Not sure how this is disagreeable it’s just relaying an easily verifiable fact. In the US any decent academic affiliated institution or well funded private one will have institutional memberships to one or more of these products. I’ve never paid out of pocket for either UpToDate or Dynamed, for instance, but obviously not everyone has that benefit, especially on a global level.

> The institution’s wealth doesn’t trickle down to the docs

As a general statement that’s just nonsense. Richer institutions provide better equipment for one, and will often pay for personal equipment memberships like POCUS (and that tends to be more segmented to the top institutions), training, and of course expenses for conferences.

If it isn’t clear by POCUS “personal equipment memberships” I mean portable per user licensed devices like the Butterfly or Clarius (have you heard of them?) not the trusty biohazard in the supply room. Those are very much not standard of care since most make do without it and I question how with the times you are if you think I was referring to ultrasound in general.

Your anecdote doesn’t change the fact that the access to costly resources is correlated with the finances of both the locale and the organizations. To argue otherwise is detachment from reality. And I’m going to wager that the “poorer” system in your story was still quite wealthy in absolute terms.

> Those funds are sometime allotted as part as a compensation package, but it's just that-- an employment benefit that offsets what they have to pay you.

There’s a nugget of truth here but this is overall a gross oversimplification.

You don’t seem well and I’m sorry about your personal axe to grind with your institution but it’s not pertinent to the topic at hand.