And look what happens:
Lesson 1, you cannot practice primary care with true integrity in the current atmosphere, you must either turn patients away or schedule so many that your quality of care becomes questionable (even to you). Lesson 2, my integrity is not more important than my family. I am not the only one who struggled I watched my family struggle because I tried to do what is right.
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This is what happens when you think being a “good doctor” translates to mean you can afford to be a poor businessman. This story is an object lesson of that fallacy.
Taking patients on their word that they will pay you later for work done today is in the end a losing proposition, no matter how sentimental you may feel about what seems like a kindness. It is a poor policy.
I feel bad for this young doctor and his story is not uncommon. In the current environment it is highly unlikely you will be able to thrive as a solo primary care doctor. That is just how it is.
Ah, the business of medicine.
After reading the whole posting I recommend another book, same old story,
Hilfikers, Healing the Wounds. Primary Care guy in Minnesota burns out in the 1980’s.
Unfortunately, medicine is now big business and the sooner doctors realize that – the better.
By blaming this on “US healthcare” you are inviting the “US” a/k/a the government to try and fix it. That is not waht you want.
Med school would do well to teach a little business sense.
Kevin, here’s another big multispecialty clinic dropping out of traditional Medicare:
http://seattletimes.nwsource.com/html/localnews/2003961526_medicare19m.html
Everett (WA) Clinic this time. And Washington Medicare pays better than Oregon Medicare, when you covered the Corvallis Clinic a while back.
So far, seems they are just dropping out of traditional Medicare, the managed care product is still accepted. We’ll see how long that lasts.
I think 5 years is about the right length of time it takes to wear away someone’s trust in humanity. It is time to get your hands dirty– stop seeing medicaid patients and go where the money is. No one cares about your integrity. Pay your bills and if you have liberal guilt, volunteer on the weekends you aren’t on call.
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