Medicine today

This sounds just about right. The reader has fee-for-service reimbursement and malpractice to thank:

The operating doctor could not visit me in the hospital or in rehab, which was a lice-infested nursing home. He did nothing.
My internist forgot to make arrangements for my stress test. He also did not visit me in the hospital. Both these doctors sent their associates to see me, and the associates don’t even know me.
I’m grateful I was born in 1929. Doctors were doctors then. Why do all the young people want to be doctors? They can become electricians, handymen, etc., and not worry about being sued. More doctors now post signs that tell you they don’t carry malpractice any longer. What does one devise from all this? You can never speak to a doctor on the phone because he isn’t available.

Like I’ve said many times before, don’t hate the players, hate the game.

Comments

Anonymous
Aren’t you the “players” who keep choosing to play by the fee for service rules? Why isn’t that your fault?
Kevin
It’s not, since there’s only one game in town.
Kevin
Anonymous
If the “players” don’t like the rules of the game, then band together and change the rules.
Anonymous
The reader had Medicare and a secondary insurer for payment. Her payment has a fixed ceiling, fixed that is by the federal government.
“The operating doctor . . . ” might not have had privileges at the hospital she went to or at her nursing home. They might not have even been in the same community for all we know.
I guess we will have to take the writer’s word about the arrangements for her stress test. I also suppose it didn’t occur to her to ask, of if she was under the impression of being scheduled, to call the center to verify. And so the covering associate made the hospital visit, big deal. She whines as if she was abandoned, which does not appear to be the case.
I am sure the doctors who saw her in 1929 were also glad she was born then. They probably were paid in cash as people felt they had a moral obligation to pay their bills, something that many more people these days think is optional. Doctors were doctors then? Hard to know what that means, except perhaps that they were respected and valued more than today, even if they weren’t paid as well or trained as well. There was still time to fill up medical school curricula with Latin in those days.
“What does one devise from all this?” Good question. Maybe the malpractice premiums in her community are prohibitive for doctors in private practice. Are the doctors there worse than elsewhere or are the juries just more generous? Can a doctor in practice seeing patients like this writer afford the costs of practice business when his patients pay as the writer does, with Medicare, under Medicare fee limitations?
Fee for service isn’t the problem.
Price fixing is the problem.
Anonymous
If the “players” don’t like the rules of the game, then band together and change the rules.
The courts have ruled such action to be illegal. All attempts by physicians to organize in an effort to bargain collectively have been deemed illegal by the courts, having labelled such action “price-fixing” or collusion.
The best we can hope for it to convince all doctors to drop everything, hoping that there is not a single hold out, because we have no power in numbers, by virtue of court order.
Know the facts.
Anonymous
“It’s not, since there’s only one game in town.
Kevin”
Nonsense. Stop trying to blame everyone else for the contracts you keep signing.
Anonymous
The leaders of the AMA were labeled a bunch of reactionary curmudgeons for predicting, among other things, that medicare would undermine the ethics and values of doctors themselves and erode their sense of responsibity. Most people thought they were silly.
Now those same people complain about how doctors values and sense of repsonsibility have eroded. Their professional autonomy has likewise been all but destroyed. No meaningful self-regulation is possible. Renegades can now only be dealt with by the coarse and cowardly hand of government bureaucrats. As noted by Frederick Hayek 70 years ago, government regulation of markets actually eventually works to undermine personal morality. Caveat emptor.
Anonymous
re: “Nonsense. Stop trying to blame everyone else for the contracts you keep signing”
Do you realize how uneducated you sound about the system as it now stands when you make blanket statments like that? With the exception of niche specialties (derm, plastic surgery, conceierge medicine), opting out of the present system as it now stands is not an option. The vast majority of Americans are either medicaid, medicare or private insurance. Know what your talking about before you pontificate CJD.
Anonymous
And yet physicians all over the country are opting out of it.
What you mean to say is that opting out is not an option for those unwilling to risk their current standard of living. Endlessly bitching is their only option.
Anonymous
“And yet physicians all over the country are opting out of it.”
No CJD doctor’s all over the country AREN’T opting out of medicare, medicaid, and private insurance. Some opt out of medicaid, fewer still opt out of medicaid, and fewer still opt out of all three (the elective procedure derm/plastics and the conc docs). Of course you don’t know what you are talking about so please feel free to ad more clueless quotes.
“What you mean to say is that opting out is not an option for those unwilling to risk their current standard of living”
You are good at trying to put words in peoples mouthes aren’t you CJD. Do you understand that over 1/2 of all health care dollars are provided by the feds? Do you understand that unless you are in a niche specialty, saying no to the big three means you don’t have patients. Do you know that private insurance rates directly key off medicare rates? Do you know how much of a total baffoon you come across with your clueless cutsy one liners? I doubt it, that requires a greater amount of introspection than you seem to have a capacity for.

Medicine today

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