segunda-feira, novembro 12

Médicos


Quanto valem?
Porque é bom dizer que quando um médico aparece sénior e experiente no privado ele "custou milhões de euros ao erário público e aos portugueses".link
Isto foi dito em plena consciência ? ou é demagogia barata ?
Ficaram-lhe foi a dever muito dinheiro e ele, farto de dar para o peditório pôs-se a caminho como qualquer outro profissional de outra área.

Um médico custa dinheiro ao Estado na licenciatura e nos 1ºs anos da especialização - a partir daí, graças ao Senhor, passa a dar lucro, naturalmente.

Mas perguntem-lhe se ele está disposto a financiar de forma diferente os Serviços do Curry Cabral que fazem formação e os que não fazem ?
Ele quer é mais consultas, mais cirurgias, mais transplantes - mais e mais - mas eles têm de ser feitos por quem sabe.

Quem não sabe, chapéu !
Cardeal Patriarca

3 Comments:

Blogger e-pá! said...

SCIENCE POLICY: ON THE COST OF MEDICAL EDUCATION

The following points are made by Gail Morrison (New Engl. J. Med. 2005 352:117):

1) The cost of obtaining a medical education has been spiraling upward for the past 20 years. Despite a great deal of rhetoric in articles[1,2] and at meetings of the Association of American Medical Colleges, nothing has happened to change the alarming pattern. The average annual tuition and fees at public medical schools during the 2003-2004 academic year amounted to $16,153, and the corresponding figure for private schools was $32,588.[3] Adding $20,000 to $25,000 for living expenses, books, and equipment brings the estimated cost of four years of attendance to approximately $140,000 for public schools and $225,000 for private schools.

2) The continuing increases in tuition are the primary reason why a medical education is less affordable today than it was two decades ago. In the 1984-1985 academic year, average annual tuition and fees were $3,877 at public medical schools and $12,973 at private schools. Thus, in 19 years, the costs increased by 317 percent and 151 percent, respectively.[3] Despite low inflation during the past several years, this escalation continued. Recent shortfalls in state budgets have caused major budget crises at most public medical schools, resulting in a need for marked increases in tuition, which went up by 11.9 percent in 2003 and 17.7 percent in 2004. Private medical schools, though not as reliant on state money, raised tuition by 4.4 percent in 2003 and 5.7 percent in 2004 --increases well above the rate of inflation.

3) Accompanying this continuing escalation, there has been an enormous increase in the average indebtedness of graduating students. The average debt carried by 1984 graduates was $22,000 for public school and $26,500 for private school. By 2004, the debt had increased to $105,000 for public school and $140,000 for private school, and only about 20 percent of medical students graduated with no debt.[4]

4) Although the consumer price index is less than twice what it was 20 years ago, medical-student debt was 4.5 times as high in 2003 as it was in 1984. Tuition, however, has increased at only 2.7 times the rate of the consumer price index at private medical schools and at 3.8 times that rate at public schools. The greater increase in student debt suggests that medical students have chosen to borrow money not only for tuition but also for other costs associated with attending medical school.

5) Since more students now live in apartments rather than dormitories, are married or marry during medical school, have children, need to buy cars for travel to affiliated hospitals and outpatient facilities, and buy computers and other electronic equipment, these other costs have increased dramatically. Most students, even if they come from affluent families, prefer to take out low-cost educational loans to pay for their expenses. Moreover, unlike law or business students, who enter the workforce immediately after graduation and can begin to pay off their debt, the average graduating medical student spends an additional three to six years in postgraduate training programs while interest continues to accrue.

6) All of this means that a 2003 graduate with $100,000 in debt who begins repayment after a three-year residency will generally pay $15,000 per year for 10 years. Consolidating the debt and extending repayment over a period of 25 years will result in payments of $12,000 per year for a quarter-century. In 2003, the consolidated interest rate for Stafford loans was only 2.82 percent. When interest rates reach the maximum allowable rate of 8.25 percent, as they have been known to do, or when students need to borrow additional money from private sources, repayments can well exceed these estimates.[5]

7) What have been the effects of these increases? Although there has been a decrease in applications to medical schools from about 47,000 in 1996 to 35,700 in 2004, there are still two applicants for each of the 16,000-plus yearly medical-student positions. In 2003, the average salary of a practicing physician ranged from about $146,000 for a family practice physician to a bit more than $400,000 for an invasive cardiologist.5 So far, physicians' salaries have allowed them to pay off their debt, generally without defaulting on their loans.

References (abridged):

1. Petersdorf RG. Financing medical education. Acad Med 1991;66:61-65

2. A word from the president: you owe how much? Vol. 11. No. 10. AAMC Reporter. July 2002. Washington, D.C.: Association of American Medical Colleges.

3. Jolly P. Medical school tuition and young physician indebtedness. Washington, D.C.: Association of American Medical Colleges, March 23, 2004

4. Division of Medical Education. Medical School Graduation Questionnaire 2003: all schools report. Washington, D.C.

5. Association of American Medical Colleges, 2003. Salaries for physicians. Washington, D.C.: Bureau of Labor Statistics, 2004

New Engl. J. Med. http://www.nejm.org

12:20 da tarde  
Blogger tambemquero said...

"There are two objects in medical education: to heal the sick and advance the science."
- Dr. Charles H. Mayo

2:25 da tarde  
Blogger O cavalinho da chuva said...

"Agora não acho que haja uma sangria, há médicos bons que saem, o que é pena, mas o sector público também tem grande capacidade de regeneração, porque é nos hospitais públicos que todos fazem a sua formação".

Não se importa de repetir ? Mas eles fazem a formação a aprender com quem sabe ou por tentativa - erro ?

E que apoio dá o Hospital Curry Cabral, sim, este do MD, à formação no seu Hospital.

O seu irmão em Aveiro, embora tenha o Hospital de cangalhas, parece até estar a dar aos Internos alguma possibilidade de formação.

Mas a experiência é outra, naturalmente.

9:01 da tarde  

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