Comments on: Primary care incomes and universal health coverage http://www.kevinmd.com/blog/2007/07/primary-care-incomes-and-universal.html Tue, 14 Feb 2012 19:56:00 +0000 hourly 1 By: Anonymoushttp://www.kevinmd.com/blog/2007/07/primary-care-incomes-and-universal.html#comment-110875 Anonymous Mon, 31 Aug 2009 21:34:23 +0000 http://clients.emmense.com/kevinmd/2007/07/primary-care-incomes-and-universal-health-coverage.html#comment-110875 Really, let's face it. 1) Fix the tort lottery. 2) Pay an Orthopaedic specialist (one of those surgeons Obama thinks makes 30K for an amputation - WTF) less than what they make now and if you get injured (broken bone, not litigation based injury) in the middle of the night, on a weekend, or during his/her vacation, you are just gonna have to suck it up and wait. Iwouldn't go in during the middle of the night or deal with all those drunk idiots at 2:00 AM for less money. Orthopaedics is primary care and specialty care all rolled into one. If you disagree, then how come FP's do a fellowship in Sports Medicine to learn to diagnose sports injuries that most second year Orthopaedic students can do in their sleep. Most older FP's and internists had a good grasp of anatomy, could do a musculoskeletal exam and could treat basic injuries including fractures. Now, they are just as dependent on technology as your average radiologist and refer sprains for fear of litigation. And, BTW, make radiologists technicians (not doctors), or at least the ones that never treat a patient, and bill for work they do at home - they aren't doctors anymore anymore than an ECHO tech is for the cardiologist. That would save a ton of money. Oh yeah, BTW, when you give universal coverage, get rid of all the "not-for-profit" hospital tax exemptions and collect over three times your current revenue in taxes from those self-serving hospitals given a tax break to provide indigent care (NOT). Solving this is easy, if you know where to look and have a set of large cojones. If you don't, just sit down and watch from the sidelines like the rest of the spectators. Really, let’s face it. 1) Fix the tort lottery. 2) Pay an Orthopaedic specialist (one of those surgeons Obama thinks makes 30K for an amputation – WTF) less than what they make now and if you get injured (broken bone, not litigation based injury) in the middle of the night, on a weekend, or during his/her vacation, you are just gonna have to suck it up and wait. Iwouldn’t go in during the middle of the night or deal with all those drunk idiots at 2:00 AM for less money. Orthopaedics is primary care and specialty care all rolled into one. If you disagree, then how come FP’s do a fellowship in Sports Medicine to learn to diagnose sports injuries that most second year Orthopaedic students can do in their sleep. Most older FP’s and internists had a good grasp of anatomy, could do a musculoskeletal exam and could treat basic injuries including fractures. Now, they are just as dependent on technology as your average radiologist and refer sprains for fear of litigation. And, BTW, make radiologists technicians (not doctors), or at least the ones that never treat a patient, and bill for work they do at home – they aren’t doctors anymore anymore than an ECHO tech is for the cardiologist. That would save a ton of money. Oh yeah, BTW, when you give universal coverage, get rid of all the “not-for-profit” hospital tax exemptions and collect over three times your current revenue in taxes from those self-serving hospitals given a tax break to provide indigent care (NOT). Solving this is easy, if you know where to look and have a set of large cojones. If you don’t, just sit down and watch from the sidelines like the rest of the spectators.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2007/07/primary-care-incomes-and-universal.html#comment-78241 Anonymous Thu, 26 Jul 2007 23:37:00 +0000 http://clients.emmense.com/kevinmd/2007/07/primary-care-incomes-and-universal-health-coverage.html#comment-78241 "When will the national organizations that claim to represent internists do the right thing and condemn outright any entity that ties compensation to business performance ahead of good practice?"<br/><br/>And the AMA wonders why membership continues to fall. Heaven forbid that they pursue the good of the physicians, that is, those who are the face of American medicine. Primary care is underpaid and overworked; it will remain so until a physician'sorganization can force change. Good luck.<br/><br/>The AMA does not represent the best interests of physicians, and has not for some time. “When will the national organizations that claim to represent internists do the right thing and condemn outright any entity that ties compensation to business performance ahead of good practice?”

And the AMA wonders why membership continues to fall. Heaven forbid that they pursue the good of the physicians, that is, those who are the face of American medicine. Primary care is underpaid and overworked; it will remain so until a physician’sorganization can force change. Good luck.

The AMA does not represent the best interests of physicians, and has not for some time.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2007/07/primary-care-incomes-and-universal.html#comment-78219 Anonymous Thu, 26 Jul 2007 19:13:00 +0000 http://clients.emmense.com/kevinmd/2007/07/primary-care-incomes-and-universal-health-coverage.html#comment-78219 If primary care medicine wants to save itself and to lead the way to halting one of the most pernicious trends in health care, it must disassociate itself from third-party payment as much as possible. Away from Medicare, Medicaid and HMOs, away from insurance companies and their arbitrary and self-serving requirements, away from the immoral tasking of doctors as gatekeepers and as professionals who can be compromised by withholding earned compensation or by being given downrated copayment status for failing to meet the business objectives of an insurance company.<br/><br/>When will the national organizations that claim to represent internists do the right thing and condemn outright any entity that ties compensation to business performance ahead of good practice? When will those same organizations go public and name the names of those companies and government agencies that no consciencious and ethical doctor should have anything to do with? Where is the sense of responsibility and leadership that these professional organizations need to show? If primary care medicine wants to save itself and to lead the way to halting one of the most pernicious trends in health care, it must disassociate itself from third-party payment as much as possible. Away from Medicare, Medicaid and HMOs, away from insurance companies and their arbitrary and self-serving requirements, away from the immoral tasking of doctors as gatekeepers and as professionals who can be compromised by withholding earned compensation or by being given downrated copayment status for failing to meet the business objectives of an insurance company.

When will the national organizations that claim to represent internists do the right thing and condemn outright any entity that ties compensation to business performance ahead of good practice? When will those same organizations go public and name the names of those companies and government agencies that no consciencious and ethical doctor should have anything to do with? Where is the sense of responsibility and leadership that these professional organizations need to show?

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