Comments on: Who speaks for the doctors who spend time with patients?

By: Edwin Leap

Edwin Leap — Fri, 07 Aug 2009 13:31:04 +0000

This is an excellent point. Who speaks for the practictioner? And not just the one volunteering at a shelter, etc. The practice of medicine is valuable, even if it is not in a ‘free setting,’ but is compensated (however shocking the concept is to the modern mind). Maybe I’m more sensitive to this as an emergency physician. Every day feels a little like practicing in a shelter or free clinic; because so much of the care is free!

Let me make a prediction as someone working in a government mandated setting (which means all of EM). The question for us is not ‘do we get paid for our time’ or ‘do we get paid for doing stuff,’ but ‘do we get paid?’

The EMTALA mandate forces us to see all without any promise of payment from the government that set the rules. They have stiffed us ever since. the mid 80′s. Does anyone really believe the same government will devise ANY just, reasonable system to compensate all doctors fairly? Ask your local ER doctor the question and listen closely.

Edwin

By: R Watkins

R Watkins — Thu, 06 Aug 2009 01:18:30 +0000

Marybeth:

“call us! If you don’t call or email I can’t know how to represent you.”

Who is us? No one gives me a list of lobbyists for primary care docs. As for the AAFP, physicians have been telling them for 15 years that the relative value system is killing primary care, but they refuse to criticize or disassociate themselves from the AMA.

Thanks

By: Marybeth

Marybeth — Tue, 04 Aug 2009 17:06:46 +0000

I am employed as a lobbyist for primary care physicians. I listen to our physician members before supporting any legislation, I seek legislation only when our members request it, and I speak regularly to legislators about how primary care physicians are suffering in the current payment environment. I work at the discretion of my association’s physician members this means I can only work on issues that physicians let me know about. If you want your association to work on an issue- call us! If you don’t call or email I can’t know how to represent you.

I don’t receive any increase in payment when I’m successful and I don’t receive any increase in payment for the number of hours I work, so I’m confused as to how I’m defending my own financial self interest. I believe in the importance of primary care, which is why I work in this field.

By: R Watkins

R Watkins — Mon, 03 Aug 2009 13:55:23 +0000

I agree with Family Doc. The AMA is actively hostile towards primary care, and the AAFP and other primary care organizations have been unwilling to represent the interests of their memberships.

Sermo’s blog is a good resource.

By: Susan H

Susan H — Mon, 03 Aug 2009 13:36:04 +0000

Absolutely physicians should not have to act like lawyers.
They should be protected from any necessity of doing so by those with the power to protect them.

A profession driven by inherent dignity, honor and compassion is such an easy target for exploitation by groups whose charter is otherwise.

By: Pankaj Karan,MD

Pankaj Karan,MD — Mon, 03 Aug 2009 04:37:17 +0000

If doctors start acting like lawyers,it will be the end of medical profession.People still look at us with some dignity and respect and trustworthiness. As for lawyers,all in contraries.

By: Pankaj Karan,MD

Pankaj Karan,MD — Mon, 03 Aug 2009 04:29:06 +0000

This is what happnes when medicine and caring become capitalism. You just cannot practice without thinking how to pay your overhead expenses. As an Internist or FP you have to see certainnumber of pts. daily to meet your expenses otherwise you cannot survive.In general,we all try to do out best given current circumstances.Isee 1/3 of my pts in hospital for free and cannot even claim tax break for my time spent with indigent pts.
To change the system will take many yrs and will have to start in residency training program itself.

By: family doc

family doc — Sat, 01 Aug 2009 18:12:13 +0000

Sermo is doing a better job of voicing the opinions of most of the family docs I know than the either the AAFP or the AMA.
http://www.sermo.com/blog/

By: Susan H

Susan H — Sat, 01 Aug 2009 16:53:28 +0000

Has any prominent physician asked President Obama, or the ATLA, or any legislator to outline conditions under which medical providors might be indemnified from civil liability for care given pro bono publico…
or conditions under which the docs and nurses might be allowed to know a quantifiable amount of $$ risk for pain and suffering awards available to potential civil plaintiffs?

By: Ray

Ray — Sat, 01 Aug 2009 08:36:25 +0000

It is really really sad that our system rewards only procedures, ordering tests, MRIs more than time a doctor can spend to reassure patients when more tests are not needed. Crunched for time, fear of missing something promotes more referrals and tests that could be avoided. The sector that can really bend the curve of costs is doctors. Unless they are incentivised, nothing will change. We need incentives to make patients better with sensible care. If congress has guts to make this hard choice and elevate cognitive care, we probably can bend the curve and save 700 billion a year! We also need to train med students and residents to be aware of what their decisions mean for costs,amazing that the very people who the main cause of costs are mostly clueless about the costs. Has anyone ever asked their doctor what the medication or test would cost and did you get a straight answer?