Comments on: My take: Slow medicine, destroying the medical home, animosity, patient communication http://www.kevinmd.com/blog/2008/05/my-take-slow-medicine-ruc-destroys.html Tue, 14 Feb 2012 19:56:00 +0000 hourly 1 By: Anonymoushttp://www.kevinmd.com/blog/2008/05/my-take-slow-medicine-ruc-destroys.html#comment-85492 Anonymous Thu, 08 May 2008 02:19:00 +0000 http://clients.emmense.com/kevinmd/2008/05/my-take-slow-medicine-destroying-the-medical-home-animosity-patient-communication.html#comment-85492 When Australian patients are allowed to be given accurate reports on radiology scans and appropriate medical treatment when it involves injuries from car accidents, workcover and other insurance claims then you can have something comment about.<br/><br/>Who will take responsibility?<br/>Is it corrupt Government or Health system? When Australian patients are allowed to be given accurate reports on radiology scans and appropriate medical treatment when it involves injuries from car accidents, workcover and other insurance claims then you can have something comment about.

Who will take responsibility?
Is it corrupt Government or Health system?

]]> By: wojhttp://www.kevinmd.com/blog/2008/05/my-take-slow-medicine-ruc-destroys.html#comment-85490 woj Thu, 08 May 2008 01:32:00 +0000 http://clients.emmense.com/kevinmd/2008/05/my-take-slow-medicine-destroying-the-medical-home-animosity-patient-communication.html#comment-85490 hi, first time here..would like to continue reading ur blog...would you mind we exchange link?<br/>hav a nice day ahead! hi, first time here..would like to continue reading ur blog…would you mind we exchange link?
hav a nice day ahead!

]]> By: Richardhttp://www.kevinmd.com/blog/2008/05/my-take-slow-medicine-ruc-destroys.html#comment-85489 Richard Thu, 08 May 2008 01:27:00 +0000 http://clients.emmense.com/kevinmd/2008/05/my-take-slow-medicine-destroying-the-medical-home-animosity-patient-communication.html#comment-85489 Urology is actually rather popular at the moment. Unglamorous as the penis and prostate may be, it's a laid-back specialty with decent call and lots of reimbursement for procedures.<br/><br/>But yes, as one surgeon told me:<br/>"Don't go into surgery if you can see yourself doing anything else in medicine."<br/><br/>It simply isn't worth it unless you know you really want it, because the lifestyle can be so tough. Urology is actually rather popular at the moment. Unglamorous as the penis and prostate may be, it’s a laid-back specialty with decent call and lots of reimbursement for procedures.

But yes, as one surgeon told me:
“Don’t go into surgery if you can see yourself doing anything else in medicine.”

It simply isn’t worth it unless you know you really want it, because the lifestyle can be so tough.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2008/05/my-take-slow-medicine-ruc-destroys.html#comment-85480 Anonymous Wed, 07 May 2008 23:18:00 +0000 http://clients.emmense.com/kevinmd/2008/05/my-take-slow-medicine-destroying-the-medical-home-animosity-patient-communication.html#comment-85480 "Slow medicine" is not a movement that needs to be spread. It is the historical usual way of taking care of those dying of "old age" that I was taught was normative to offer to the elderly back in the "old days" of the 80's in the avant garde state of Arkansas.<br/><br/>The RVS system is set to pit specialty against specialty and reforming it will not change that. Rather what PCP's need to do is write and float their own CPT system with distinct code and lobby for it's implementation for primary care services by CMS. There is absolutely no reason not to do that.<br/><br/>You are comparing apples and oranges and their downgrading of your services compared to other specialities is as groundless as your constant sniping about it is useless. They need not and should not be compared at all. “Slow medicine” is not a movement that needs to be spread. It is the historical usual way of taking care of those dying of “old age” that I was taught was normative to offer to the elderly back in the “old days” of the 80′s in the avant garde state of Arkansas.

The RVS system is set to pit specialty against specialty and reforming it will not change that. Rather what PCP’s need to do is write and float their own CPT system with distinct code and lobby for it’s implementation for primary care services by CMS. There is absolutely no reason not to do that.

You are comparing apples and oranges and their downgrading of your services compared to other specialities is as groundless as your constant sniping about it is useless. They need not and should not be compared at all.

]]> By: Ian Furst http://www.waittimes.blogspot.comhttp://www.kevinmd.com/blog/2008/05/my-take-slow-medicine-ruc-destroys.html#comment-85474 Ian Furst http://www.waittimes.blogspot.com Wed, 07 May 2008 18:15:00 +0000 http://clients.emmense.com/kevinmd/2008/05/my-take-slow-medicine-destroying-the-medical-home-animosity-patient-communication.html#comment-85474 Regarding #3 -- ED vs admitting our hospital has come full circle and it related to the ED docs to a large degree. When we had a team of community docs (those that lived locally) in the ED and they where a full time team they never called in the dead of night unless they really needed you and in turn no one gave them a hard time when they did call. Move in a contract dispute and new locum docs and the mutual respect evaporated and the animosity developed. Now 3-4 years later we have mostly full time docs back and things have greatly improved. Regarding #3 — ED vs admitting our hospital has come full circle and it related to the ED docs to a large degree. When we had a team of community docs (those that lived locally) in the ED and they where a full time team they never called in the dead of night unless they really needed you and in turn no one gave them a hard time when they did call. Move in a contract dispute and new locum docs and the mutual respect evaporated and the animosity developed. Now 3-4 years later we have mostly full time docs back and things have greatly improved.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2008/05/my-take-slow-medicine-ruc-destroys.html#comment-85473 Anonymous Wed, 07 May 2008 17:30:00 +0000 http://clients.emmense.com/kevinmd/2008/05/my-take-slow-medicine-destroying-the-medical-home-animosity-patient-communication.html#comment-85473 If I were a primary care doc I would step out of the system. If I were a primary care doc I would step out of the system.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2008/05/my-take-slow-medicine-ruc-destroys.html#comment-85472 Anonymous Wed, 07 May 2008 16:54:00 +0000 http://clients.emmense.com/kevinmd/2008/05/my-take-slow-medicine-destroying-the-medical-home-animosity-patient-communication.html#comment-85472 The shortages are just beginning, with primary care only being the most obvious.<br/><br/>In the coming years, almost every frontline field will be affected, if not already:<br/>1)general surgery: why take out an appendix at 3 am when you can do elective carotids in vascular surgery, and make more money?<br/>2) general ob-gyn: why do a c-section at 3 am if you can become an infertilfity specialist?<br/>3) cardiothoracic surgery: although high paying, is it really worth the risk if one can go into derm? or plastics?<br/>4) neurosurgery: ditto above<br/>5) general orthopedics: why repair 85 year old hip fractures when you can do "hand"?<br/>6) nephrology: why be dependant on low paying dialysis patients when you can go into GI?<br/>The list goes on.<br/><br/>Every physician should be worrying about the fate of primary care. Once we're gone, they're going to come for you next. The shortages are just beginning, with primary care only being the most obvious.

In the coming years, almost every frontline field will be affected, if not already:
1)general surgery: why take out an appendix at 3 am when you can do elective carotids in vascular surgery, and make more money?
2) general ob-gyn: why do a c-section at 3 am if you can become an infertilfity specialist?
3) cardiothoracic surgery: although high paying, is it really worth the risk if one can go into derm? or plastics?
4) neurosurgery: ditto above
5) general orthopedics: why repair 85 year old hip fractures when you can do “hand”?
6) nephrology: why be dependant on low paying dialysis patients when you can go into GI?
The list goes on.

Every physician should be worrying about the fate of primary care. Once we’re gone, they’re going to come for you next.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2008/05/my-take-slow-medicine-ruc-destroys.html#comment-85471 Anonymous Wed, 07 May 2008 15:55:00 +0000 http://clients.emmense.com/kevinmd/2008/05/my-take-slow-medicine-destroying-the-medical-home-animosity-patient-communication.html#comment-85471 If there was a PCP majority on the the RVU board and the shoe was on the other foot, can you imagine how hard it would be to fill the specilities. <br/><br/>Not only are specialities that are high paying usually longer training in terms of years, but they are more intense in terms of hours worked and the immensely physical nature of the job. <br/><br/>I'm sorry, but if you want to see a real crisis then you should lower payment to specialty medicine because those are going to be the spots that will NEVER be filled if the money isn't there. At least internal medicine and family practice is only 3 years of residency. <br/><br/>Good luck filling jobs like Urology (5-6 years training, dealing with the unglamorous penis), orthopedics (horrible work hours, physically demanding), cardiology (horrible work hours, must be willing to miss every kids birthday), etc. <br/><br/>Kevin, I've said it before and I'll say it again... your coverage of this specific area is biased and you are being motivated by self interest. If there was a PCP majority on the the RVU board and the shoe was on the other foot, can you imagine how hard it would be to fill the specilities.

Not only are specialities that are high paying usually longer training in terms of years, but they are more intense in terms of hours worked and the immensely physical nature of the job.

I’m sorry, but if you want to see a real crisis then you should lower payment to specialty medicine because those are going to be the spots that will NEVER be filled if the money isn’t there. At least internal medicine and family practice is only 3 years of residency.

Good luck filling jobs like Urology (5-6 years training, dealing with the unglamorous penis), orthopedics (horrible work hours, physically demanding), cardiology (horrible work hours, must be willing to miss every kids birthday), etc.

Kevin, I’ve said it before and I’ll say it again… your coverage of this specific area is biased and you are being motivated by self interest.

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