Comments on: Op-ed: Cut Medicare payments for doctors, you’ll have fewer doctors

By: Anonymous

Anonymous — Fri, 22 Aug 2008 06:23:00 +0000

I am a third-year resident in a primary-care specialty and am happy to tell y’all that every single resident I know is thinking of cash-based practice. We all hate medicare/medicaid and the other insurances aren’t much better. Sure, we will such it up for a couple of years hamstering for some multi-specialty group, but the majority of us will abandon these slavedrivers in a heartbeat when we get a better opportunity. One of my best friends in the residency program is going to start working for a gym (!!) when he graduates. Lawyers and politicians have destroyed primary care in America and they will get what they deserve and I’m not shedding a single tear over it.
AyurMD

By: Anonymous

Anonymous — Wed, 04 Jun 2008 14:44:00 +0000

I am sorry to see all the anger in these blogs. As an RN (working on my master’s degree for FNP) who is married to a physician, I try to see all sides of the coin. First, We do not live in a mansion, my children do not wear designer clothes and we (like everyone else) live with a mortgage and budget. We own our own practice, situated in a small town. It is extremely challenging to run any small business. Medical practices are harder than most other businesses because we cannot control costs (usually dictated by inflation), nor can we control what we charge. When Medicare cuts reimbursement, the private insurance companies do the same, United Health Care usually leads the way. So to say, “Stop taking Medicare” really doesn’t help the financial aspect. Physician’s (and other providers) would have to stop taking all insurance. Some practices are doing just that. But that is not the reason any of us went into medicine or nursing. We wanted to help mankind. And most of us still do. The problem is how to do it without going bankrupt. My husband and I work 24/7 to keep our practice running. I answer the phones on the off hours and triage each patient. Our teenage children earn their spending money by cleaning, painting and keeping up the office. And my husband starts his day at 6:30 am. Makes rounds at two hospitals, gets to the office at 9:00 and sees patients until they are gone, usually around 6:00 pm. Then he spends two more hours returning patient calls and doing paperwork. Although the office hours are 9-5 with an hour for lunch, he doesn’t finish until 8 or 9 pm, frequently doesn’t get a lunch because he is finishing seeing the morning patients and is forced to take hospital ER call (which he is rarely paid for). Last year his salary was a whopping $100,000.00, but the practice lost $20,000.00, so in reality, he made $80,000.00. Why does he do it? Because he Cares! That seems to be forgotten in all this fighting. Lets try to work together to develop ways to enable our profession to care for all our patients. Right now, HR 6129 needs support. It will not increase Medicare payments, but it will stop the immediate cuts. Please contact your legislators to support this bill. Working together, we can make health care accessible and affordable. CaringRN

By: Troy

Troy — Tue, 05 Feb 2008 06:14:00 +0000

Health care is probably the most elastic service on the market; in terms of, if the situation is right, people will give every dime they have for the surgery that will save their leg. This price floor that the government is instating is almost ridiculous to me. For a well educated specialized doctor, it is 13 years of post high-school training, as I’m sure most of you know, not to mention the loans and time spent getting to where they want to be. All of those costs should be reimbursed by a good salary, look at lawyers! Sure you can go grab a free public defendant, but your not going to win the case, but you now can go to the best doctor in America and whip out a card that will save you a few grand?

By: Anonymous

Anonymous — Mon, 07 Jan 2008 05:26:00 +0000

It is amazing how the public will pay high ticket prices to see their favorite professional athletes, who make millions hitting a white ball or put an air filled piece of leather through a hoop, yet scream bloody murder when they get a medical bill. What's more important, entertainment or your life?

Look at the problems with trauma, which happens to be the leading cause of death for those 20 - 45. Nobody wants to pay for a trauma system or subsidize physicians who take care of these patients, who are disproportionately uninsured. So right now, unless you are in an urban setting, you will have a long wait and transfer time to a place where a surgeon is willing to take care of you after you smash yourself into a telephone pole. People are dying in the process. If you don't think this is happening, then get your head out of your ass.

Complain all you want about how much doctors make. They earn every cent. Stop paying, then you will see doctors no longer willing to get out of bed at 2 am to see you in the ER. This is already happening.

What is worth more to you, your big screen TV or someone who can stop your internal bleeding at 4 am?

By: Anonymous

Anonymous — Fri, 24 Aug 2007 04:58:00 +0000

Bill like a dentist.
Amazing that the dentist accepts "insurance" covering less than half of my dental cleaning and I pay the rest ($75 + $75).
My patients whine about the copays and the expense of their urology visit.
1. Medicare WILL be bancrupt by 2017 as the baby-boomers reach the age of 65 (50% are 60)
2. Fee-For-Service will become more popular. Either see the FMG (foriegn med grad) in a VA (Veterans Assoc) style system...and take a number and wait or pay the difference in what your insurer provides to get good care.
3. Deregulate Medicine. Let the docs be the McDonald's. Cut my salary but allow me to own the lab/ct scanner / hospital / surgical center and accept all because of my better product for less.
STARCK and anti-trust b.s. is rediculous! DE REGULATE the industry. Let private enterprise SHINE!

By: Anonymous

Anonymous — Tue, 14 Aug 2007 00:32:00 +0000

Anon:
You will be waiting a long time for evidence from his ilk. He is the smoke and mirrors type not evidence-based.

By: Anonymous

Anonymous — Mon, 13 Aug 2007 08:33:00 +0000

Well CJD
Your silence speaks volumes. Get back to me when you have some evidence to support your statements

By: Anonymous

Anonymous — Sat, 11 Aug 2007 19:10:00 +0000

CJD:
I am still waiting for the data that you specifically CAN’T SHOW. Leave out your worthless statements and put your money where your mouth is. Unlike you, I’ve worked in this business. I know the people who are and are not taking insurance/medicare/medicaid. I know how the only ones who cannot fall into the niche specialties and how the rest of us are stuck because pt’s are monopolized by the big three. Either show me some data to support your statement or keep your clueless statements to yourself. As I stated, I have worked in a free market system (outside of medicine) and in this system. I know the difference. Do you?

By: Anonymous

Anonymous — Sat, 11 Aug 2007 12:48:00 +0000

“I take responsibility for every patient I see, ALL THE TIME.”

That’s great, but all professionals take responsibility for their patients/clients. I’m talking about taking responsibility for the financial choices you’ve made. Something you seem unwilling to do.

At the end of the day, you continue to expect different results from doing the same thing. Why, I don’t know. But if that’s how your mind works, you definitely don’t need to be in the truly free market.

By: Anonymous

Anonymous — Fri, 10 Aug 2007 15:07:00 +0000

"You don't have to sign the contract. Physicians existed before Medicare/Medicaid and even today they exist without utilizing those contracts. They even *gasp* find time to blog about it."

You just don't get it CJD. Tell you what. Why don't you look up and find the statisitic's about all those docs who make it without medicare/medicaid/private insurance. Put your money where your mouth is. I have been in this field for for well over a decade (after training) and have yet to see such a doc (outside of concierge/elective procedure types). Do show me all those docs out there is the hardcore fields of medicine and surgery making it on cash patient's. Good luck. The simple fact is the big three have a monopoly on patient's. Get back to me when you find the stats.

"Sack up and be a man and take responsibility for something once in awhile."

I take responsibility for every patient I see, ALL THE TIME. That is real responsibility, not throwing out childish, uninformed, anonymous, insults on the internet.