Comments on: Pay primary care by the hour, again http://www.kevinmd.com/blog/2008/03/pay-primary-care-by-hour-2.html medical blog Sun, 22 Nov 2009 07:50:13 -0500 http://wordpress.org/?v=2.8.4 hourly 1 By: Anonymous http://www.kevinmd.com/blog/2008/03/pay-primary-care-by-hour-2.html/comment-page-1#comment-84405 Anonymous Fri, 21 Mar 2008 18:35:00 +0000 http://clients.emmense.com/kevinmd/2008/03/pay-primary-care-by-the-hour-2.html#comment-84405 Well, if the patient wants a doctor who talks about football and is willing to pay by the hour, whose business is it anyway?<br/><br/>And I have seen too much important stuff missed by the "get right to the point" crowd. To get right to the point, they have to decide what the point is that they are getting to before they have enough information to know what "point" they are missing. Well, if the patient wants a doctor who talks about football and is willing to pay by the hour, whose business is it anyway?

And I have seen too much important stuff missed by the “get right to the point” crowd. To get right to the point, they have to decide what the point is that they are getting to before they have enough information to know what “point” they are missing.

]]> By: Anonymous http://www.kevinmd.com/blog/2008/03/pay-primary-care-by-hour-2.html/comment-page-1#comment-84348 Anonymous Thu, 20 Mar 2008 18:10:00 +0000 http://clients.emmense.com/kevinmd/2008/03/pay-primary-care-by-the-hour-2.html#comment-84348 No matter how you put it, it's still paying for inefficiency. The guy that gets right to the point and sees 30 people gets paid the same as a guy seeing 10 that talks to every patient about the local football team and the price of wheat. No matter how you put it, it’s still paying for inefficiency. The guy that gets right to the point and sees 30 people gets paid the same as a guy seeing 10 that talks to every patient about the local football team and the price of wheat.

]]> By: Conciergedoc http://www.kevinmd.com/blog/2008/03/pay-primary-care-by-hour-2.html/comment-page-1#comment-84336 Conciergedoc Thu, 20 Mar 2008 04:30:00 +0000 http://clients.emmense.com/kevinmd/2008/03/pay-primary-care-by-the-hour-2.html#comment-84336 Anon 4:41 - misses the point entirely. We don't need to talk about the extremes. <br/><br/>Some formula based arounding paying for time in primary care will result in better, organized, more comprehensive care. <br/><br/>Hey, in my practice, I have the luxury of considerable forethought and reflection. But how many can say that in the current system. Anon 4:41 – misses the point entirely. We don’t need to talk about the extremes.

Some formula based arounding paying for time in primary care will result in better, organized, more comprehensive care.

Hey, in my practice, I have the luxury of considerable forethought and reflection. But how many can say that in the current system.

]]> By: Anonymous http://www.kevinmd.com/blog/2008/03/pay-primary-care-by-hour-2.html/comment-page-1#comment-84331 Anonymous Thu, 20 Mar 2008 01:57:00 +0000 http://clients.emmense.com/kevinmd/2008/03/pay-primary-care-by-the-hour-2.html#comment-84331 If you are writing it on my orders and it takes you that long to give thoughtful consideration to what you are signing, you are damned right I will be glad to pay you for an hour to do it rather than for 2 minutes for the distracted, mindless slapdash work that I see all too often! If you are writing it on my orders and it takes you that long to give thoughtful consideration to what you are signing, you are damned right I will be glad to pay you for an hour to do it rather than for 2 minutes for the distracted, mindless slapdash work that I see all too often!

]]> By: Anonymous http://www.kevinmd.com/blog/2008/03/pay-primary-care-by-hour-2.html/comment-page-1#comment-84330 Anonymous Thu, 20 Mar 2008 01:53:00 +0000 http://clients.emmense.com/kevinmd/2008/03/pay-primary-care-by-the-hour-2.html#comment-84330 Slower is not always less efficient. Fee for service means that if you slap a diagnosis on after a faked 3 minute exam rather than take time to do it properly. you get the same fee and make more money for your time. But in the end the right diagnosis is likely to be more "efficient" as the patient therefore has a better chance of recovering.<br/><br/>In my administrative capacity I have reviewed thousands of charts and have seen a great deal of waste made by haste--and more than a few people seriously injured.<br/><br/>If that name is being written after an hour because it took my doctor that long to review the chart, talk to the nurses, talk to my family, get my history, examine me, listen to me talk about how scared I am and offer some emotional support, and help me work with him to choose and plan how to implement treatment--then I will gladly pay for that hour whatever level CPT code it is and without regard to what the RVS Nazi's think it is worth. It my ass that is sick, not theirs.<br/><br/>Some kinds of efficiency I don't want from the guy in whose hands my life lies. Slower is not always less efficient. Fee for service means that if you slap a diagnosis on after a faked 3 minute exam rather than take time to do it properly. you get the same fee and make more money for your time. But in the end the right diagnosis is likely to be more “efficient” as the patient therefore has a better chance of recovering.

In my administrative capacity I have reviewed thousands of charts and have seen a great deal of waste made by haste–and more than a few people seriously injured.

If that name is being written after an hour because it took my doctor that long to review the chart, talk to the nurses, talk to my family, get my history, examine me, listen to me talk about how scared I am and offer some emotional support, and help me work with him to choose and plan how to implement treatment–then I will gladly pay for that hour whatever level CPT code it is and without regard to what the RVS Nazi’s think it is worth. It my ass that is sick, not theirs.

Some kinds of efficiency I don’t want from the guy in whose hands my life lies.

]]> By: Anonymous http://www.kevinmd.com/blog/2008/03/pay-primary-care-by-hour-2.html/comment-page-1#comment-84316 Anonymous Wed, 19 Mar 2008 21:41:00 +0000 http://clients.emmense.com/kevinmd/2008/03/pay-primary-care-by-the-hour-2.html#comment-84316 So the slower and less efficient you are the more you get paid? How does that make any sense. Are you going to pay me if it takes an hour to write my name? So the slower and less efficient you are the more you get paid? How does that make any sense. Are you going to pay me if it takes an hour to write my name?

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