Comments on: Are hospitals purposely causing a PCP shortage? http://www.kevinmd.com/blog/2007/04/are-hospitals-purposely-causing-pcp.html Tue, 14 Feb 2012 22:28:00 +0000 hourly 1 By: Anonymoushttp://www.kevinmd.com/blog/2007/04/are-hospitals-purposely-causing-pcp.html#comment-73617 Anonymous Wed, 04 Apr 2007 06:36:00 +0000 http://clients.emmense.com/kevinmd/2007/04/are-hospitals-purposely-causing-a-pcp-shortage.html#comment-73617 I feel like anybody who understands the slightest amount about reimbursement for ED care saw this as an April Fool's joke. Move along, nothing to see here. I feel like anybody who understands the slightest amount about reimbursement for ED care saw this as an April Fool’s joke. Move along, nothing to see here.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2007/04/are-hospitals-purposely-causing-pcp.html#comment-73615 Anonymous Wed, 04 Apr 2007 02:54:00 +0000 http://clients.emmense.com/kevinmd/2007/04/are-hospitals-purposely-causing-a-pcp-shortage.html#comment-73615 That is an interesting idea, that there is a conspiracy of hospital administrators trying to promote a scarcity of primary care doctors. <br/><br/>Two thoughts:<br/><br/>One--in my opinion hospital administrators are just that evil. <br/><br/>Two--while being that evil, there are just not that smart. It also takes long term planning. Long term planning in any mid-size hospital refers to months, not years. <br/><br/>The only thing more chaotic and random than an ER on friday night is the hospital boardroom on monday morning. <br/>b That is an interesting idea, that there is a conspiracy of hospital administrators trying to promote a scarcity of primary care doctors.

Two thoughts:

One–in my opinion hospital administrators are just that evil.

Two–while being that evil, there are just not that smart. It also takes long term planning. Long term planning in any mid-size hospital refers to months, not years.

The only thing more chaotic and random than an ER on friday night is the hospital boardroom on monday morning.
b

]]> By: Catronhttp://www.kevinmd.com/blog/2007/04/are-hospitals-purposely-causing-pcp.html#comment-73597 Catron Tue, 03 Apr 2007 17:42:00 +0000 http://clients.emmense.com/kevinmd/2007/04/are-hospitals-purposely-causing-a-pcp-shortage.html#comment-73597 Believe it or not, hospital administrators (including heartless finance types like me) are less concerned with an ER patient's insurance than in her condition. The real "crisis" in the ER is over-utilization. The clinicians must spend far too much of their time dealing with runny noses and other non-emergent problems, which leaves fewer resources to devote to ACTUAL emergencies. Believe it or not, hospital administrators (including heartless finance types like me) are less concerned with an ER patient’s insurance than in her condition. The real “crisis” in the ER is over-utilization. The clinicians must spend far too much of their time dealing with runny noses and other non-emergent problems, which leaves fewer resources to devote to ACTUAL emergencies.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2007/04/are-hospitals-purposely-causing-pcp.html#comment-73583 Anonymous Tue, 03 Apr 2007 09:44:00 +0000 http://clients.emmense.com/kevinmd/2007/04/are-hospitals-purposely-causing-a-pcp-shortage.html#comment-73583 I agree with anonymous 1:53. Hospital administrators of community hospitals feel you are clogging up the ER only if you are uninsured. The well-insured are welcomed with open arms, no matter how minor the complaint. I agree with anonymous 1:53. Hospital administrators of community hospitals feel you are clogging up the ER only if you are uninsured. The well-insured are welcomed with open arms, no matter how minor the complaint.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2007/04/are-hospitals-purposely-causing-pcp.html#comment-73582 Anonymous Tue, 03 Apr 2007 06:53:00 +0000 http://clients.emmense.com/kevinmd/2007/04/are-hospitals-purposely-causing-a-pcp-shortage.html#comment-73582 Some ERs absolutely Do steer patients towards its ER. Where I live they advertise on local TV stations. Promise to be seen within 20-30 minutes. Fast track this or that. Everyone knows that fast track is not intended for REAL emergencies, so just who do you think they are marketing towards?<br/><br/> Some of you just seem to live in a vacumn, where you have NO comprehenison of what is going on outside of your own little space. Some ERs absolutely Do steer patients towards its ER. Where I live they advertise on local TV stations. Promise to be seen within 20-30 minutes. Fast track this or that. Everyone knows that fast track is not intended for REAL emergencies, so just who do you think they are marketing towards?

Some of you just seem to live in a vacumn, where you have NO comprehenison of what is going on outside of your own little space.

]]> By: Catronhttp://www.kevinmd.com/blog/2007/04/are-hospitals-purposely-causing-pcp.html#comment-73577 Catron Tue, 03 Apr 2007 01:59:00 +0000 http://clients.emmense.com/kevinmd/2007/04/are-hospitals-purposely-causing-a-pcp-shortage.html#comment-73577 This is a definite LOL post. The idea that any hospital would implement a strategy that steers patients TO its ER is utterly preposterous. Are you sure this isn't a gag from the Onion? This is a definite LOL post. The idea that any hospital would implement a strategy that steers patients TO its ER is utterly preposterous. Are you sure this isn’t a gag from the Onion?

]]> By: Anonymoushttp://www.kevinmd.com/blog/2007/04/are-hospitals-purposely-causing-pcp.html#comment-73569 Anonymous Mon, 02 Apr 2007 23:51:00 +0000 http://clients.emmense.com/kevinmd/2007/04/are-hospitals-purposely-causing-a-pcp-shortage.html#comment-73569 Last time I checked ERs are big money losers for hospitals. His article is misinformed. Last time I checked ERs are big money losers for hospitals. His article is misinformed.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2007/04/are-hospitals-purposely-causing-pcp.html#comment-73563 Anonymous Mon, 02 Apr 2007 22:25:00 +0000 http://clients.emmense.com/kevinmd/2007/04/are-hospitals-purposely-causing-a-pcp-shortage.html#comment-73563 I'm not sure how clogging up the ED generates more revenues for the hospitals as an overwhelming proportion of EDs in the US lose money due to piss poor reimbursement rates providing indigent care. I’m not sure how clogging up the ED generates more revenues for the hospitals as an overwhelming proportion of EDs in the US lose money due to piss poor reimbursement rates providing indigent care.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2007/04/are-hospitals-purposely-causing-pcp.html#comment-73562 Anonymous Mon, 02 Apr 2007 22:19:00 +0000 http://clients.emmense.com/kevinmd/2007/04/are-hospitals-purposely-causing-a-pcp-shortage.html#comment-73562 I doubt there is any such plan in action.<br/><br/>Starting a practice is an expensive and unfortunately less certain enterprise now than in the past. It isn't enough to be trained and ready to work with a community needing doctors to assure a successful practice launch. In order to be able to attract patients, one has to have access to some insurance panels, which, depending on the area, can take a long time to establish. Patients could have limbs falling off and still not be willing to see a doctor out of their network. Without an income stream, the practice cannot build a cash flow and relieve its startup costs, which can require a substantial loan. Bringing in enough to cover operations and pay the doctor a living--no small consideration especially if there is educational debt to pay--is a non-negotiable requirement. And many recently, and some not-so-recently graduated doctors cannot afford a long period without net earnings to live on. Any hint of abnormal startup risk, whether it is difficulty getting on local insurance panels, undesirable payer mix, high real estate and/or other operating costs, unattractive lending terms or getting hospital privileges or any other barrier to earning can make the risk seem not worthwhile to the prospective small business owner/doctor. Just having a community screaming for dotors isn't enough. Screaming doesn't pay the bills. I doubt there is any such plan in action.

Starting a practice is an expensive and unfortunately less certain enterprise now than in the past. It isn’t enough to be trained and ready to work with a community needing doctors to assure a successful practice launch. In order to be able to attract patients, one has to have access to some insurance panels, which, depending on the area, can take a long time to establish. Patients could have limbs falling off and still not be willing to see a doctor out of their network. Without an income stream, the practice cannot build a cash flow and relieve its startup costs, which can require a substantial loan. Bringing in enough to cover operations and pay the doctor a living–no small consideration especially if there is educational debt to pay–is a non-negotiable requirement. And many recently, and some not-so-recently graduated doctors cannot afford a long period without net earnings to live on. Any hint of abnormal startup risk, whether it is difficulty getting on local insurance panels, undesirable payer mix, high real estate and/or other operating costs, unattractive lending terms or getting hospital privileges or any other barrier to earning can make the risk seem not worthwhile to the prospective small business owner/doctor. Just having a community screaming for dotors isn’t enough. Screaming doesn’t pay the bills.

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