Tuesday, September 02, 20083
Emergency physicians and the medical home
The medical home has been hailed as the savior for primary care. Specialists have yet to hop on board, likely because of the threat the increased payments have on their salaries.
Emergency physicians aren't that enthused either. They seem pretty bitter with EMTALA, and want primary care to take on all comers as well:
Emergency physicians aren't that enthused either. They seem pretty bitter with EMTALA, and want primary care to take on all comers as well:
According to the ACEP, primary care sites should promise to continue to offer medical home services even if a patient loses their insurance (which would help keep the uninsured away from emergency rooms by making the primary care physicians provide a service for free?).One point I do agree with. Small practices are going to have trouble meeting the criteria for the medical home. Most can't even get a functional EMR running, yet alone meet the enhanced requirements the medical home demands.
Comments
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Anonymous
Many patients for some reason think our small primary care practice doesn't want them if they're uninsured. On the contrary, we're happy to have uninsured patients; many practices will offer a cash discount for immediate payment to level the prices for these patients. In many ways, they're preferable to the Medicare and Medicaid patients.
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AD
Most ER doctors DO NOT get a subsidy for mandated unfunded care EMTALA care from the hospital. I know I don't and I know most in our large metropolitan area do not.
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Anonymous
to "ad" and ER doctors in general:
Post a CommentOf course, if the ACEP thinks that primary care office should be mandated to see patients for free, that's even nuttier than EMTALA. At least the ERs suffering EMTALA get a subsidy from the hospital profit centers. That would be the last straw for independent primary care practices.
2:31 PM
EMTALA in no way mandates that the hospital subsidize the ER doctors.
Our group does pay about 15 dollars per uninsured patient visit for malpractice and billing.
4:25 PM
1) does your group pay for rent in the ER?
2) how about the nursing staff - do your gross revenues get reduced by their salaries & benefits?
3) how about the electric bill and cleaning fees for the ER?
4) secretarial staff?
5) do you order (& pay for) supplies, or is that taken care of for you by the hospital?
NO, you work in a HOSPITAL, and as such have a steady stream of patients without the usual expenses & hassles of a private office (of which malpractice insurance is just a small part, for most small primary care offices).
And when you go home, you don't get paged after hours, in the middle of the night after working a long day, like your local primary care colleagues.
I agree that EMTALA is a load of crap. But don't confuse what YOU do with actually having the hassles of running a small business - something most small outpatient practices would gladly give up for the ability to just practice medicine.
9:10 PM