Comments on: Death of primary care: Who cares? http://www.kevinmd.com/blog/2007/04/death-of-primary-care-who-cares.html Tue, 14 Feb 2012 21:39:00 +0000 hourly 1 By: Anonymoushttp://www.kevinmd.com/blog/2007/04/death-of-primary-care-who-cares.html#comment-74258 Anonymous Wed, 25 Apr 2007 13:32:00 +0000 http://clients.emmense.com/kevinmd/2007/04/death-of-primary-care-who-cares.html#comment-74258 "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<br/><br/>Does any of this sound familiar? “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?

]]> By: Anonymoushttp://www.kevinmd.com/blog/2007/04/death-of-primary-care-who-cares.html#comment-74244 Anonymous Tue, 24 Apr 2007 23:17:00 +0000 http://clients.emmense.com/kevinmd/2007/04/death-of-primary-care-who-cares.html#comment-74244 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...... 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……

]]> By: Anonymoushttp://www.kevinmd.com/blog/2007/04/death-of-primary-care-who-cares.html#comment-74237 Anonymous Tue, 24 Apr 2007 15:11:00 +0000 http://clients.emmense.com/kevinmd/2007/04/death-of-primary-care-who-cares.html#comment-74237 Because we all know that "listening-thinking- explaining" is unique to non-procedural medicine. Because we all know that “listening-thinking- explaining” is unique to non-procedural medicine.

]]> By: Greg Phttp://www.kevinmd.com/blog/2007/04/death-of-primary-care-who-cares.html#comment-74228 Greg P Tue, 24 Apr 2007 13:17:00 +0000 http://clients.emmense.com/kevinmd/2007/04/death-of-primary-care-who-cares.html#comment-74228 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.<br/><br/>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. 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.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2007/04/death-of-primary-care-who-cares.html#comment-74220 Anonymous Tue, 24 Apr 2007 03:23:00 +0000 http://clients.emmense.com/kevinmd/2007/04/death-of-primary-care-who-cares.html#comment-74220 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’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”..

]]> By: Happymanhttp://www.kevinmd.com/blog/2007/04/death-of-primary-care-who-cares.html#comment-74213 Happyman Tue, 24 Apr 2007 00:45:00 +0000 http://clients.emmense.com/kevinmd/2007/04/death-of-primary-care-who-cares.html#comment-74213 A 1.5% bonus for reporting quality data. hmmm, let's see:<br/><br/>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.<br/><br/>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. <br/><br/>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. 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.

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