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Politics : Politics for Pros- moderated -- Ignore unavailable to you. Want to Upgrade?

To: skinowski who wrote (284373)	12/15/2008 2:59:38 PM
From: DMaA	Read Replies (3) \| Respond to of 793916

We have a friend, an endocrinologist of some repute here, who started a private practice in St. Paul some years ago. It is not going so well. They are on the verge of personal bankruptcy.

To: skinowski who wrote (284373)	12/15/2008 3:28:51 PM
From: SmoothSail	Read Replies (2) \| Respond to of 793916

A few years back, I thought I'd found the most perfect doctor. She was young, about 38, up on all the technology, caring, smart and direct. Then I got a call from her (she called everyone of her patients personally) saying she'd decided to become a hospitalist because the pay was better, she only had to work 8 hours, instead of the typical 14, and it gave her more time to spend with her family. A marketing/ad agency (that I sometimes do consulting for) caters to cardiologists and radiologists, who have had to become businessmen and market their services. As was stated by someone else here, most fees are determined by the Medicare models, and in the case of radiologists in particular, they are limited in what they can make. It used to be that most radiologists worked for a hospital, but because of the limitations on how much they can make, they are branching out and opening clinics. This means they are now in competition with the hospitals for the CT, PET and MRI scans that bring in a lot of money. The GP I have now recently added a CT and Ultrasound to his office and has a radiologist come in once a week to run that part of his practice. He said that most of the tests he runs are elective and not covered by insurance, but his patients opt for the tests anyway. A urologist we did a campaign for doesn't take any insurance anymore. Even adding to his fee after insurance paid, didn't work for him. His waiting room is full all the time. As is the case with any business or industry, if there are rules and regulations, people will find a way around them.

To: skinowski who wrote (284373)	12/16/2008 2:06:46 AM
From: KLP	Read Replies (2) \| Respond to of 793916

I've considered becoming more outspoken about all this, maybe write... maybe I will... but the impact that one guy (without bureaucratic leverage) can have... ain't great... :) Remember Helen Keller, skinowski! One person CAN do something...she showed us the way. You have worked on both sides of the medical/hospital issue as a provider, and probably, life being what it is, have been on the patient side of the issue too. Honestly, until this recent experience I didn't really realize what has happened to medicine today. My bet again is, MOST of the people in the country don't realize it either....as yet. What happened when I left the hospital, is that they were to do a procedure, and had planned for it for about 36 or so hours. 75 minutes before the procedure they told me (via the Big Gun Hospitalist who is the Co Founder of the Hospitalist movement around the country,) that since I wouldn't be having the surgery (guess that is how they termed the procedure,) I was to leave that day... What startled me is the way it was handled....I haven't given any thought at all to staying or going. I just wanted to be "fixed" or patched back together as soon as possible. We didn't make the choice to go the HMO route for several reasons over the years...the biggest one was here that Group Health was a big one, and didn't have a good reputation. It's better now, and a relative even worked in their hearing center for several years as a manager. She eventually left and wouldn't go back. (Early 1990's) During the Clinton years, insurance companies got really afraid because the government was issuing more and more mandates, so many insurance companies left this state (WA) as well as several other similarly quite liberal states. I've always wondered WHY we didn't have smaller hospitals, fewer large pieces of expensive equipment in EVERY hospital on every corner on pill hill.... We should have SMALLER hospitals with ALL types of equipment, and LARGER less acute care as an inbetween...These would be for patients who would be staying after their ICU, or Urgent care rooms, but still needed skilled care...just rooms for recovering that had nurses on duty. These would not nursing homes which are generally for people who will stay there for months, if not years. What I think I am learning from the past two weeks is.....We now seem have ourselves in a HMO type of operation, like it or not. The private care Docs are banding together in groups, and using the Hospital as their HMO emergency care center. The private care Docs are handing over their patients for urgent care, or critical care to Hospitalists they have never seen before, and that don't know them. Am I right in this assumption? Please consider writing your book.....Maybe the new medicine will be better than the old medicine....but how will anyone know when no stats are kept on people who are sent home. People die one by one....sometimes alone. Who will note they were home and fell down stairs because the drugs they were taking made them woozy.... On a happier note...remember the old days in history, where the ole Doc made home calls...people lived and died early sometimes, and life went on. Maybe that's where we are headed.