Comments on: My take: Telephone care, dumb mandates http://www.kevinmd.com/blog/2008/02/my-take_08.html medical blog Sun, 22 Nov 2009 07:50:13 -0500 http://wordpress.org/?v=2.8.4 hourly 1 By: jb http://www.kevinmd.com/blog/2008/02/my-take_08.html/comment-page-1#comment-83481 jb Sun, 10 Feb 2008 15:27:00 +0000 http://clients.emmense.com/kevinmd/2008/02/my-take-telephone-care-dumb-mandates.html#comment-83481 I'll accept strict liability if it's limited to paying for whatever is required to fix/ameliorate the results of the bad care outcome. Pay for the extended hospitalization, additional surgery, loss of wages, physical therapy. No payment for pain and suffering, loss of consortium, loss of chance for cure. Some payments would go up, of course, but just about all payments would go to the patient. No need for lawyers, except to help fill out the paper work in questionable cases. Can CJD accept that? I’ll accept strict liability if it’s limited to paying for whatever is required to fix/ameliorate the results of the bad care outcome. Pay for the extended hospitalization, additional surgery, loss of wages, physical therapy. No payment for pain and suffering, loss of consortium, loss of chance for cure. Some payments would go up, of course, but just about all payments would go to the patient. No need for lawyers, except to help fill out the paper work in questionable cases. Can CJD accept that?

]]> By: Anonymous http://www.kevinmd.com/blog/2008/02/my-take_08.html/comment-page-1#comment-83471 Anonymous Sun, 10 Feb 2008 00:35:00 +0000 http://clients.emmense.com/kevinmd/2008/02/my-take-telephone-care-dumb-mandates.html#comment-83471 jb is exactly right, except instead of liability for gross negligence only, just make it strict liability, likes workers comp.<br/><br/>This issue cannot be addressed until a baseline of care is established for what the government is paying for.<br/><br/>CJD jb is exactly right, except instead of liability for gross negligence only, just make it strict liability, likes workers comp.

This issue cannot be addressed until a baseline of care is established for what the government is paying for.

CJD

]]> By: jb http://www.kevinmd.com/blog/2008/02/my-take_08.html/comment-page-1#comment-83470 jb Sun, 10 Feb 2008 00:12:00 +0000 http://clients.emmense.com/kevinmd/2008/02/my-take-telephone-care-dumb-mandates.html#comment-83470 <i> Hyundais are good cars too, and sometimes that's all you really need.</i><br/><br/>Important correction: It's rare that anyone ever <b>needs</b> anything other than a Hyundai to get from one place to another. It's just that folks understandably <b>want</b> the Mercedes ride. This is especially true when someone else is paying for the Mercedes.<br/><br/>The cure for our health care problems: Create a Hyundai quality tax supported health care system. Basic transportation, no requirements for excessive documentation, possibly generic meds only, liability for gross negligence only, no payment for bad outcome. It will get you to your destination just as fast as the Mercedes. I suspect that overall outcomes would be no worse than the current system, although there would be well publicized occasional spectacular failures.<br/><br/>People who want the Mercedes would be welcome to go to the Mercedes dealership and pay cash. Hyundais are good cars too, and sometimes that’s all you really need.

Important correction: It’s rare that anyone ever needs anything other than a Hyundai to get from one place to another. It’s just that folks understandably want the Mercedes ride. This is especially true when someone else is paying for the Mercedes.

The cure for our health care problems: Create a Hyundai quality tax supported health care system. Basic transportation, no requirements for excessive documentation, possibly generic meds only, liability for gross negligence only, no payment for bad outcome. It will get you to your destination just as fast as the Mercedes. I suspect that overall outcomes would be no worse than the current system, although there would be well publicized occasional spectacular failures.

People who want the Mercedes would be welcome to go to the Mercedes dealership and pay cash.

]]> By: ERP http://www.kevinmd.com/blog/2008/02/my-take_08.html/comment-page-1#comment-83467 ERP Sat, 09 Feb 2008 17:55:00 +0000 http://clients.emmense.com/kevinmd/2008/02/my-take-telephone-care-dumb-mandates.html#comment-83467 The "Go to the ER" debate in interesting. I know when certain PCP's send their patients to the ER (usually at night or weekends), it is often a dump. The patient is very annoying and I know the doc just wants to get rid of them. Others are the complete opposite - they always try to handle nonemergent conditions on the phone before sending them in - and when they do, the findings or history completely back up the decision to send them in. Just like some PCP's are almost helpless without the teaching service and call a million consults. Others can handle most things themselves and only call consults when there is a good reason. It clearly is a quality issue. There are good and there are bad PCPs. Just like there are good and bad ERP's (I know because one of my colleagues is pretty bad!). The “Go to the ER” debate in interesting. I know when certain PCP’s send their patients to the ER (usually at night or weekends), it is often a dump. The patient is very annoying and I know the doc just wants to get rid of them. Others are the complete opposite – they always try to handle nonemergent conditions on the phone before sending them in – and when they do, the findings or history completely back up the decision to send them in. Just like some PCP’s are almost helpless without the teaching service and call a million consults. Others can handle most things themselves and only call consults when there is a good reason. It clearly is a quality issue. There are good and there are bad PCPs. Just like there are good and bad ERP’s (I know because one of my colleagues is pretty bad!).

]]> By: Anonymous http://www.kevinmd.com/blog/2008/02/my-take_08.html/comment-page-1#comment-83465 Anonymous Sat, 09 Feb 2008 04:39:00 +0000 http://clients.emmense.com/kevinmd/2008/02/my-take-telephone-care-dumb-mandates.html#comment-83465 Kevin, how many times has a doctor been sued for an incorrect phone consultation? <br/><br/>In fact, why would a doctor ever GIVE a phone consultation? Even absent the nonsense claim of "defensive medicine"? Kevin, how many times has a doctor been sued for an incorrect phone consultation?

In fact, why would a doctor ever GIVE a phone consultation? Even absent the nonsense claim of “defensive medicine”?

]]> By: Anonymous http://www.kevinmd.com/blog/2008/02/my-take_08.html/comment-page-1#comment-83459 Anonymous Sat, 09 Feb 2008 03:50:00 +0000 http://clients.emmense.com/kevinmd/2008/02/my-take-telephone-care-dumb-mandates.html#comment-83459 I agree. I just want a plan to pay the really big expenses and don't want coverage to see quacks and witch doctors--but in my state I have to pay for it.<br/><br/>Lets put the "free" back in "free country" I agree. I just want a plan to pay the really big expenses and don’t want coverage to see quacks and witch doctors–but in my state I have to pay for it.

Lets put the “free” back in “free country”

]]> By: Anonymous http://www.kevinmd.com/blog/2008/02/my-take_08.html/comment-page-1#comment-83458 Anonymous Sat, 09 Feb 2008 03:47:00 +0000 http://clients.emmense.com/kevinmd/2008/02/my-take-telephone-care-dumb-mandates.html#comment-83458 Given all the patients that get admitted from ER's with no evidence of any effort make a judgement call, I don't think he can really complain. Given all the patients that get admitted from ER’s with no evidence of any effort make a judgement call, I don’t think he can really complain.

]]> By: Anonymous http://www.kevinmd.com/blog/2008/02/my-take_08.html/comment-page-1#comment-83453 Anonymous Sat, 09 Feb 2008 00:11:00 +0000 http://clients.emmense.com/kevinmd/2008/02/my-take-telephone-care-dumb-mandates.html#comment-83453 Kevin,<br/><br/>If you read Panda's post he is not really deriding PCP's at all and acknowledges that they don't have time to see all the crap either. I think he is more just saying that it is what it is. Kevin,

If you read Panda’s post he is not really deriding PCP’s at all and acknowledges that they don’t have time to see all the crap either. I think he is more just saying that it is what it is.

]]> By: Dermdoc http://www.kevinmd.com/blog/2008/02/my-take_08.html/comment-page-1#comment-83452 Dermdoc Fri, 08 Feb 2008 20:35:00 +0000 http://clients.emmense.com/kevinmd/2008/02/my-take-telephone-care-dumb-mandates.html#comment-83452 I agree, these snippet / comment posts are great. <br/><br/>When you strip down the plans though, then you get the guy who complains about how it costs $45 to come see you and $40 for his biopsy and $25 dollars for the presciption. <br/><br/>Patients can't have it both ways. If you buy a stripped down plan to save on your monthly premium, then you are going to have to reach into your pocket to pay when you receive a service. I agree, these snippet / comment posts are great.

When you strip down the plans though, then you get the guy who complains about how it costs $45 to come see you and $40 for his biopsy and $25 dollars for the presciption.

Patients can’t have it both ways. If you buy a stripped down plan to save on your monthly premium, then you are going to have to reach into your pocket to pay when you receive a service.

]]> By: Anonymous http://www.kevinmd.com/blog/2008/02/my-take_08.html/comment-page-1#comment-83450 Anonymous Fri, 08 Feb 2008 19:00:00 +0000 http://clients.emmense.com/kevinmd/2008/02/my-take-telephone-care-dumb-mandates.html#comment-83450 is he upset that they can't be squeezed into an already triple overbooked schedule or upset that they don't call and discuss? my filter has blocked his site from reading his comments. is he upset that they can’t be squeezed into an already triple overbooked schedule or upset that they don’t call and discuss? my filter has blocked his site from reading his comments.

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