sumiyia said

so a private plastic surgeon in a suburban area would probably make bank?

I imagine so. I rotated at a private plastics clinic once -- that joint was ridiculous. And, a lot of the stuff that they do is cash only because it's cosmetic and insurance won't pay for it. Making rich people prettier is a great source of income -- who knew?

That's actually generally true in medicine -- if you can build a practice based on a cash paying population rather than an insurance-carrying one, you will earn a lot more money. Also, procedures are reimbursed better than diagnoses and medical treatments are.

[Khairan]

Jaysh said

I think she is talking about someone who graduates from UCLA Med school.

Oh, I see. Yes, I misunderstood.

Jaysh said

It's much different than lawyers actually. It doesn't matter where you graduated from. More than that is where you did your residency...although honestly, I don't think that makes much difference either.

Your med school matters insofar as it helps you get a better residency, your residency matters insofar as it helps with fellowship, and where you do your fellowship may or may not ever matter, depending on where you want to work and who you want to hire you.

[sumi]

thanks guys... now i know exactly which doctor friends to suck up to the most... especially because mccain will probably get elected.

[Jaysh]

Khairan said

Your med school matters insofar as it helps you get a better residency, your residency matters insofar as it helps with fellowship, and where you do your fellowship may or may not ever matter, depending on where you want to work and who you want to hire you.

In that case, it depends on where you went to kindergarten, which is important insofar as where you get into an elementary school, which is important insofar as which high school, which undergrad, which med school, which residency, and which fellowship you get into, which may or may not matter in the end.

Honestly, these things matter much less in medicine than in law. I have heard consistently from doctors that these things become insignificant in the long run. Wallahu Aalim.

Of course, you're closer to the end of the tunnel than I am, so you probably know better.

All I am saying is that I cannot see any direct correlation between which med school you graduate from and your income.

[Khairan]

Jaysh said

In that case, it depends on where you went to kindergarten, which is important insofar as where you get into an elementary school, which is important insofar as which high school, which undergrad, which med school, which residency, and which fellowship you get into, which may or may not matter in the end.

Honestly, these things matter much less in medicine than in law. I have heard consistently from doctors that these things become insignificant in the long run. Wallahu Aalim.

Of course, you're closer to the end of the tunnel than I am, so you probably know better.

But wouldn't one assume that the top resident from a lower ranked program would be preferred over a below-average resident at a great program?

These things become insignificant only once you've already reached your goals and have the weight of experience behind you, not when you are trying to establish yourself. In medicine, you can get anywhere FROM anywhere, provided you have sufficient talent and luck. However, sometimes you may not have an open door through which to walk to get to your goal. In that case, you may have to compromise and use an open window, and fitting through that window can be a problem if you are a fatty (like me! ).

Jaysh said

All I am saying is that I cannot see any direct correlation between which med school you graduate from and your income.

There isn't a *direct* correlation because income in medicine doesn't work that way. Someone who goes to podunk medical school will earn more as a urologist than a harvard graduate might as a pediatrician. That doesn't mean it's not easier for that harvard grad to land a high-powered residency that will get him a coveted position in a cardiology fellowship further down the road.

As I said, you can get anywhere from anywhere, but depending on where you start you may need to work just that much harder and have that much more luck come your way.

[Jaysh]

Khairan said

These things become insignificant only once you've already reached your goals and have the weight of experience behind you, not when you are trying to establish yourself. In medicine, you can get anywhere FROM anywhere, provided you have sufficient talent and luck. However, sometimes you may not have an open door through which to walk to get to your goal. In that case, you may have to compromise and use an open window, and fitting through that window can be a problem if you are a fatty (like me! ).

Sorry, I edited my post after you replied. My basic point was just this here:

All I am saying is that I cannot see any direct correlation between which med school you graduate from and your income.

[Khairan]

Jaysh said

Sorry, I edited my post after you replied. My basic point was just this here:

All I am saying is that I cannot see any direct correlation between which med school you graduate from and your income.

Ha! Well *I* edited my post after *you* edited your post. So there!!

[Jaysh]

Khairan said

There isn't a *direct* correlation because income in medicine doesn't work that way. Someone who goes to podunk medical school will earn more as a urologist than a harvard graduate might as a pediatrician. That doesn't mean it's not easier for that harvard grad to land a high-powered residency that will get him a coveted position in a cardiology fellowship further down the road.

As I said, you can get anywhere from anywhere, but depending on where you start you may need to work just that much harder and have that much more luck come your way.

Ahhhh, I see what you are saying.

But let's say a radiologist from a crappy med school goes to an average residency program and a fellowship at University X.

And compare that same guy to someone who goes to a top med school, excellent residency program, and a fellowship at University X.

I would think that the difference between the two in potential income would be insignificant, right? (Assume that they work equally hard after they finish the fellowship.)

I see what you mean that it matters because you have to work harder in order to get to the same place. That I totally agree with you. But I am talking about let's say two guys did their fellowship at the same place, I don't think where they went to med school would have any significance.

Also, even if they went to two different fellowships (in the same subspeciality), I *still* think any difference between the two would be insignificant. One would assume that there are so few fellowships to begin with, that getting into any of them would be prestigious enough. What do you think?

[Khairan]

Jaysh said

Ahhhh, I see what you are saying.

But let's say a radiologist from a crappy med school goes to an average residency program and a fellowship at University X.

And compare that same guy to someone who goes to a top med school, excellent residency program, and a fellowship at University X.

I would think that the difference between the two in potential income would be insignificant, right? (Assume that they work equally hard after they finish the fellowship.)

I see what you mean that it matters because you have to work harder in order to get to the same place. That I totally agree with you. But I am talking about let's say two guys did their fellowship at the same place, I don't think where they went to med school would have any significance.

Also, even if they went to two different fellowships (in the same subspeciality), I *still* think any difference between the two would be insignificant. One would assume that there are so few fellowships to begin with, that getting into any of them would be prestigious enough. What do you think?

That's correct -- in the end it's the fellowship that matters most (or residency, if that's the last thing you did).

But consider also that where you did the fellowship may matter in other ways. It may not help you make more money, but if you want to be the head of cardiology at MGH graduating from a fellowship at Hopkins will certainly give you an edge over someone who graduated from a lesser program.

Ultimately, I think the most significant factor in determining income is *field,* not so much a specific program. That said, specific programs may make or break your ability to get into a given field, and that's why they can matter in the long run.

[Jaysh]

Khairan said

But consider also that where you did the fellowship may matter in other ways. It may not help you make more money, but if you want to be the head of cardiology at MGH graduating from a fellowship at Hopkins will certainly give you an edge over someone who graduated from a lesser program.

Ummm, we're desi. We go for the money. (i.e. private practice)

Ultimately, I think the most significant factor in determining income is *field,* not so much a specific program.

Yes, like going into Radiology and voting for McCain.

[Khairan]

Jaysh said

Ummm, we're desi. We go for the money. (i.e. private practice)

Yes, like going into Radiology and voting for McCain.

Gotta pay the bills somehow.


Although, if we're being technical about it, voting for Obama makes much more financial sense for me right now given my what my income level will be for most of the next decade.

[Khairan]

sixpakistan said

Can you cite any examples of this? Going by "Audacity of Hope" - which admittedly, reads very much like it was written for political purposes - he repudiates a lot of socialist ideals, including the idea of socialist healthcare. I think he probably sees government as playing a role in helping people moreso than say, Newt Gingrich (for instance) does, but he's radically different from the liberal "old guard" in terms of his approach to government.

Here's an article discussing a lot of Obama's policies and his designs to expand the government and its role in redistributing money.

IBDeditorials.com: Editorials, Political Cartoons, and Polls from Investor's Business Daily -- Barack Obama's Stealth Socialism

Mind you, I'm not claiming it's objective -- it clearly has a spin as does anything in the media, but as far as I can tell it is factually accurate. It also talks about some of his ties to various thinkers committed to communist or socialist philosophies.

sixpakistan said

By that criteria, Barack Obama is an exponentially better choice than John McCain. :P

I don't know how much either will do to reduce the size of the government, to be honest -- but I think Obama is certainly committed to increasing its size and its role in our private lives. Like I said, on this matter I don't find either side even remotely ideal.

sixpakistan said

I agree with you completely on both counts. To clarify though, Barack Obama does not support late term or partial birth abortions, except in cases where the mother's life is endangered. I disagree with his pro-choice stance in general, though.

That's the thing though -- medically speaking late-term abortions are NEVER "necessary" as far as I'm concerned. At this point, the baby is viable. We can keep 22 week babies alive in a neonatal ICU; if the pregnancy is threatening to the mother, for instance in the case of preeclampsia/eclampsia, a cesarean section is certainly a viable option. It can be performed in under ten minutes. Why kill the baby?

sixpakistan said

Obama's been a senator at a national level for 4 years. Palin's only real experience is being a governor of a state with < 1 million people for less than 2 years. Prior to that, she was a mayor of a town of 7000 people. Obama had many times that # of constituents as a state senator since 1996.

We'll have to agree to disagree on this point. In my mind, they are both relatively inexperienced, and I don't think Palin is any more so than Obama. The difference is that he's at the top of his ticket, she's at the bottom of hers. To be honest, I don't much care HOW experienced they are, as I'm not sure it's that crucial. Bush had a great deal of experience running a big state, and he was a horrifically bad president.

sixpakistan said

How exactly did she 'buck' her own party?

For one thing, she was went after Randy Ruedrich, chair of the state party, for illegal activites involving his position as the oil and gas conservation commissioner. He was forced to resign from his post and pay a large fine as a result.

sixpakistan said

Based on what?

Well, I think whether one likes her or hates her, the rapidity of her rise in the Republican Party and in Alaskan politics shows that she is a formidable individual. As I said, I don't know if this means she can be a good president, but certainly she's not the inept politician that the media wants to make her out to be.

sixpakistan said

So the criticism of Obama is a plus factor for Palin? Obama went from state senator to federal senator to Democratic presidential nominee in less time than Sarah Palin went from mayor of Wasilla to governor of Alaska. To be one of two senators from a state like Illinois is arguably much more difficult to achieve than becoming governor of Alaska. To be the Democratic presidential nominee is obviously another level entirely, especially when he had to contend with someone with the last name "Clinton" in the primary.

Again, I'm not the one criticizing either candidate for their relative lack of experience. As it is, I think that it is worse to have an inexperienced president than an inexperienced vice president, so I don't think Obama wins this comparison in any case, but my point in bringing up Obama's inexperience was that it invalidates any criticism of Palin on that front, at least from people who support him.

sixpakistan said

What exactly has she done as governor of Alaska?

She raised taxes on oil companies, for one thing.
She's cleaned up some of the corruption in her party. I don't think she's done anything earth shattering though -- but then again, I don't really think Obama has either.

sixpakistan said

I think most people are curious to see Biden-Palin in the same way most people were curious to see Tyson-Spinks in 1988. Even though it's obvious she'll be coached to hell and back, I know I can't wait.

Yeah, I think most of what we know of Palin right now is basically all a result of the media frenzy around her. I suspect that the debates will make little difference at any rate but they will be of personal interest to me.

I don't mean to sound as if I'm a hardcore Palin supporter -- I'm not, but I think she's an interesting individual who the media is trying to write off far too quickly because the image she brings to the McCain campaign is very dangerous for the Democratic ticket. I also think that most of the criticisms against Palin that I've heard are pretty "soft," and moreso than actually "supporting" her I really just want to hear about real issues related to her style and policies.

To reiterate, one aspect of her policies that I favour is her apparent support of states' rights and what seems like her willingness not to pursue her personal beliefs on a national level. Perhaps that's just showmanship for the election -- I have no idea. Time will tell.

[sixpakistan]

Khairan said

Here's an article discussing a lot of Obama's policies and his designs to expand the government and its role in redistributing money.

IBDeditorials.com: Editorials, Political Cartoons, and Polls from Investor's Business Daily -- Barack Obama's Stealth Socialism

Mind you, I'm not claiming it's objective -- it clearly has a spin as does anything in the media, but as far as I can tell it is factually accurate. It also talks about some of his ties to various thinkers committed to communist or socialist philosophies.

Bro, as Muslims, we should know better than anyone else to not rely on people's partisan/ideological enemies to form our views on them. :P The article is garbage. It's so flawed, I don't even know where to begin with it. It's heavy on innuendo, absent of facts.

First of all, the "investments" it claims Obama wants to engage in are either outright lies or gross mischaracterizations. What is their source for any of that? Why don't they cite the exact policy he's pursuing?

Then stuff like this:

Amid all this, Obama reunited with his late father's communist tribe in Kenya, the Luo, during trips to Africa.

Really, the Luo are a "communist tribe" now?! what do they derive that nonsense from? Because Raila Odinga has had accusations of "communist" (which he isn't) leveled at him? That's a comically simplistic understanding of Kenyan politics.

As a Nairobi bureaucrat, Barack Hussein Obama Sr., a Harvard-educated economist, grew to challenge the ruling pro-Western government for not being socialist enough. In an eight-page scholarly paper published in 1965, he argued for eliminating private farming and nationalizing businesses "owned by Asians and Europeans."

.. How is this relevant? Barack Obama wasn't even raised by his father, and even if he was.. it's still not relevant.

The article is full of even more tenuous attempts at guilt by association.

And this:

"Economic justice" simply means punishing the successful and redistributing their wealth by government fiat. It's a euphemism for socialism.

Really? According to who? The article's full of attempts at twisting Obama's words to lend them sinister meaning, or putting new words into his mouth entirely.

Khairan said

That's the thing though -- medically speaking late-term abortions are NEVER "necessary" as far as I'm concerned. At this point, the baby is viable. We can keep 22 week babies alive in a neonatal ICU; if the pregnancy is threatening to the mother, for instance in the case of preeclampsia/eclampsia, a cesarean section is certainly a viable option. It can be performed in under ten minutes. Why kill the baby?

That's a good point. I agree with you fully. Like I said, I disagree with his stance on abortion in general and don't consider it to be moral.

Khairan said

For one thing, she was went after Randy Ruedrich, chair of the state party, for illegal activites involving his position as the oil and gas conservation commissioner. He was forced to resign from his post and pay a large fine as a result.

That, along with a lot of other activities that have been trumpeted as her bucking the party, seem on closer examination to be mere political opportunism.

Khairan said

Well, I think whether one likes her or hates her, the rapidity of her rise in the Republican Party and in Alaskan politics shows that she is a formidable individual. As I said, I don't know if this means she can be a good president, but certainly she's not the inept politician that the media wants to make her out to be.

I don't know if it shows that she's formidable or just opportunistic. The same argument could be made even moreso for Barack Obama, in any case.

Khairan said

Again, I'm not the one criticizing either candidate for their relative lack of experience. As it is, I think that it is worse to have an inexperienced president than an inexperienced vice president, so I don't think Obama wins this comparison in any case, but my point in bringing up Obama's inexperience was that it invalidates any criticism of Palin on that front, at least from people who support him.

I don't really buy that Obama's inexperienced, though. Experience is more than just chronology. 4 years as a senator > Sarah Palin's entire career.

Khairan said

She raised taxes on oil companies, for one thing.

Yeah, she raised taxes while Alaska already had a budget surplus from the previous governor.. thus sending gas prices in Alaska rocketing through the roof, way higher than the rest of the country. Doesn't really make sense to me, but whatever.

Khairan said

She's cleaned up some of the corruption in her party.

See above re: political opportunism. She was perfectly happy being a chamchi for Ted Stevens, Murkowski, et al until it became politically expedient not to be.

Khairan said

Yeah, I think most of what we know of Palin right now is basically all a result of the media frenzy around her. I suspect that the debates will make little difference at any rate but they will be of personal interest to me.

I think she's gonna get crucified in those debates. I'm sure they're prepping her hard, but as she showed on ABC, they can't prepare canned answers for everything under the sun. Biden is on another level from Sarah Palin, who at this point is a cardboard cutout whose main drawing point is that she was female and she looks like she might've been attractive in the 1980s.