After a long day on the road, Dave Carter sat down with Ricochet’s very own @DocJay for a free wheeling discussion on everything from Rocky Mountain Oysters to concierge medical practices and the future of American medical care generally (hint: It isn’t exactly peachy). Regardless of the prognosis, we think you’ll enjoy the conversation.

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Members have made 25 comments.

  1. Profile photo of Columbo Member

    It tastes like “chicken” …

    • #1
    • March 15, 2017 at 12:42 pm
    • Like5 likes
  2. Profile photo of Blondie Thatcher

    I can’t wait to listen to two of my favorite Rico guys! Just knowing I have this to look forward to has made my day!

    • #2
    • March 15, 2017 at 1:31 pm
    • Like6 likes
  3. Profile photo of mezzrow Member

    Haven’t listened yet, but as soon as I saw the title I broke out into the biggest grin I’ve had in a couple of weeks.

    Now to listen…

    • #3
    • March 15, 2017 at 1:32 pm
    • Like4 likes
  4. Profile photo of Dave Sussman Contributor

    Nice job gentlemen. Since blowing up the system and starting from scratch isn’t an option, I’ll join you for that whiskey … or three.

    • #4
    • March 15, 2017 at 1:58 pm
    • Like7 likes
  5. Profile photo of drlorentz Member

    I like the idea of medical ‘fireside chats,’ perhaps conducted by the secretary of HHS. People really don’t understand healthcare delivery and its relation to true insurance. The MSM would probably criticize the chats but some people might learn something.

    Regarding DocJay’s experience with family practice and insurance companies, I knew a guy who had been a family practice physician (sole practitioner) in northern Utah. By the time I met him, he’d gone back to school to become a mechanical engineer. It’s a shame to have lost this person from medical practice after all those years of training and experience in medicine. I’m sure he was a better doctor than he was an ME.

    • #5
    • March 15, 2017 at 2:36 pm
    • Like4 likes
  6. Profile photo of DocJay Member

    Thank you very much Dave. Next time I talk on radio just trigger a shock collar on me when I ramble.

    I know American ingenuity can solve our problems but only if our leaders and our voting public have the stomach for it. Medicare is a decade away from a fiasco and the dems are running ads on Paul Ryan’s plan killing grandma….again.

    • #6
    • March 15, 2017 at 2:41 pm
    • Like9 likes
  7. Profile photo of Blondie Thatcher

    Great podcast you two. If we could only be king for a day…..

    • #7
    • March 15, 2017 at 5:10 pm
    • Like3 likes
  8. Profile photo of CuriousJohn Thatcher

    Sadly I’ll be waiting to listen to our boys until after the games tonight. With a little luck the second game will be a blow out and I’ll quickly turned to a great conversation.

    • #8
    • March 15, 2017 at 5:33 pm
    • Like1 like
  9. Profile photo of Ann Inactive
    Ann

    Nicely done! I enjoyed it very much, thanks.

    • #9
    • March 15, 2017 at 6:59 pm
    • Like1 like
  10. Profile photo of Dave Carter Contributor

    Just got in after an extremely long day of playing trucker. Thanks, all, for the kind comments. Doc Jay is a class act and it’s always a pleasure to spend time chatting with him. I throughly enjoyed our exchange.

    • #10
    • March 15, 2017 at 8:01 pm
    • Like6 likes
  11. Profile photo of Ray Member
    Ray

    This podcast was bad to the bone, and I thoroughly enjoyed it.

    • #11
    • March 16, 2017 at 1:48 am
    • Like3 likes
  12. Profile photo of Majestyk Thatcher

    Thanks for the shout-out @docjay! Just wish more people had chimed in…

    • #12
    • March 16, 2017 at 6:30 am
    • Like3 likes
  13. Profile photo of Susan Quinn Contributor

    Really enjoyed this podcast, you guys! Fun, informative and helpful. You both sound just the way I would expect you to! (Not sure why that matters . . . ) Thanks to you both.

    • #13
    • March 16, 2017 at 6:36 am
    • Like2 likes
  14. Profile photo of RightAngles Member

    Very good!

    • #14
    • March 16, 2017 at 6:59 pm
    • LikeLike
  15. Profile photo of Kay Ludlow Member

    I often catch up on the Ricochet podcasts while I cook. Tonight, I was so interested in DocJay’s discussion of healthcare, I just about sliced my finger off. Very bloody. Great podcast though!

    • #15
    • March 16, 2017 at 7:49 pm
    • Like4 likes
  16. Profile photo of Dave Carter Contributor

    Kay Ludlow (View Comment):
    I often catch up on the Ricochet podcasts while I cook. Tonight, I was so interested in DocJay’s discussion of healthcare, I just about sliced my finger off. Very bloody. Great podcast though!

    Sorry you were injured during the podcast! I knew Doc’s commentary would be incisive, but dang!

    • #16
    • March 16, 2017 at 9:42 pm
    • Like6 likes
  17. Profile photo of Chris Campion Thatcher

    Dave Carter (View Comment):
    Just got in after an extremely long day of playing trucker. Thanks, all, for the kind comments. Doc Jay is a class act and it’s always a pleasure to spend time chatting with him. I throughly enjoyed our exchange.

    That he’s a class act is somewhat…disappointing.

    Can’t wait to listen.

    • #17
    • March 17, 2017 at 3:46 am
    • Like2 likes
  18. Profile photo of Chris Campion Thatcher

    Kay Ludlow (View Comment):
    I often catch up on the Ricochet podcasts while I cook. Tonight, I was so interested in DocJay’s discussion of healthcare, I just about sliced my finger off. Very bloody. Great podcast though!

    I do the same thing – if I don’t listen on a run, I’ll play it in the background while I drop food onto the floor and play the “7 second rule” in my head.

    • #18
    • March 17, 2017 at 3:47 am
    • Like2 likes
  19. Profile photo of Rapporteur Member

    Very educational listen – thanks @davecarter and @docjay!

    I am curious about how one finds a DocJay-ish concierge doc. I Googled and found an outfit called MDVIP, which charges $1800 a year and has all of four docs in the Columbus, Ohio area. Or do concierge docs follow my old company’s recruiting model, “Eagles don’t flock – you need to find them one at a time”?

    • #19
    • March 17, 2017 at 12:00 pm
    • Like1 like
  20. Profile photo of DocJay Member

    Rapporteur (View Comment):
    Very educational listen – thanks @davecarter and @docjay!

    I am curious about how one finds a DocJay-ish concierge doc. I Googled and found an outfit called MDVIP, which charges $1800 a year and has all of four docs in the Columbus, Ohio area. Or do concierge docs follow my old company’s recruiting model, “Eagles don’t flock – you need to find them one at a time”?

    MDVIP does have concierge docs but the company itself is a middle man (parasitic IMO but I am rebellious by nature) and the docs usually more kestrel than eagle but there are exceptions. Try http://www.aapp.org but word of mouth may be the best. Free markets have opened up this field immensely with many options for healthy people with families or internal med docs for more complicated adult cases.

    • #20
    • March 17, 2017 at 2:49 pm
    • Like4 likes
  21. Profile photo of DocJay Member

    Chris Campion (View Comment):

    Dave Carter (View Comment):
    Just got in after an extremely long day of playing trucker. Thanks, all, for the kind comments. Doc Jay is a class act and it’s always a pleasure to spend time chatting with him. I throughly enjoyed our exchange.

    That he’s a class act is somewhat…disappointing.

    Can’t wait to listen.

    I had no script and was sipping Bullet Rye so Dave just had to wrangle me, hence some free wheeling.. I made a mental note that despite the intro topic there would potentially be kids listening and Dave has his excellent reputation I didn’t want to besmirch.

    I promise to win the race to the gutter whenever we meet. I’ll even bet the family jewels. 😉

    • #21
    • March 17, 2017 at 2:58 pm
    • Like3 likes
  22. Profile photo of Chris Campion Thatcher

    I keep misreading Doc’s name here as “Joc Day”, which sounds vaguely….

    Image result for french guy

    • #22
    • March 18, 2017 at 6:16 am
    • Like3 likes
  23. Profile photo of Larry Koler Member

    Dave and Doc: excellent podcast.

    Dave, I listened to your first podcast and forgot to check lately. I just happened upon this one and I am going to listen to the other three that I missed. Doc’s right — you have a great radio voice. And you also have an excellent mind and that odd combination: a good heart with that good mind.

    Doc, thanks for all the information and insight into the whole mess with the health care system in America. Really topical and excellent analysis. Your patients are very lucky.

    My son and family live in the Montreux area. The next time I’m down there it would be nice to meet up with you.

    • #23
    • March 18, 2017 at 5:40 pm
    • Like1 like
  24. Profile photo of Chris Campion Thatcher

    An auto mechanic’s shop analogy is relevant.

    You get in a car accident. Your car is fine, but damaged. Where do you take it? Well, in most cities and towns, you have a ton of choices. The parts, the materials to repair the car, are generally the same price for everybody, because those can all be bought online or through parts dealers.

    What’s different, then? The price of labor, and the quality of the labor. So what do most people do? They get a couple of quotes, and pick what they want, based on price, quality, delivery, etc.

    You cannot do that in the direction health care is going. There is no market. Some 40% of patients are in Medicare/Medicaid, which is a “thou shalt” option – meaning if you’re in there, you have no options to shop, because the providers all get paid the same from Medicare per procedure/service. At a loss.

    You can’t drive costs down by declaring prices too high. You can only drive costs down through volume, collective bargaining on supplier components (to drive per unit costs down), and competition. When labor is roughly 65% or so of the cost of care, and you’re not willing to cut salaries, how in the hell does any clown in DC think that they can mandate a reduction in the price of health care without having significant impacts on the national cohort that provides the care?

    As Jacque was saying, burn-out, discouragement, and surrender seem to be the options available to providers. In this, as in any organization or market, the least capable in the cohort (meaning the worst performers) will stay in the organization or market, because they have fewer outside options. The highest performers will leave (as DJ has) and do something different entirely, in the hopes of salvaging his practice and his income.

    This negative feedback loop only winds in one direction. We will have fewer good or great doctors. We will have more mediocre doctors. Our collective health will suffer, and the political “fix” for this in 5 years will be more of the same.

    Because that’s all stupid people know. More of the same. Despite the data being smacked into their pinched and tiny faces.

    • #24
    • March 19, 2017 at 3:38 pm
    • Like3 likes
  25. Profile photo of Aaron Miller Member

    Dave Carter (View Comment):

    Kay Ludlow (View Comment):
    I often catch up on the Ricochet podcasts while I cook. Tonight, I was so interested in DocJay’s discussion of healthcare, I just about sliced my finger off. Very bloody. Great podcast though!

    Sorry you were injured during the podcast! I knew Doc’s commentary would be incisive, but dang!

    A cutting edge discussion! She was probably chopping meatballs, too.

    Motley Crue, David Allan Coe, some dixie blues… This podcast certainly has the best music.

    @docjay ‘s point about sympathy diminishing in society as everyone’s troubles pile up will stick with me. I can’t be the only one whose mind turned to Russians after that comment.

    That touches on my greatest fear for America’s future: that we will stomach so much for the sake of security and our material standards of living that any chances for painful restoration will pass us by. In other words, the United States will endure in name only, relinquishing all customs and legal limits which made us unlike other nations.

    • #25
    • March 20, 2017 at 2:23 pm
    • Like2 likes