Comments on: Are cardiologists going to take their reimbursement frustrations out on primary care residents? http://www.kevinmd.com/blog/2009/09/cardiologists-reimbursement-frustrations-primary-care-residents.html Tue, 14 Feb 2012 23:00:00 +0000 hourly 1 By: doctor stevehttp://www.kevinmd.com/blog/2009/09/cardiologists-reimbursement-frustrations-primary-care-residents.html#comment-111687 doctor steve Sat, 12 Sep 2009 03:07:12 +0000 http://www.kevinmd.com/blog/?p=40037#comment-111687 why do we not have a primary care union? i do not understand why the aafp does not come out in support of this. with strength in numbers, we could change the health care system. this system is broke because we are an 'after the fact' nonsystem instead of a preventative health system. big pharma, big insurers, and alot of our specialists' livelihoods depend on the continuation of preventable chronic disease. pharma depends on us prescribing their drugs, reading their glossy media. specialists rely on our referrals. insurance relies on us being the bottleneck in prolonging or delaying their need to pay any money-the referral system-whether it be for a test or to a specialist; and the prior authorization system-another great stalling technique. good preventative care requires time to develop good repoire and trust with one's patients. it doesn't work in our favor from a reimbursement standpoint, but it is the only thing that is going to help change bad behaviors and inspire healthy ones, and to prevent or reverse chronic disease. if we had a union, we could make these points and refuse to work as hamsters in a wheel, providing less than ideal care. all talk, no action. why do we not have a primary care union? i do not understand why the aafp does not come out in support of this. with strength in numbers, we could change the health care system. this system is broke because we are an ‘after the fact’ nonsystem instead of a preventative health system. big pharma, big insurers, and alot of our specialists’ livelihoods depend on the continuation of preventable chronic disease. pharma depends on us prescribing their drugs, reading their glossy media. specialists rely on our referrals. insurance relies on us being the bottleneck in prolonging or delaying their need to pay any money-the referral system-whether it be for a test or to a specialist; and the prior authorization system-another great stalling technique. good preventative care requires time to develop good repoire and trust with one’s patients. it doesn’t work in our favor from a reimbursement standpoint, but it is the only thing that is going to help change bad behaviors and inspire healthy ones, and to prevent or reverse chronic disease. if we had a union, we could make these points and refuse to work as hamsters in a wheel, providing less than ideal care. all talk, no action.

]]> By: newsdochttp://www.kevinmd.com/blog/2009/09/cardiologists-reimbursement-frustrations-primary-care-residents.html#comment-111672 newsdoc Sat, 12 Sep 2009 00:34:54 +0000 http://www.kevinmd.com/blog/?p=40037#comment-111672 Healthcare costs are going to increase with the aging population. If nothing is done to the present "system" Medicare and others will continue to see the solution as chipping away at physician and other healthcare providers income. If we change the system we can get some of the money from tort reform, CYA medicine, reduction in administrative costs (billing for all the insurances and the games they play overlapping programs Medicaid, Medicare, VA, community clinics who receive relatively large per patient fees and medically indigent programs) and drug costs . Healthcare costs are going to increase with the aging population. If nothing is done to the present “system” Medicare and others will continue to see the solution as chipping away at physician and other healthcare providers income. If we change the system we can get some of the money from tort reform, CYA medicine, reduction in administrative costs (billing for all the insurances and the games they play overlapping programs Medicaid, Medicare, VA, community clinics who receive relatively large per patient fees and medically indigent programs) and drug costs .

]]> By: TrenchDochttp://www.kevinmd.com/blog/2009/09/cardiologists-reimbursement-frustrations-primary-care-residents.html#comment-111665 TrenchDoc Fri, 11 Sep 2009 23:47:05 +0000 http://www.kevinmd.com/blog/?p=40037#comment-111665 With all the money the cardiologists have been able to generate over that last 20 years they should be able to slide by a few more years. They will just dump more work back on the PCPs. In our area it is routine for them to send our mutual patients to our office with a long list of labs they want done with directions to fax them the results. This beharior will accelerate and they will focus more on being cathetiers. With all the money the cardiologists have been able to generate over that last 20 years they should be able to slide by a few more years. They will just dump more work back on the PCPs. In our area it is routine for them to send our mutual patients to our office with a long list of labs they want done with directions to fax them the results. This beharior will accelerate and they will focus more on being cathetiers.

]]> By: Doctor Dhttp://www.kevinmd.com/blog/2009/09/cardiologists-reimbursement-frustrations-primary-care-residents.html#comment-111654 Doctor D Fri, 11 Sep 2009 21:59:36 +0000 http://www.kevinmd.com/blog/?p=40037#comment-111654 I wish that Amy were right and "professional adults" never yelled at medical student.One of my more traumatic experiences in medical school was getting screamed at by a Cardiologist when I told him I was going to study Family Medicine. He was infuriated that I would waste my mind on such a career.Getting demeaned and yelled at by specialists is already a right of passage for primary care students. I wish that Amy were right and “professional adults” never yelled at medical student.

One of my more traumatic experiences in medical school was getting screamed at by a Cardiologist when I told him I was going to study Family Medicine. He was infuriated that I would waste my mind on such a career.

Getting demeaned and yelled at by specialists is already a right of passage for primary care students.

]]> By: docanonhttp://www.kevinmd.com/blog/2009/09/cardiologists-reimbursement-frustrations-primary-care-residents.html#comment-111641 docanon Fri, 11 Sep 2009 19:41:37 +0000 http://www.kevinmd.com/blog/?p=40037#comment-111641 Anybody who says that, just cut off his or her referrals. Easy enough.Don't forget who has the power here. Use it! Anybody who says that, just cut off his or her referrals. Easy enough.

Don’t forget who has the power here. Use it!

]]> By: anonymoushttp://www.kevinmd.com/blog/2009/09/cardiologists-reimbursement-frustrations-primary-care-residents.html#comment-111626 anonymous Fri, 11 Sep 2009 16:45:43 +0000 http://www.kevinmd.com/blog/?p=40037#comment-111626 Can you imagine the paperwork that would create. You would make a great well meaning beurcrat PICUdoc Can you imagine the paperwork that would create. You would make a great well meaning beurcrat PICUdoc

]]> By: PICUDochttp://www.kevinmd.com/blog/2009/09/cardiologists-reimbursement-frustrations-primary-care-residents.html#comment-111620 PICUDoc Fri, 11 Sep 2009 15:37:34 +0000 http://www.kevinmd.com/blog/?p=40037#comment-111620 Personally I don't think the answer is to pay less for these procedures. What will happen is that they will just do more procedures. I think the answer is to keep the pay for these procedures the same but change the indications for reimbursement. So if you don't meet certain evidence based criteria you don't get your cath paid for. (you can still get your cath, but not paid for with PUBLIC money). Now, I think there has to be some leeway since everyonce in a while someone will go outside the evidence based on experience or our gut. So you could say in a given year 90% of your procedures should meet evidenced based guidelines. Personally I don’t think the answer is to pay less for these procedures. What will happen is that they will just do more procedures. I think the answer is to keep the pay for these procedures the same but change the indications for reimbursement. So if you don’t meet certain evidence based criteria you don’t get your cath paid for. (you can still get your cath, but not paid for with PUBLIC money). Now, I think there has to be some leeway since everyonce in a while someone will go outside the evidence based on experience or our gut. So you could say in a given year 90% of your procedures should meet evidenced based guidelines.

]]> By: amyhttp://www.kevinmd.com/blog/2009/09/cardiologists-reimbursement-frustrations-primary-care-residents.html#comment-111605 amy Fri, 11 Sep 2009 12:19:39 +0000 http://www.kevinmd.com/blog/?p=40037#comment-111605 Oh please, these are professional adults who are mature enough not to take their frustrations out on students and understand doing so doesn't change the situation. Oh please, these are professional adults who are mature enough not to take their frustrations out on students and understand doing so doesn’t change the situation.

]]> By: Doc Stonehttp://www.kevinmd.com/blog/2009/09/cardiologists-reimbursement-frustrations-primary-care-residents.html#comment-111604 Doc Stone Fri, 11 Sep 2009 12:04:00 +0000 http://www.kevinmd.com/blog/?p=40037#comment-111604 And so the house of medicine falls. And so the house of medicine falls.

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