tag:blogger.com,1999:blog-18943510.post6792970886217751533..comments2023-08-21T02:57:37.362-05:00Comments on Dr. Wes: Final Rule HieroglyphicsDrWeshttp://www.blogger.com/profile/17438019699222125477noreply@blogger.comBlogger15125tag:blogger.com,1999:blog-18943510.post-79071239201083865822008-11-16T16:11:00.000-06:002008-11-16T16:11:00.000-06:00We would have lesser demand for specialist service...We would have lesser demand for specialist services if we took better care of ourselves and focused on prevention, as opposed to treating illness. Then the law of supply and demand would assist our efforts in allocating our healthcare dollars more efficiently.Deron S.https://www.blogger.com/profile/10525503477462231505noreply@blogger.comtag:blogger.com,1999:blog-18943510.post-1118253933535878462008-11-11T09:48:00.000-06:002008-11-11T09:48:00.000-06:00No one in medicine seems to get the big picture. N...No one in medicine seems to get the big picture. No one should be envious of others who have higher incomes, nor seem to have some advantage. First they came for them and them and , then they came for me...<BR/><BR/>Seems to me as physicians despite the challenges we should realize we are in a fairly unique group. Snipping and snarking at one group is not going to increase your income....That isGary M. Levinhttps://www.blogger.com/profile/16205704913440150198noreply@blogger.comtag:blogger.com,1999:blog-18943510.post-46623732487340580872008-11-10T23:52:00.000-06:002008-11-10T23:52:00.000-06:00anon. I wish I could clarify more, but I can't. ...anon. I wish I could clarify more, but I can't. You'll just have to believe me when I say I think the whole system of RVU/SGR economics is an exercise in futility for the delivery of health care in our country. It has destroyed comprehensive care. And eventually, it will destroy the specialty societies as well.<BR/><BR/>It is not a viable program. The collapse of out patient comprehensive The Happy Hospitalisthttps://www.blogger.com/profile/14392872203166584371noreply@blogger.comtag:blogger.com,1999:blog-18943510.post-70174774348031505212008-11-10T19:47:00.000-06:002008-11-10T19:47:00.000-06:00The point is Dr Wes that HH is an employee of priv...The point is Dr Wes that HH is an employee of private hospitalist group (unless he is a partner) and his group receives a subsidy from the hosptial. Hence in reality he doesn't directly deal with the issues that the rest of us do. Nothing wrong with it, he just doesn't presently have firsthand experience. I guess we can all become hospitalists once our big salary specialty practices go under. <BRAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-18943510.post-27452324116426887812008-11-10T19:25:00.000-06:002008-11-10T19:25:00.000-06:00Thanks for the clarification and appreciate the in...Thanks for the clarification and appreciate the info, Happy. Your model seems relatively unique - most hosptialist groups around here are employed by the hospital systems themselves.<BR/><BR/>Any non-compete clause in that contract you have (or would you have to shoot me if you told me)? I realize this might not be an issue if your hospital is the only game in town...DrWeshttps://www.blogger.com/profile/17438019699222125477noreply@blogger.comtag:blogger.com,1999:blog-18943510.post-6482354952852032842008-11-10T19:09:00.000-06:002008-11-10T19:09:00.000-06:00Hey doc. Just to clarify. the $100,000 figure is...Hey doc. Just to clarify. the $100,000 figure is what the Society of Hospital Medicine published in their report in April of this year. The actual figure was about $93,000 per doc per year in hospital funding. <BR/><BR/>The contractual relationship that Happy's Hospitalist group has with Happy's Hospital is something that I am contractually obligated never to talk about. <BR/><BR/>So I won'tThe Happy Hospitalisthttps://www.blogger.com/profile/14392872203166584371noreply@blogger.comtag:blogger.com,1999:blog-18943510.post-48669783787327697732008-11-10T18:50:00.000-06:002008-11-10T18:50:00.000-06:00anony 2:44 PM:Your answer can be found in the comm...anony 2:44 PM:<BR/><BR/>Your answer can be found in the comments <A HREF="http://thehappyhospitalist.blogspot.com/2008/11/drawing-line-in-sand.html" REL="nofollow">here</A>. It seems Happy's group is subsidized by the hospital to the tune of about $100,000 per physician per year.DrWeshttps://www.blogger.com/profile/17438019699222125477noreply@blogger.comtag:blogger.com,1999:blog-18943510.post-24664578349628647202008-11-10T14:44:00.000-06:002008-11-10T14:44:00.000-06:00I wonder if Happy's private hospitalist group rece...I wonder if Happy's private hospitalist group receives a subsidy from the hospitals they service, effectively minimizing the financial impact? I also wonder what overhead the hospitalist groups have, which would also serve to minimize the effects on hospitalist groups.<BR/><BR/>Should all medical groups receive subsidies from the hospitals to help defray these expenses?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-18943510.post-62204284655099582212008-11-10T13:36:00.000-06:002008-11-10T13:36:00.000-06:00Anonymous:Not sure what region you live in.Census ...Anonymous:<BR/><BR/>Not sure what region you live in.Census problems really depend upon where you live?<BR/><BR/>You cannot generalize.. Let me know and I'll get you the answersGary M. Levinhttps://www.blogger.com/profile/16205704913440150198noreply@blogger.comtag:blogger.com,1999:blog-18943510.post-18805145253621101362008-11-10T09:32:00.000-06:002008-11-10T09:32:00.000-06:00Doc - could you talk about the census problems tha...Doc - could you talk about the census problems that hospitals are currently facing? Thanks CJAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-18943510.post-21440520623358698702008-11-10T09:03:00.000-06:002008-11-10T09:03:00.000-06:00Yes, all of the above is true Dr. Wes. If the rea...Yes, all of the above is true Dr. Wes. If the readers will check out my healthtrain blog I have written an article on 'Peak Oil Medicine". Interesting analogy.<BR/>Our problem is that we preach to the choir. Our situation is illogical,and defies rational thinking. Our 'raises' are running far behind inflation, while the healthcare dollars go elsewhere.<BR/>My financial analysts and advisors Gary M. Levinhttps://www.blogger.com/profile/16205704913440150198noreply@blogger.comtag:blogger.com,1999:blog-18943510.post-76993223382917501232008-11-10T08:56:00.000-06:002008-11-10T08:56:00.000-06:00Hey Doc. Actually, I'm not employeed by a hospita...Hey Doc. Actually, I'm not employeed by a hospital. I am part of an independently owned private practice hospitalist group. And we are hardly immune to the skewed and flawed Medicare Economics. <BR/><BR/>The whole SGR/RVU system is inherently flawed, and I have maintained that fromt he beginning. IN the fixed pot of Medicare part B, for every winner, there is a loser. That's why hospitalist The Happy Hospitalisthttps://www.blogger.com/profile/14392872203166584371noreply@blogger.comtag:blogger.com,1999:blog-18943510.post-14868716882319957512008-11-10T06:24:00.000-06:002008-11-10T06:24:00.000-06:00Happy-I'm willing to bet that you are salaried...Happy-<BR/><BR/>I'm willing to bet that you are salaried by the hospital that employs you. As such, you are immune to the reality of what a 1.1% Medicare "raise" in payments means to the private practice, stand-alone practice charged with paying for their office overhead. Certainly, the current efforts are better than the threatened alternative (5.4% decrease). But E&M codes DrWeshttps://www.blogger.com/profile/17438019699222125477noreply@blogger.comtag:blogger.com,1999:blog-18943510.post-35360677138987833202008-11-09T19:44:00.000-06:002008-11-09T19:44:00.000-06:00Didn't you mean back bowels of government...sound...Didn't you mean back bowels of government...sounds much more apropos.Gary M. Levinhttps://www.blogger.com/profile/16205704913440150198noreply@blogger.comtag:blogger.com,1999:blog-18943510.post-42032374618910721872008-11-09T18:59:00.000-06:002008-11-09T18:59:00.000-06:00Actually Dr.Wes, the codes that increased reimburs...Actually Dr.Wes, the codes that increased reimbursement, the cognitive care codes for outpatient and evaluation codes and consultation codes as well as inpatient admitting, consultation and follow up codes are codes used by all physicians that engage in thinking evaluation.<BR/><BR/>That includes specialists. Every doc that uses these codes gets a raise.<BR/><BR/>However, the payment model is The Happy Hospitalisthttps://www.blogger.com/profile/14392872203166584371noreply@blogger.com