Can you diagnose in the field?

[zippyRN]

I'm not quite sure what your arguement is here. Yes, I made a comment about billing, so what. My point is that while anyone can make a diagnosis, only certain people can bill for that diagnosis (pretty much the same there on your side of the Atlantic I would imagine, unless you let lay people bill for things).

it's the tail wagging the dog of clinical practice, it;snot clinicians deciding who can diagnose and therefore bill for that diagnosis - it;s thelaw makers and or lay management / insurers

As far as my comment about legal grounds, no there is not a staute that says exactly what you said, but we do have laws that prevent people from practicing medicine without a license. Seems like a pretty good idea, but I guess you feel otherwise.

this seems to be a recurring cultural difference between the so called 'land of the free' and elsewhere - in the UK most our health care legislation is drafted in such a way as to leave boundariesa little blurred and let professional regulators and the health service define exactly where the boundaries stand.

practising without a licence / registration iin the uK is seen as a problem foof those who aren't part of the recognised structures of healthcare - i.e. frauds,

we don't have legislation that says only 'X'can do something - lots of primary legislation has terms like 'appropriate practitioner' and the determination of that is left to secondary regulation which changes pretty frequently or even to the professional regulators. the ionising radiation medical exposure regulations talks about 'referrers' , 'operators' and 'practitioners' without reference to professional status

referrers is pretty much self explanatory, but 'operator' isn't necessarily a radiographer and 'practitioners' aren't just radiologists - there are radiogrpahers who are practitioners as advanced practioners (started with doing their own reporting and giving contrast under patient group directives severla years ago m but is getting increasingly interventional ) but there are also other speciality COnsultants who are 'practitioners' under IR(ME)R such as the hand surgeons who use the mini -C-arms which are designed to be surgeon operated and the interventional cardiologists

there also seems to be aspects of exclusivity where certain groups of practitioners have skills, interventions or therapies ring fenced and other groups of practitioners can't do these roles without becoming licenced/ registered in that profession as well. The UK tends to look more from proving equivalence in education and preparation for practice - a lot of this follows the original publication ofthe UKCC's " scope of professional Practice " document for nurses and Midwives in early 1990s which opened up practice development considerably

Other than that, I'm not sure how to address your arguements, as I am not sure exactly what your arguement is. Some of your statement make no sense. If you'd like to have an intelligent debate, I'd be more than happy to, but you need to clean your post up so that I can rebuttal your agruements.

i hope the above makes it a little clearer ?

As for socailized medicine vs US medicine, each has its good and bad. I would hate to have to wait a few months to get a CABG with a ticking timebomb in my chest in some countries that have socialized medicine.

for acute MI we are increasingly seeing primary PCI - most of London is now a primary PCI area and more and more urban areas are becoming primary PCI areas, rural alreas as usual lag behind, but most of those are delivering pre-hospital thrombolysis and the few that aren't are delivering very good pain to needle times in for ' in -hospital' thrombolysis (current record where i work is 7 minutes "door to needle "and i think somethign like 35 minutes "call to needle" - pain to needle depends on perople actually calling for EMS ...

elective CABGs usually come faround through increasingly unstable angina or post thrombolysis - it's a numbers game and it's suboptimal but this gets into the realms of philosphy and economic theory - it also depends where the money is thrown - how do you quantify primary preventions impact on the numbers who need treating for a condition ...

US medicine does have problems with insurance companies and drug companies that are out to make huge profits, but with all the good that goes on, I guess you have to put up with some evil. We can attempt to minimize the evil as much as we want, but there will always be some there.

i think no one would dispute this

in answer to other posters there would still be a huge amount of medical research going on without the US commercial interests - i'm not sure how much US federal or charity money is psent on medical research , as well as many european nations are spending 7 figure dollar / euro sums each year on medical research as well as the R+D spending of 'european' pharmaceutical business - plus the money being spent by India, China, east asian and AUS /NZ ...

[Dustdevil]

i'm not sure how much US federal or charity money is psent on medicla research , as well as many european nations are spending 7 figure dollar / euro sums each year o nmedicla research as well as the R+D spending of 'european' pharmaceutical business - plus the money being spent by India, China, east asian and AUS /NZ ...

Well, I do know that the US spends more per year on AIDS and cancer research than all of the rest of the world combined. You don't think that amounts to something?

[Asysin2leads]

Here's a puzzler for you, if the world hates the United States so much, how come we see so few returned foreign aide checks? If you really want to make a statement, don't go with the cliche burning of Uncle Sam in effigy, return our foreign aide money with a "No thanks!" attached. That'll really show us.

[hfdff422]

Americans are lazy and greedy. So what! We can stereotype with the best of them too. I personally feel that there is no reason to hate or be upset with anyone person or culture for the beliefs they hold or the differences they bear. We do some horrible things as a nation, and those individual acts are to be condemned, not our society. It should be clear here that the difference of opinion between peoples trained and educated in similair manners can be monumental so to judge all peoples based on a few corrupt individuals is narrow minded and worthy of angered reactions by us fat, lazy Americans.

[BushyFromOz]

Damn...

I hope none of this is directed at me, cause this is deffinately not my view!

[Just Plain Ruff]

billions and billions of loans to third world countries and not much paid back

They all seem to hate us but they sure love our foreign aid and loans.

I'll bet they'd sing a different toon if we stopped giving out all this money.

[zippyRN]

Here's a puzzler for you, if the world hates the United States so much, how come we see so few returned foreign aide checks? If you really want to make a statement, don't go with the cliche burning of Uncle Sam in effigy, return our foreign aide money with a "No thanks!" attached. That'll really show us.

pretty much irrelevant to Europe, the 'old' Commonwealth, and industrialised and industrialising Nations outside those groupings ... which was where the concerns over cultural imperalism are being voiced from ...

[Dustdevil]

What exactly is this "cultural imperialism" nonsense you keep spouting like a brainwashed mantra?

Somebody's forcing Britons to buy US goods and services?

[zippyRN]

What exactly is this "cultural imperialism" nonsense you keep spouting like a brainwashed mantra?

Somebody's forcing Britons to buy US goods and services?

the suggestion that 'most of the innovations in current use ' are American we'll give you USS and hell yeah let's throw electronic TV in as TV as is is close the Farnsworth than Logie Baird...

see also the links ref U571 etc...

also the habit of turning up 2 to 3 years late and requiring hand holding through it all ...

or i suppose it was the long game funding irish republican terrorism so the British Army were the world Experts on OBUA/FIBUA/FISH

http://en.wikipedia.org/wiki/Cultural_imperialism

http://en.wikipedia.org/wiki/Overseas_expa...ral_imperialism

[Dustdevil]

I want to know what YOU think it is, not what some anonymous wiki dork thinks it is.

Unable to think or speak for yourself these days?