Well, you'd be wrong. There is a strong and increasing trend for medical students to avoid primary care. The lifestyle and affluent specialties are ballooning. http://www.nytimes.com/2008/12/12/health/11doctors.html?partner=permalink&exprod=permalink

You can't seriously believe that there aren't scads of premeds thinking exactly what you are? And unless cardiology practices some serious birth control like Anesthesia did, there will be a glut. Though if they do practice serious birth control to avoid a glut, a cards fellowship will be harder to come by than an ENT spot.

Good. You'll probably make well over 100,000 by the time you graduate. However as I said, that's not a ton if you are entering it for the money (given that you'll first spend 8 years going into debt unless you've got rich parents) followed by 5 years making around minimum wage (you'll make a small salary as a resident, but because of the hours you work it ends up being for crap hourly.) And with debts in the 200-300k range common, you won't break even with your friends who entered a career after undergrad till you are a decade out from finishing your training.

Ah, that's almost cute in its naivete. If you spend a day in the cath lab (now) doing procedures you'll make $5000. If you spend the day in clinic (which is I think what you mean by 'private practice') you will be lucky to clear $1000. The whole reason that people enter fields like cardiology to make money is that they are procedure heavy. Seeing grandma in clinic gets you squat (except the chance that grandma might need a cath or a pacer from you.)

As an example from my own practice, if I spend 60 minutes with you assessing and diagnosing your abdominal pain, doing a big work-up, and admitting you to the hospital for appendicitis, I make less than if I pull a bean out of a toddlers nose. Procedures are the cash cow of medicine and you will be a pretty poor cardiologist indeed if you keep the attitude that you'd rather be in clinic than the cath lab.

Of course those figures are today, and the well will be drier when you come out. Insurers and the government are seriously putting the clamps on high ticket procedure-monkeys. For example, CA just recently enacted a rule that says hospital based physicians can't bill HMO patients the balance of what their insurer doesn't pay for. So if you do a cath at a hospital in CA and bill Ms Smith's HMO $2000, they can pay you $500 and your only real recourse is a lawsuit against the insurer. And that's just one example. Making money from procedures is going to be far less guaranteed than it is now.

Well as Carl Sagan said: "The absence of evidence is not evidence of absence." This is especially the case when you don't seem to have looked at the abundance of evidence out there suggesting you're projected income will be significantly less than you seem to think. But at least you were a nice young man and demonstrated that my use of 'Sport' was in fact, appropriate.

Not always. Sometimes people take a defeatist attitude. It depends on how you frame that risk to the patient and how the patient sees it. A good example of such defeatism (and general adolescent 'fuck you' attitude) is kids with CF who start smoking.

Let me give you two bits of advice, Sport:

1) If you are going into medicine for the money and are pre-med now, you are basically going to end up in the same situation that all those kids coming out of Harvard with MBAs expecting to make millions on Wall Street. Once you finish 4 years of med school, three of IM residency, and 2 of Cards fellowship, the well will have dried up significantly for specialists who don't do fee for service (which few people are for a cath and stent). Have you considered plastics?

2) If you insist on persisting with your career plans, take Spanish now. You're going to be amazed how being bilingual in a useful language in the US sells on your med school and residency application. Because while you are going to be making less money, you are going to have a lot more Spanish speaking patients when you get out. Maybe if you grow a sense of moral responsibility to your fellow men (which should be a pre-rec for med school but sadly isn't) you'll be glad you took my advice and can converse with your patients in their native language in a culturally competent way.

Or just go into plastics.

Can you mod parent complete utter fucking douchebag?

Or better yet, childhood diagnosis with this particular condition would merit lifetime treatment with statins and aggressive control of other modifying factors. Prevent these kids from smoking, get them in a daily exercise habit, teach them a good diet, and monitor and aggressively treat for diabetes and hypertension if/when they appear. Except for the genetic test itself, the rest of that is cheaper than spit. Even in the US, the real cost of the blood tests and medicines would be less than $200 annually. Add two NP visits and its maybe $400 annually. The cost in India would obviously be even cheaper.

However what is expensive is the political will to prevent smoking in children. Its also politically expensive to have cheap and effective public health prevention programs. Heaven forbid you give medicines or pap smears to people who don't have insurance or money.... why.... it.... would be an ENTITLEMENT!

Shudder! Aiiigh! No, not that!

Wait, did that sound bitter?

Actually you are right in one way. It wasn't added, it was there from the beginning in Article 1 of the Bill of Rights. "Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press; or the right of the people peaceably to assemble, and to petition the Government for a redress of grievances."

The phrase 'separation of church and state' was originally coined by Jefferson referring as establishing a 'wall of separation' between church and state.

What you may be referring to is the issue that there are two things implied by separation of church and state: 1) freedom of religion and 2) the secularity of government. However given that the founders and the SCOTUS on numerous occasions has interpreted Article 1 to mean both those concepts, I feel pretty safe in stating yes, its in there.

Ze or Sie. http://en.wikipedia.org/wiki/Gender-neutral_pronoun

And before anyone claims these are never used, I can honestly say that I actually use them.

Though I work as a physician at a clinic in San Francisco that treats a large population of transgender patients. So if you have reason to use it, the terms actually (well almost) start to come naturally. I see them as sort of a technical jargon from my perspective. Though it does come in useful when you are talking about Chris Jones whose gender is not obvious before you meet hir (or maybe not even after.)

Yes, I always find that same argument to be inane. Those with at least an order of magnitude greater financial and capital power (Israel) complain that the far less well funded and enfranchised group (Hamas) doesn't fight fair because they are not respecting the 'rules of engagement'.

If I were forced to fight someone substantially larger and more powerful, I would feel no qualms about 'fighting dirty'. Its not a fair fight to start with and whining about someone not being 'fair' is ridiculous.

1) Commandeer the newsmedia and make the following policy announcements:
2) All major highways out of the area in question will be made unidirectional for 5 days (with a one lane exception for police/military/fuel supply). If you have a car/van/MC/etc and wish to leave with it, you must do so within the next 5 days.
3) National guard/army/police will be at crucial checkpoints inspecting vehicles. Any vehicle without one passenger for every seat will not be allowed to pass. However, people without vehicles (such as the poor who were left during Katrina) may assemble at these sites and will be offered a seat in your car/van/etc if it is not full.
4) If you refuse to take assigned passengers and/or refuse to eject possessions to do so, your vehicle will be commandeered and given to a car-less driver.
5) On the 6th day all roads will be shut down to personal vehicles and the roads become bidirectional.
6) On days 6-10 buses (and semis capable of hauling people in the trailer) will begin making round trips to evacuate as many of the remaining people as possible. Only vehicles capable of carrying at least 10 people will be allowed on the road.
7) Continued refusal to comply and/or seriously disruptive behavior will result in you being shot on site (both because the delay or misuse of resources you are causing will threaten the lives of others and absolute order is essential to getting as many people out as possible.)
8) The seriously infirm (i.e. nursing home patients, people in the ICU/on vents in hospitals, people who have a less than 6 month life expectancy due to cancer/etc) will not be transported out. If supplies are available and these people consent, euthanasia should be offered by health care workers. To prevent too much hysteria though, during the first 5 days, if you can schlep your family member, they can go in your car/van/suv.
9) All people living outside the 1000km radius will have people assigned to inhabit their living spaces and will be required to accommodate them until more habitable space is available for them. (#7 applies outside of the 1000km radius as well.)

Of course this assumes I have those dictatorial powers. And this certainly would not get everyone out, but I think it would do the most good for the most possible. Though just instituting #3 would have saved hundreds of lives and the suffering of thousands during Katrina.

I don't think it is unreasonable to use the Communist Manifesto to answer the question "What is communism?".

That is like using On the Origin of Species to answer questions about evolution. Of course quote mining Creationists like to do just that since it weakens the argument, which is I suspect why you use Marx rather than contemporary communist theorists.