Steve, I'm sorry to say that in many ways, physicians have brought this on themselves. Not that there aren't external factors, but all too often physicians have put themselves in a position diametrically opposed to the (financial) interests of their patients. When you can no longer act 100% as a patient advocate, you've lost your standing. The fact that it has been abetted by poor government regulation, i.e. the in-house ancillary exception, is of little solace. The AMA in particular has been awful on this...
Small Business: Doctors going broke
- Thread starter Steve williams
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Steve, I'm sorry to say that in many ways, physicians have brought this on themselves. Not that there aren't external factors, but all too often physicians have put themselves in a position diametrically opposed to the (financial) interests of their patients. When you can no longer act 100% as a patient advocate, you've lost your standing. The fact that it has been abetted by poor government regulation, i.e. the in-house ancillary exception, is of little solace. The AMA in particular has been awful on this...
Mark
I agree with you somewhat but for you to categorically state that doctors brought this on themselves suggests you mean this collectively and if so I strongly disagree.
Mark as a radiologist I submit to you that your clinical work is vastly different from that of those oncologists or cardiologists. IMO they are indeed patient advocates. I have yet to see a radiologist who is a patient advocate. How many hours do you spend on the phone talking to insurance companies to get a patient covered. By the time a patient reaches you, they are in your system and pretty much all of them have insurance approval---all done by the referring doctors
I agree with you somewhat but for you to categorically state that doctors brought this on themselves suggests you mean this collectively and if so I strongly disagree.
Mark as a radiologist I submit to you that your clinical work is vastly different from that of those oncologists or cardiologists. IMO they are indeed patient advocates. I have yet to see a radiologist who is a patient advocate. How many hours do you spend on the phone talking to insurance companies to get a patient covered. By the time a patient reaches you, they are in your system and pretty much all of them have insurance approval---all done by the referring doctors
Steve, my statement was not intended as blanket condemnation of all physicians, rather it was to point out that those physicians who act in this manner bring down the whole profession. My bad for not being clear.
Actually, in our practice, we did all of the scheduling and insurance approvals for our referring physicians. We purchased a phone system with embedded hardware that our schedulers logged into and we tracked parameters including: time to answer, time spent scheduling, number of patients scheduled, etc. For high volume referrers, we rented space in their offices (to be compliant with government regulations) where our schedulers took care of scheduling their patients. Referring physicians loved that we only needed 4 pieces of patient information from them. We would contact the patient and take care of the rest. It saved their offices the burden of extra staff to deal with all of the paper work. If a patient failed to show after three scheduled appointments, we sent a letter to the patient and referring physician to let them know. (As you know there are few things worse for a referring physician than thinking your patient had a test when they really did not).
We had a dedicated scheduler and dedicated staff for obtaining insurance approval for PET scans (Positron Emission Tomography) and later MRI and CT pre-approvals. As the Clinical Director of PET, I can't tell you how many hours I spent with staff getting approvals and talking to insurance companies. I can honestly say that no patient was refused for inability to pay. Two of our physicians participated in weekly operations meetings with our practice manager/CEO in no small measure to deal with these type of operational issues.
Our group co-purchased the PACS system (the system that stores and distributes the images) with our hospital. We (not the hospital) provided the IT support staff that helped referring physicians offices install hardware and software to view images and reports performed in our offices and the hospital.
The costs of these services was absorbed by my practice. I'm not implying it was altruistic...it was good for business, but it was also good patient/customer care.
Congrats Mark
I applaud you then cuz you are more the exception than the rule.
Mark I did so much time in the trenches for my patients that it took hours out of every day either on the phone, on the computer etc etc that I fortunately retired.
Medicine is vastly different now than when I trained not so much in the learning but rather in the sophisticated management of a practice and yes this is where greedy doctors can give the whole profession a bad name....how do you say Dr Conrad Murray
I applaud you then cuz you are more the exception than the rule.
Mark I did so much time in the trenches for my patients that it took hours out of every day either on the phone, on the computer etc etc that I fortunately retired.
Medicine is vastly different now than when I trained not so much in the learning but rather in the sophisticated management of a practice and yes this is where greedy doctors can give the whole profession a bad name....how do you say Dr Conrad Murray
Just caught up on this interesting topic gentlemen.
As to your question jazdoc---my liberty is already impeded by folks without healthcare using the ER and thereby driving up my premiums.
The problem from my point of view (I am a healthcare provider analyst---NFP hospitals/systems) is that we are in a vicious loop where costs are increasing (supplies, drugs, services, it really doesn't matter), so hospitals need more managed care contract increases, which ultimately is passed along to the consumer.
There is no "free market" that conservatives believe exists in healthcare (I don't go shop for a triple bypass---i just go to the hospital and get it done). At the same time, we can't be all to everyone---care will be rationed and more liberal minded folks need to accept that.
On the doctor bit, just remember that over in socialized Europe the docs make on average something closer to 100,000.
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