Tuesday, July 31, 2012

Things Are About to Get Interesting

It was a chance encounter.

After all it's not every day you see an internist who still frequents a hospital.  We've known each other for years and he's been watching the changes in health care, too.
"Boy, they're really not happy Over There.  Seems they've contracted with Big Boy insurance as part of their new ACO model.  Everyone's going to get their piece before the doctors: Over There hospital, their four million administrators,  lawyers, grounds crews, parking staff....  Then, after everyone else is paid, the doctors might get a few scraps if there's some left over.  No guarantees.  All risk, no certainty of reward.  There was no way I could still go there.  I joined them, but had to leave when I saw how unworkable that was."
"Isn't this our new way forward?" I asked.
"I guess so.  Scary.  But I've got just a few more years.  Just have to get the kids through college."
There are those who will call this doctor's statement a veiled threat.  Perhaps it is.  Maybe economic times will make it difficult for many physicians to leave the security of their workplace in the upcoming years, but we should not take this doctor's comments lightly.  There is an aire of uncertainty, and with it, anxiety.  Doctors, like every person working today, are under growing financial pressure.  But unlike every person today, they are saddled with unique physical, emotional, and legal threats, and it is no wonder many will leave the field for other endeavors if it's not worth it to stay.

Thirty percent of all of today's doctors are over 55.  Most of these doctor just want to get their kids through college.

What happens then is anybody's guess, but one thing's for sure: these resourceful individuals aren't likely to  be left holding the financial health care bag.

And with them will depart important leaders for our younger generation of doctors in medicine.

-Wes





10 comments:

Bradley Hennenfent, M.D. said...

It's important to speak up Dr. Wes. My entire blog (http://www.bradmd.com/) is against BAD ObamaCare and BAD ObamaNomics. We need Patient Power healthcare not all the power given away to uncaring bureaucrats. We need to repeal ObamaCare and do healthcare reform to empower patients. Patients and doctors to be on the same team saving lives again instead of the mess called ObamaCare that we have been given.

Anonymous said...

We physicians over 55 need to stick around and fix things for the next generation of doctors. The Association of American Physician and Surgeons is fighting back. Since 1970, the number of physicians has doubled. In that same time the number in health administrative positions has increased 35-fold. ObamaCare is the mother of all mega-administrators. It needs to be repealed and doctors and their patients need to take back control.

Alieta Eck, MD
President, AAPS

Anonymous said...

"after everyone else is paid, the doctors might get a few scraps if there's some left over"

And we're supposed to be surprised?

More and more docs who sold their practices out of fear will wake up and find themselves in similar pickles.

(Hate to state the obvious, but this isn't Obamacare, it's unregulated private insurers and hospitals.)

Lew said...

"We repudiate only forced organization, not natural organization. We repudiate the forms of association that are forced upon us, not free association. We repudiate forced fraternity, not true fraternity. We repudiate the artificial unity that does nothing more than deprive persons of individual responsibility. We do not repudiate the natural unity of mankind under Providence."
Frederic Bastiat (1801-1850)

The only successful course we can take to right the ship of medicine in the eye of this perfect storm of adversity.....is less government, less third party involvement, and more opportunity for market forces. Anything less, and we will get exactly what you might expect from a non-market-driven system...namely, mediocrity, practiced by shift workers, plundered by statists, and promoted by socialists.
Nuff said.

Anonymous said...

What Anon 9:37 said.

Some of you guys walked right into this one more than a decade ago as easy corporate prey. You have ruined things for not only yourselves but for future generations of doctors and nurses. History will reflect.

-SCRN

Anonymous said...

How dare that doctor demand to be paid! The practice of medicine is a calling. Doing call is a privilege--serving your fellow man. It is your duty. Doctors knew going into training that they would be public servants. Fire fighters and police officers place their lives at risk and get paid 20% of what a doctor makes.

There are people who can't even find a job in this economy. Who can afford to pay a doctor? Americans are dying while doctors demand more money.

Signed,

Hospital administrators of America

Anonymous said...

Let me know when doctors fall off the Ten Highest Paid Professions List.

We've got a lot of people in this country who can't afford medical care. What do you suggest we do with them? And when do they get to worry about getting their kids through college.

Here's one very small violin for you folks.

Anonymous said...

I second the motion to empower patients! First thing you guys need to do is be able to tell me how much you charge for valve replacement surgery so I can do some empowered "comparison shopping". And no doubt you will support patients having the same ability to comparison shop for the hospital charges. And no doubt you'll be able to tell me how much that script you're writing is going to cost.

Lord. There is so much wrong with health care today and all you guys can moan about is Obama.

Anonymous said...

Anonymous at 4:09

Every doc I know would be glad to post their fees, but, if we've contracted with insurers, we're prohibited from doing so by a combination of contractual agreements and government anti-trust regulations.

And how in the world am I supposed to know how much your pharmacy is going to charge for a prescription and how much your insurer will cover? That's your responsibility to research if it's an issue for you.

Anonymous said...

As a pharmacist (paid decently, I might add), this hullabaloo started with intimidating (by insurance industry in the name of capitalism) all health care providers from the physician ON DOWN.

All that the new health care plan really ensures is that patients start out a little more equally on the bumpy surface of what's available in the market that they can access. Sure, they can go to the ER, but is that good well-care? All that does is break the freebie bank provided by tax-payers.

There is NO way patients can 'shop' around! There is NOTHING to select from to make a choice. Insurance (or its lack) dictates where will patients have to go, when it comes down to paying $75.00 for groceries or a $50.00 bill to the doctor (and $25.00 to the pharmacy --if they're lucky what's been prescribed is on the insurance's cheap tier.)

Don't tell me that medical professionals are so far from their student days when they worked part-time jobs for peanuts while putting in 100 hrs/week on school. (Oh, born with a silver spoon in the mouth, or were a merit scholar and the government paid tuition costs, and no meals were missed, or perhaps decided to rack up the tuition bills that must charge patients (and the government) exorbitant fees to pay off?) Whatever. Excuses.

The physicians have always been MAJOR players in setting prices and now they're crying foul when the patients demand a part of what they contribute to group health 'plans'?

For the record, in my college town nine indies and two one-town multi-location pharmacies closed up shop in the last 15 year, not just because Wal-mart (and Target and all the me-toos) came in with below-cost and free drugs. But, because MDs refused to be paid low Medicare and other set fees and had no qualms about ensuring that they were paid top wages because they could, because they'd long-enjoyed the top of foodchain status, to heck with everyone else providing healthcare. Mostly because pharmacies could not afford below-cost reimbursement for drugs (reimbursement prices set by the very same people that set physician fees--insurers), as well as pay for lights, heat, water, etc. Dare one suggest that the reason physicians are afraid of government regulation is that much of the cost of healthcare is to cover Medicare fraud, for which those at the top of the foodchain should be focusing on?

But, I'm not exclusively pointing out the source of the rotting smell as physicians and those that answer directly to them as nurse practitioners and most nurses, but that there is a bad case of C.diff all over the whole bloomin' beast.

When doctors think that 'they' as an organization are being treated deplorably by the government it is because they are not standing with pharmacists, dentists, speech pathologists and patients and saying that healthcare should be available to all.

A patient's family should not go into debt just because a member had a illness or some other health-related issue.

Accessing a prescriber and getting treatment is not and SHOULD NOT be the same as choosing between a bag of Golden Delicious, Fuji or Jonathan apples, whichever is available for the cheapest price.

Patients can't even keep track of their prescriptions, let alone make cost decisions if their insurer is changing reimbursement co-pays all the time. Pharmacists cannot even tell a patient what a prescription will cost unless they run the script through as if filling it with the innumerable variety of insurers.

Cathy Lane RPh