March 13th, 2010 by DrRob in Better Health Network, Health Policy, Humor
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AUTHOR’S NOTE: I am very frustrated with a system that increases cost dramatically and yet reduces what I get paid. The rest of the money is going somewhere, and since it is not improving the overall quality of care, it is mostly waste. We are enamored with MRI scans, stents, and expensive cancer treatments, with little to show for them except increased expenses and a lot of third parties getting rich off of this waste: drug and device manufacturers, medical imaging companies and other para-healthcare industries. This story, which originally appeared at Musings of Distractible Mind, is prompted by my frustration with waste and how it spurs unneeded health care delivery.
Once upon a time there was a land on the ocean. The people lived off of the food from the ocean and were very happy. But as they grew bigger, they had a problem: They made a lot of waste! Yuk! Nobody likes waste. What could they do about all of this that stuff that nobody needed? Read more »
*This blog post was originally published at ACP Internist*
March 7th, 2010 by DrRob in Better Health Network, Health Policy, Humor
1 Comment »
Chaos theory – Noun – The branch of mathematics that deals with complex systems whose behavior is highly sensitive to slight changes in conditions, so that small alterations can give rise to strikingly great consequences.
Alternative definition:
Chaos theory – Noun – The branch of healthcare that deals with making the payment system increasingly complex and ever changing. This complexity and confusion impact physicians and patients in such a way that appropriate services in care of the patient are subject to rules and regulations that are deliberately complex, making alterations from the momentary rules inevitable. This exists so that even small alterations will free the insurance company from the responsibility to pay for said service.
I am no physicist, but I honestly think that a grasp and understanding of the first type of Chaos theory is more likely than that of the second. Let me give a demonstration of the second chaos theory in action: Read more »
*This blog post was originally published at Musings of a Distractible Mind*
March 2nd, 2010 by DrRob in Better Health Network, Humor
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People are asking for more physical exam posts.
People asked for more Millli Vanilli too. People aren’t always smart.
But you ask, I give. I am just that kind of guy. It’s been a long time (since October) since I have done a post on this subject. So for all of you “newbies” out there (I just wanted to use that word and sound like a nerd), I want to give you a recap of what I have already done on the physical exam. That way people who have not inflicted upon themselves read the old ones can get all caught up. To be honest, this is one of my favorite series as well. Or is that “serieses?” Where’s Grammar Girl when you need her? Read more »
*This blog post was originally published at Musings of a Distractible Mind*
February 26th, 2010 by DrRob in Better Health Network, True Stories
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“He gave me the look,” the patient said to my nurse as he walked out of the exam room.
My nurse laughed and said, “I had a feeling you’d get it today.”
What were they talking about? ”What look? I didn’t know I had a look!” I asked my nurse.
The patient tipped his chin down and looked at me over his glasses. My nurse laughed, pointing at the patient, “That one! Exactly! You give that look to me too!”
I was mystified. I don’t like lecturing people or acting like their parent. Patients do no harm to me when they gain weight, don’t take their medications, or eat a lot of Little Debbies. My job is not to get them to do everything I say, it is to give them enough information and motivation to do it for themself. I am the coach; they are the ones who have to go out on the field and play. I may be disappointed when they mess up, but it’s not my job to patronize them and wag my finger. Read more »
*This blog post was originally published at Musings of a Distractible Mind*
February 17th, 2010 by DrRob in Better Health Network, Health Policy, Opinion
6 Comments »
I am going to state something that is completely obvious to most primary care physicians: I do not accept Medicare and Medicaid patients because it is good business, I accept them despite the fact that it is bad business.
In truth, I could make that statement about insurance as a whole; my life would be easier and my income would be less precarious if I did not accept any insurance. If I did, I would charge a standard amount per visit based on time spent and require payment at the time of that visit. This is totally obvious to me, and I suspect to most primary care physicians. A huge part of our overhead comes from the fact that we are dealing with insurance. A huge part of our headache and hassle comes from the fact that we are dealing with insurance. Read more »
*This blog post was originally published at Musings of a Distractible Mind*
