Comments on: Is primary care set for a turnaround? http://www.kevinmd.com/blog/2008/11/is-primary-care-set-for-turnaround.html Tue, 14 Feb 2012 20:59:00 +0000 hourly 1 By: DCShttp://www.kevinmd.com/blog/2008/11/is-primary-care-set-for-turnaround.html#comment-88314 DCS Mon, 24 Nov 2008 19:29:00 +0000 http://clients.emmense.com/kevinmd/2008/11/is-primary-care-set-for-a-turnaround.html#comment-88314 Increasing reimbursements would not change my decision to leave primary care for its cousin, urgent care. I made a decent living at the former occupation. What scares me about current utopian propsals is the continued erosion of autonomy and being held hostage to guidelines promulgated by "experts" who, in my opinion, lack any recent experience in the trenches of medicine and who seem to believe that the primary care physician owns lifestyle problems of patients of the non-compliant persuasion. Increasing reimbursements would not change my decision to leave primary care for its cousin, urgent care. I made a decent living at the former occupation. What scares me about current utopian propsals is the continued erosion of autonomy and being held hostage to guidelines promulgated by “experts” who, in my opinion, lack any recent experience in the trenches of medicine and who seem to believe that the primary care physician owns lifestyle problems of patients of the non-compliant persuasion.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2008/11/is-primary-care-set-for-turnaround.html#comment-88269 Anonymous Fri, 21 Nov 2008 14:24:00 +0000 http://clients.emmense.com/kevinmd/2008/11/is-primary-care-set-for-a-turnaround.html#comment-88269 "Yet, I think there will be a turnaround ahead, if only because we're close to the bottom."<br/><br/>I'll say this for you Kevin -while you're not much of a realist, you're a hell of an optimist! “Yet, I think there will be a turnaround ahead, if only because we’re close to the bottom.”

I’ll say this for you Kevin -while you’re not much of a realist, you’re a hell of an optimist!

]]> By: Anonymoushttp://www.kevinmd.com/blog/2008/11/is-primary-care-set-for-turnaround.html#comment-88267 Anonymous Fri, 21 Nov 2008 01:16:00 +0000 http://clients.emmense.com/kevinmd/2008/11/is-primary-care-set-for-a-turnaround.html#comment-88267 You're dreaming if you look to the government for bail-out. Sell, and fast. You’re dreaming if you look to the government for bail-out. Sell, and fast.

]]> By: mudphudderhttp://www.kevinmd.com/blog/2008/11/is-primary-care-set-for-turnaround.html#comment-88266 mudphudder Thu, 20 Nov 2008 22:03:00 +0000 http://clients.emmense.com/kevinmd/2008/11/is-primary-care-set-for-a-turnaround.html#comment-88266 What we need is more doctors in legislative positions who can advocate in the best interest of patients. Sometimes (well, more often than not) it seems lawmakers have little insight as to the consequences of their decisions. I wonder if doctors got to make these decisions--or at least were heavily involved-- whether the medical field and the problems it currently faces (from medical education to clinical practice) would be any different. What we need is more doctors in legislative positions who can advocate in the best interest of patients. Sometimes (well, more often than not) it seems lawmakers have little insight as to the consequences of their decisions. I wonder if doctors got to make these decisions–or at least were heavily involved– whether the medical field and the problems it currently faces (from medical education to clinical practice) would be any different.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2008/11/is-primary-care-set-for-turnaround.html#comment-88264 Anonymous Thu, 20 Nov 2008 18:47:00 +0000 http://clients.emmense.com/kevinmd/2008/11/is-primary-care-set-for-a-turnaround.html#comment-88264 Anon 9:43 : The market is already taking a big step to acually cut specialists out of the picture completely. As of Jan. 1, 2009 Wellpath will be offering patients the option of having joint replacement surgery in India for nothing versus a significant copay in the US. By the way ( I am a surgeon) surgeons do cognate alot! Anon 9:43 : The market is already taking a big step to acually cut specialists out of the picture completely. As of Jan. 1, 2009 Wellpath will be offering patients the option of having joint replacement surgery in India for nothing versus a significant copay in the US. By the way ( I am a surgeon) surgeons do cognate alot!

]]> By: DR. MARY JOHNSONhttp://www.kevinmd.com/blog/2008/11/is-primary-care-set-for-turnaround.html#comment-88262 DR. MARY JOHNSON Thu, 20 Nov 2008 17:27:00 +0000 http://clients.emmense.com/kevinmd/2008/11/is-primary-care-set-for-a-turnaround.html#comment-88262 Yes, indeed, Peter. As a Pediatrician once burned in service to USDHHS, the Daschle pick made me want to cry:<br/><br/>http://drjshousecalls.blogspot.com/2008/11/why-michelle-obama-in-white-house-does.html Yes, indeed, Peter. As a Pediatrician once burned in service to USDHHS, the Daschle pick made me want to cry:

http://drjshousecalls.blogspot.com/2008/11/why-michelle-obama-in-white-house-does.html

]]> By: Katie Bee RNhttp://www.kevinmd.com/blog/2008/11/is-primary-care-set-for-turnaround.html#comment-88259 Katie Bee RN Thu, 20 Nov 2008 15:20:00 +0000 http://clients.emmense.com/kevinmd/2008/11/is-primary-care-set-for-a-turnaround.html#comment-88259 Will be interesting to see if we get an "it's the economy, stupid" answer to the primary care problem too. As less people can afford specialists, there will be less demand, and some can sense a massive workforce trimming in healthcare. Will the sudden abundance of jobs in primary care be met with a sudden abundance of job seekers? Will be interesting to see if we get an “it’s the economy, stupid” answer to the primary care problem too. As less people can afford specialists, there will be less demand, and some can sense a massive workforce trimming in healthcare. Will the sudden abundance of jobs in primary care be met with a sudden abundance of job seekers?

]]> By: Anonymoushttp://www.kevinmd.com/blog/2008/11/is-primary-care-set-for-turnaround.html#comment-88258 Anonymous Thu, 20 Nov 2008 14:43:00 +0000 http://clients.emmense.com/kevinmd/2008/11/is-primary-care-set-for-a-turnaround.html#comment-88258 I have an unorthodox idea: the primary care lobby (such as it is) should actually argue for the SGR cuts to go through for once. The public needs to see what "nuking the system" looks like. <br/><br/>I think it will look like this: Medicare beneficiaries will encounter real difficulty accessing cognitive services, but they will have no trouble accessing most procedures and imaging services. Then the solution will be clear: increase the RVUs for the difficult-access services.<br/><br/>Let this process repeat itself many times, and we'll see a rational quasi-market-based reduction in the income discrepancy between cognates and procedurist/imagers. I have an unorthodox idea: the primary care lobby (such as it is) should actually argue for the SGR cuts to go through for once. The public needs to see what “nuking the system” looks like.

I think it will look like this: Medicare beneficiaries will encounter real difficulty accessing cognitive services, but they will have no trouble accessing most procedures and imaging services. Then the solution will be clear: increase the RVUs for the difficult-access services.

Let this process repeat itself many times, and we’ll see a rational quasi-market-based reduction in the income discrepancy between cognates and procedurist/imagers.

]]> By: Peterhttp://www.kevinmd.com/blog/2008/11/is-primary-care-set-for-turnaround.html#comment-88257 Peter Thu, 20 Nov 2008 13:42:00 +0000 http://clients.emmense.com/kevinmd/2008/11/is-primary-care-set-for-a-turnaround.html#comment-88257 The new HHS secretary is Tom Daschle, who has made it clear that his solution to primary care does not include incentivizing it to encourage more medical students to enter it. He recommends having it taken over by midlevel practitioners. Considering that HHS is the key to healthcare in this country, I would say that primary care physicians will not be better off with the new administration. The new HHS secretary is Tom Daschle, who has made it clear that his solution to primary care does not include incentivizing it to encourage more medical students to enter it. He recommends having it taken over by midlevel practitioners. Considering that HHS is the key to healthcare in this country, I would say that primary care physicians will not be better off with the new administration.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2008/11/is-primary-care-set-for-turnaround.html#comment-88256 Anonymous Thu, 20 Nov 2008 12:56:00 +0000 http://clients.emmense.com/kevinmd/2008/11/is-primary-care-set-for-a-turnaround.html#comment-88256 We need more freedom; freedom to bill for telephone calls and completing forms, and freedom to control our diagnostic testing.<br/>More freedom would make a big difference. We need more freedom; freedom to bill for telephone calls and completing forms, and freedom to control our diagnostic testing.
More freedom would make a big difference.

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