I take the 40,000 foot view. Medicine became too expensive because the law of supply & demand was not allowed to operate, due to the intervention of the AMA. That’s why more than 200 applicants to medschool are rejected for every one accepted. As a result, the guvmint tried their statist/librul solution, which is represented by Obamacare. Neither side has it right.
This article is true. Do to EMR’s I have quit my private practice of 22 years. I will now work for a hospital. I will work shifts,give up the headache of worrying about overhead, have time off and make more money. Maybe, I can make it 10 years then I will go GALT!! Unless it become illegal. I would not be surprised.
Like everything else the government touches - once federal government money came pouring in (via Medicaid and Medicare) the entire system became perverted.
Once doctors and hospitals stopped looking to the patient to pay for their own health care and started looking to the governmment, the government became the boss and the one they had to please.
Look how government money has destroyed the nations schools in the same way.
Everything the government touches, it destroys.
Again, ain’t central planning great! We’re being set up for a great Marxist fall. It never works. Ask the USSR!
I’ve never understood why doctors did not more aggressively oppose government takeover of medicine.
If the government controls medicine, doctors will become essentially civil servants. Their compensation and working conditions will be determined by politics, not markets.
the obama admin used the coding system as the carot to get ama approval for obamacare.
either they capitulate to slavery under obamacare or their coding system would be replaced. (no money for using the codes)
I don’t want to hear it. The system was great as long as the doctors were milking it. All these systemic failures could have been averted had the doctors stood against them, but instead groups like the AMA pushed them along.
A quibble: HMOs were government creations. Ted Kennedy led the legislative charge to create and impose HMOs on private insurers. The The Health Maintenance Organization Act of 1973 (42 U.S.C. §300e) was signed into law by Richard Nixon.
Additional amendments to the law required all private insurers to offer HMO plans alongside other plans sold to employers.
Ted Kennedy and the democrats are 100% responsible for the creation and problems of HMOs.
Other than that I enjoyed the physician’s perspective on the state of medical care today. Things are going to get a lot worse, very soon.
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The EMR (Electronic Medical Record) in Emergency Medicine reduces productivity - the number of patients who can be seen by an individual physician - by AT LEAST 30%. That is after a minimum of 3 months to become proficient with the system.
Instant Doctor shortage.
We spend 80% of our time with a mouse and keyboard, not a stethoscope, entering data into prescribed templates. Now the feds are complaining about “cookie cutter” records that they mandated.
Expect the majority of encounters to be with midlevels, because there are not enough physicians to do the mandated BS.
After 38 years in the ER, I can now see 1.3-1.5 patients per hour. 25 years ago it was 6-10. “Good enough for government work?” Oh yes, reimbursement is hovering around 25 cents on the dollar.
In 1985 or so I heard Leonard Peikoff give a keynote speech at the annual meeting for neurosurgeons. I was a young resident at the time. He pointed out that RBRV was the lawyer’s way of “divide and conquer” and it’s purpose was to pit the specialists against the primary care docs. It worked. At the time it seemed to me that if students wanted to get into the “higher pay” fields they should have to suffer the 100+ hour weeks for years as I was doing.
Phylis Schlafly did an excellent article on the AMA and ICD several years back. Her point was essentially that the AMA had “sold out” the doctors they claimed to represent as they realized that dwindling numbers of docs joining was going to make them extinct soon if they couldn’t find a revenue source. They found gummint’s teat and have been hanging on ever since.
Myself, I started my own business several years ago. There were a number of factors but now I don’t have to deal with any of the crap that irritates most docs. I don’t have any employees, I answer my own phone, and I had to learn coding to get paid but I have to say that since I don’t need much at this point I can “make a go of it” at just about any level. Even so I have been in the red for three years (marginally) but I see it as “Going Galt”. The area I am in is saturated so I am not very busy but I keep busy with my “projects”.
When I look down the road after 30 years what I see is not pretty. Young docs are indoctrinated into believing in socialized medicine. They have no regard for what our profession has suffered to get where we were decades ago (read Paul Star’s “The Social Transformation of American Medicine) how it took DECADES to recover from the “sawbones” era following the Civil War. Will they ever pull their head out of their butts in time to prevent total collapse of our profession? I see “gumint medicine” coming and what we now call “health maintenance” will be the ONLY free service. It will be run by SEIU cliics staffed by Union Drones given a 6 week course in how to use an algorithm similar to the Army’s FM 22-20. Maybe some “minor illness” type free service (URI Viral infections, perhaps. It is cheap to have a 25 y.o. high school dropout just tell folks yuo don’t need antibiotics, the manual says so!)
Of course The Mayo and Johns Hopkins will be there for “cash only” or the “politician’s insurance plan” which will be the ONLY one left.
Years ago I said (posted here), “We are approaching a day when abortion will be easily available on Main Street but Lipitor will only be available in alleys and handed through car windows.” We are almost there.
Nope, a surgeon cannot operate out of a clinic, except for some low-risk orthopedics and such like. He needs a hospital, with all that infrastructure of operating rooms, OR nurses and technicians, hosptial-owned equipment. Hundreds of millions of dollar, and it all must be maintained and administered for yet more millions.
Have spent many years on FR trying to persuade people that "doctor bills" are not their problem. "Hospital bills" are. Haven't made a dent yet. I still hear complaints about greedy doctors. Well, they won't be around to complain about much longer.
Nope, a surgeon cannot operate out of a clinic, except for some low-risk orthopedics and such like. He needs a hospital, with all that infrastructure of operating rooms, OR nurses and technicians, hosptial-owned equipment. Hundreds of millions of dollar, and it all must be maintained and administered for yet more millions.
Have spent many years on FR trying to persuade people that "doctor bills" are not their problem. "Hospital bills" are. Haven't made a dent yet. I still hear complaints about greedy doctors. Well, they won't be around to complain about much longer.
Bump for tomorrow...