Dr. Rob on the recent ACP cries for help:
This begs the question: so what? What is the big deal? We can just use subspecialists and physician extenders to fill the slots. Patients can become more empowered to provide their own care using e-visits and web-guided care. This sounds sacrilegious coming from a primary care physician, but it is what is being said on the outside by some. Although the feelings may not be so overt by the politicians in Washington, it seems that inaction in the face of a crisis is tantamount to denial of the reality of that crisis.What is being done? Medicare is giving a 1.5% bonus to physicians for quality measures. This will amount to a few hundred extra dollars for the average physician (with an enormous amount of work to set up a system that will properly submit the right codes in the proper format). That is not help; it is an insult.
Related posts:
- Once you hit Medicare age, good luck finding a primary care doctor
- Primary care is damn cheap, and can solve our health care woes
- Op-ed: Shortage of primary care threatens health care system
- Someone who cares about Medicare Advantage
- A bleak primary care future
- How the primary care shortage affects rural Idaho
- Today’s "death of primary care" article
KevinMD.com on Facebook
{ 6 comments }
A 1.5% bonus for reporting quality data. hmmm, let’s see:
if you were, let’s say, a hospital employee e.g. nurse, and were only given a cost-of-living increase of 1.5% annually, i think that’d piss you off – and that’s for doing NOTHING extra.
now doctors are being asked to do extra work for almost nothing, and we should be grateful that congress has prevented a medicare reimbursement CUT. Our professional societies are useless – the ACP, as well as the AMA, AAFP, and AAP have all lost credibility dramatically with their constituents by pandering to everyone BUT doctors. State medical societies are only slightly better.
I think as a PCP I’d only act if the incentive was like 10% (about $12k/year for a typical internist’s salary) and was on top of costs associated with new equipment/staff/etc. to put in place such a system. I imagine for seeing about 100 patients/week it’d be about 4-6 hours/week extra work, so that comes out to like $6/hr. I’d just as soon get a second job as a cab driver for 5 times that.
I’m not doing this stupid pet trick, which would require adding a full time employee to implement, for 1.5% or any other amount. I will simply limit access, refer out the most complicated cases, and retire within 5 years as planned if the situation does not improve significantly. What is that old adage…”you get what you pay for”..
I don’t these problems are unique to primary care. There is a general problem with any part of medical care that has to do with listening-thinking-explaining, ie, non-procedure medicine.
The way we’re going, people will evaluate themselves, then simply find some place to give them the pills or procedure they want. On the plus side, they’ll have to sue themselves for malpractice.
Because we all know that “listening-thinking- explaining” is unique to non-procedural medicine.
e-medicine? people better be careful before they fall for that. You ever go to some of these physician moderated Q/A boards online? Some of their answers are hideous and they have the nerve to charge for such answers. You can get identical or better advise just from visiting “Up to date”. A standard answer on these boards are “Your stomache pains may be symptoms of Gallbladder issues Please ask your Doc for a U/S and a hida scan.” Like this is something our Doc’s couldn’t have thought up on their own. These online boards are just a way to swindle money. No thanks, I will keep my real life doc….AND, not piss him off, by telling him some BOZO on the internet said to do this……
“Money is the barometer of a society’s virtue. When you see that trading is done, not by consent, but by compulsion — when you see that in order to produce, you need to obtain permission from men who produce nothing — when you see that money is flowing to those who deal, not in goods, but in favors — when you see that men get richer by graft and by pull than by work, and your laws don’t protect you against them, but protect them against you — when you see corruption being rewarded and honesty becoming a self-sacrifice — you may know that your society is doomed.” – Ayn Rand, Atlas Shrugged
Does any of this sound familiar?
Comments on this entry are closed.