MA had an escape clause in the law - if you didn’t accept Federal or State payments AT ALL, you could see patients outside the “system”.
I think Romneycare made this illegal.
Any national system has to break the doctors first. My reaction since graduation in 1976 to all the plans and all the planners has been consistent - “Who’s gonna fly it, kid? You?”
But the planners are gaining strength and increasing the scope of the pain they can inflict. Turning residents and fellows into hourly workers in the 1990s was a triumph, because those shift workers are now mid-career.
When I was a clinical clerk, we used to say, “what’s the only bad thing about being on every other night?” (36 on, 12 off, for several years). The answer: “You miss half the good cases”. They’ve killed that, they’ve killed solo practice except in cash businesses like boob jobs, they’ve basically destroyed psychiatry, they’re engaging in mop-up operations in pediatrics and so-called “primary care”.
They’re going to win in the end.
“They’re going to win in the end.”
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As far as my generation goes they have already won.
I go back to house calls and doctors that had office hours daily,in their homes.
The last time I went to my PCP he spent more time looking at the laptop than he did looking at me.
Last year my longtime doctor retired so I switched to one closer to where I now live-—this involved changing hospitals,both in MA and about 15 miles apart.
I found out that my records went from one hospital,on to a company in Alpharetta,Georgia, and then on to the new hospital.
To say that I was horrified would be a gross understatement.
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