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	<title>Comments on: Should patients be advised that better care is available elsewhere?</title>
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	<description>medical blog</description>
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		<title>By: Anonymous</title>
		<link>http://www.kevinmd.com/blog/2009/01/should-patients-be-advised-that-better.html/comment-page-1#comment-89197</link>
		<dc:creator>Anonymous</dc:creator>
		<pubDate>Tue, 13 Jan 2009 23:39:00 +0000</pubDate>
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		<description>As a surgeon, I am finding it increasingly difficult to refer patients to tertiary care facilities for these complex surgeries that I do not perform often( and no longer want to perform). The reimbusement is so poor from Medicare and the risk of complcations so great, that many &quot;centers of excellance&quot; no longer want these patients either.</description>
		<content:encoded><![CDATA[<p>As a surgeon, I am finding it increasingly difficult to refer patients to tertiary care facilities for these complex surgeries that I do not perform often( and no longer want to perform). The reimbusement is so poor from Medicare and the risk of complcations so great, that many &#8220;centers of excellance&#8221; no longer want these patients either.</p>
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		<title>By: Anonymous</title>
		<link>http://www.kevinmd.com/blog/2009/01/should-patients-be-advised-that-better.html/comment-page-1#comment-89196</link>
		<dc:creator>Anonymous</dc:creator>
		<pubDate>Tue, 13 Jan 2009 23:15:00 +0000</pubDate>
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		<description>I work in the VA and I am more than willing to refer people with the means (ie backup private insurance) outside the gigantic VA waitlist void.&lt;br/&gt;&lt;br/&gt;An example:&lt;br/&gt;The waitlist for joint replacement? Two years and you must not smoke or have a BMI &gt;33 or you won&#039;t even make the list.</description>
		<content:encoded><![CDATA[<p>I work in the VA and I am more than willing to refer people with the means (ie backup private insurance) outside the gigantic VA waitlist void.</p>
<p>An example:<br />The waitlist for joint replacement? Two years and you must not smoke or have a BMI &gt;33 or you won&#39;t even make the list.</p>
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