Monday, May 05, 2008
"The compensation just isn't there"
A front-page WSJ story on the death of the cognitive specialist:Many in health-policy circles have focused on how the current health-care payment system is helping create shortages among primary-care doctors, internists and others on the front lines of medicine. But often lost is how the system is endangering some of the country's most highly trained specialties as well.Dr. Wes comments.
Endocrinologists, rheumatologists and pulmonologists -- specialties that also don't involve performing many procedures -- face acute shortages. Many of the severest deficits affect children. Though nearly 300,000 children in the U.S. are diagnosed annually with juvenile arthritis, lupus or other complex rheumatic diseases, there are fewer than 200 pediatric rheumatologists to take care of them, according to the U.S. government's Health Resources and Services Administration.
Posted by Kevin |
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Comments:
I think we need to trust more in market forces. If people prefer to spend money on a high definition TV and Blu Ray player, than on a pediatric rheumatologist, then so be it.
Just don't coerce physicians to be pediatric rheumatologists. Incidentally, the ones here in suburban Long Island do much, much better than the figures cited. You have to have faith in the free market.
Just don't coerce physicians to be pediatric rheumatologists. Incidentally, the ones here in suburban Long Island do much, much better than the figures cited. You have to have faith in the free market.
# posted by 
: 1:00 PM
: 1:00 PM
I wouldn't include pulmonologists along wiht endocrinologists and rheumatologists. The pulmonologists I know perform a lot of procedures.
the article talks abuot $10,000+ spent before the patient with ptosis saw a neuro-ophthalmologist & was diagnosed with myasthenia gravis.
Really, a good primary care physician, especially in geriatrics, should consider this very early in the workup of ptosis. Neuro-ophthalmology eval after $10k in medicare billings is just a total rip-off of the system, and is what continues to kill primary care. These are the kinds of cases (and there are HUNDREDS of such examples) that will be missed by NPs & PAs in the move toward their taking over primary care, and illustrates perfectly the value of primary care.
And I agree w/Dr.Rack (cool name, btw) - pulmonologists love ICU patients, & keep them there as long as possible, bronching & bronching, and bronching again.
Really, a good primary care physician, especially in geriatrics, should consider this very early in the workup of ptosis. Neuro-ophthalmology eval after $10k in medicare billings is just a total rip-off of the system, and is what continues to kill primary care. These are the kinds of cases (and there are HUNDREDS of such examples) that will be missed by NPs & PAs in the move toward their taking over primary care, and illustrates perfectly the value of primary care.
And I agree w/Dr.Rack (cool name, btw) - pulmonologists love ICU patients, & keep them there as long as possible, bronching & bronching, and bronching again.
# posted by : 2:32 PM
: 2:32 PM
The free market and centralized fee regulation through RVS do not conexist in the same space. RVS is an abomination that no physician whose ancestors fought under the American flag for freedom should tolerate in his practice without hanging his head in shame.
# posted by : 5:57 PM
: 5:57 PM
I seriously doubt that "300,000 children in the U.S. are diagnosed annually with juvenile ... rheumatic diseases."
Juvenile RA has an incidence of 10-29 per 100,000, for example.
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Juvenile RA has an incidence of 10-29 per 100,000, for example.
