Posted on 03/26/2010 10:49:15 AM PDT by reaganaut1
A quiet revolution is transforming how medical care is delivered in this country, and it has very little to do with the sweeping health care legislation that President Obama just signed into law.
But it could have a big impact on that law’s chances for success.
Traditionally, American medicine has been largely a cottage industry. Most doctors cared for patients in small, privately owned clinics — sometimes in rooms adjoining their homes.
But an increasing share of young physicians, burdened by medical school debts and seeking regular hours, are deciding against opening private practices. Instead, they are accepting salaries at hospitals and health systems. And a growing number of older doctors — facing rising costs and fearing they will not be able to recruit junior partners — are selling their practices and moving into salaried jobs, too.
As recently as 2005, more than two-thirds of medical practices were physician-owned — a share that had been relatively constant for many years, the Medical Group Management Association says. But within three years, that share dropped below 50 percent, and analysts say the slide has continued.
For patients, the transformation in medicine is a mixed blessing. Ideally, bigger health care organizations can provide better, more coordinated care. But the intimacy of longstanding doctor-patient relationships may be going the way of the house call.
...
There are political consequences, too. As doctors move from being employers to employees, their politics often take a leftward turn. This helps explain why the American Medical Association — long opposed to health care reforms — gave at least a tepid endorsement to Mr. Obama’s overhaul effort.
Gordon H. Smith, executive vice president of the Maine Medical Association, said that his organization had changed from being like a chamber of commerce to being like a union.
(Excerpt) Read more at nytimes.com ...
So glad for your experience. Hope your baby is doing well.
You know, I’m not a philosopher and don’t have the best phrasology, but it seems to me that change is a the heartbeat of life. Nothing ever stays as it always was. Now, we’re living a period of rapid change. In the words of Mitt Romney, “It turns out that Barack 0bama goes downhill faster than Lindsay Vonn.” OK, how far down? There are going to be some of us on the trenchlines, there always are. I’m not a visionary or a leader, but I *will* be there to provide logistic and tactical support to those who are. And you will do the same. And eventually, it will get better simply because beyond a certain point, the patriots will not let it get worse.
Bid us and our posterity bow the knee, supplicate the friendship, and plow, and sow, and reap, to glut the avarice of the men who have let loose on us the dogs of war to riot in our blood and hunt us from the face of the earth? If ye love wealth better than liberty, the tranquillity of servitude than the animating contest of freedom—go from us in peace. We ask not your counsels or arms. Crouch down and lick the hands which feed you. May your chains sit lightly upon you, and may posterity forget that ye were our countrymen!
Bid us and our posterity bow the knee, supplicate the friendship, and plow, and sow, and reap, to glut the avarice of the men who have let loose on us the dogs of war to riot in our blood and hunt us from the face of the earth? If ye love wealth better than liberty, the tranquillity of servitude than the animating contest of freedom—go from us in peace. We ask not your counsels or arms. Crouch down and lick the hands which feed you. May your chains sit lightly upon you, and may posterity forget that ye were our countrymen!
http://www.nationalcenter.org/SamuelAdams1776.html
This is news? Except for the time I spent in Deep East Texas, I haven’t seen a doctor in private practice since I was a teenager. All the large hospitals, Humana, Cedar, Hopkins, Mayo, Baylor, Christus, etc etc, have had doctors on staff not only in the hospitals themselves but in corporate satellite clinics as well.
A doctor with poor English is exactly what killed my uncle...the doc prescribed two meds that CANNOT be taken together. He didn’t read English well enough to figure that out. This was many years ago in Chicago.
Don’t worry, I am sure there is an inexhaustible supply of Bangladeshi doctors.
...I’ve heard similar horror stories concerning hospital nurses/employees with 3rd world English skills.
Hi fellow MT. I do acute care a home and I would estimated 50% are ESL (English as a second language), more in California where some of my accounts are.
Thanks. However, wonder if the statement is not too far off??? EEEK!
A nice story. I hope your daughter is continuing well on her recovery. Sounds like she’s been through a lot. About 52 years ago, Dr. Reedy came to our house to throw me in the bathtub and run tepid (to me ice-cold) water to bring my skyrocketing fever down. I’ll never forget it; I didn’t want to get in, but she “put” me in. It’s nice to know there are a few doctors like that around today as well!
+1 for Mehary being a total joke. The reason? Its an affirmative action black school that gets loads of tax dollars to accept black students with subpar grades. Obamacare has a provision for more of this exact thing. Vanderbilt residents have to work with those clowns and I have heard about many near death situations.
Also lots of gov’t run hospitals (VA for one; inner city hospitals) consistently use foreign med grads on the cheap. Expect way more of the same as we lose the talent to this BS.
As for docs switching to salaries, the current batch will still maintain the belief that they are getting screwed, its the new affirmative action and subpar grads that will be leftists. Also, this allows the gov’t to force them to take Medicare which is key to their takeover. As it stands right now, if the private docs got the cajones to abandon Medicare en masse, they can’t do a thing. If all docs end up earning a salary from hospitals (which are dependent on fed dollars AND beholden to the fed legally by precedent of many years) they will be taking Medicare by default. Then the docs will no longer care about managing costs or about the insurance payouts because they no longer see the bottom line. Then the chorus will chime in that we need to regulate this “madness” of spending and hello death panels 2.0.
At the same time they will cease to care to provide true service industry quality of service as there is ZERO incentive to do so. And the quality of care goes into the toilet. Docs do this NOW. If they are working on salary and some patient comes in in the evening or at some other unfortunate time, the doctor will give a middle finger to you and will come at their leisure as their bottom line will not change one bit whether or not they come to see you that night. If the doctor makes money based on visits and face time, you bet your a$$ they will be there that evening and again the next day to maximize their cash flow and to ensure that said patient returns (if applicable to the situation). If you’ve had the privilege of working with a salaried doc in a teaching hospital fed by tax dollars vs. a private hospitalist, the difference is startling.
Mrs Dearolddad did insurance billing for an OB-GYN in Northern VA, he had never been sued for malpractice or had a medical claim against him. His malpractice insurance was over 100K per year.
With a patient base of approx. 1000 women you can see how much had to be added to each bill to cover the cost of malpractice insurance alone.
Obamacare is going to be a disaster of incredible proportions if we do not repeal it or at least defund it.
Because there is a maldistribution of practitioners, and, particularly, specialists.
I've chaired a specialty department in a multispecialty clinic of 350 physicians for about 10 years now. The maldistribution is related to the type of specialty, the geographic region of the country, and practice type and compensation. There is also a tendency for new recruits to not work as hard as they used to work. They want reduced hours and many want part-time status, especially women.
The factors related to recruitment are complex and it sometimes will take several years to recruit a given physician.
Is that from personal experience with socialized medicine?
My primary care physician announced this week that he was closing down his practice and retiring. No word on whether someone else was buying his practice or if we're all on our own to seek out another doctor ...
Welcome to ObamaCare.
Mine’s one of those giving up his practice.
The first sentence destroys the credibility of the whole article.
Let me fix that for you: Foreign medical graduates are recruited to practices where American candidates can't be recruited at the pay of foreign candidates or where demand outpaces supply (at the pay of foreign candidates) for the American graduates.
Doctors are about to get the same treatment that software developers and engineers got under H1B.
A maldistribution from your prospective is likely to simply involve doctors choosing the specialty which they believe will be most rewarding (professionally and financially). If the word got around that specialty A's pay was lousy and the hours were bad, then you would see fewer students picking that area.
Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.