September 23rd, 2011 by BobDoherty in Health Policy, Opinion
Tags: Anxiety, Disrespected, Doctors, Economy, Income, Jobless, Jobs, Laid Off, Over-managed, Overworked, Physicians, Poverty, Robert Samuelson, Salary, Stability, Underpaid, Unemployment, Washington Post, Well-compensated
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Many physicians, and especially primary care physicians, aren’t happy campers. Why should they be? They feel disrespected, overworked, over-managed, and underpaid. They tell me they wouldn’t advise their children to go into medicine. Some feel that physicians are singularly beset upon. “Our government acts toward the medical profession in an abusive fashion. No other industry or profession is humiliated in this way,” writes RyanJo, a frequent commentator to this blog.
I can appreciate why many physicians are upset. They’ve had a decade where the Medicare SGR formula repeatedly has threatened to cut their fees, only to have Congress enact last minute reprieves that replace the cut with a small token increase that has not kept pace with their costs. Last year, Congress actually allowed the cut to go into effect and then retroactively restored it, creating havoc in physicians’ offices during the four weeks when they weren’t being paid. Like Charlie Brown and Lucy’s football, they are told each year by their members of Congress that that “this will be the year when the SGR will finally get repealed, really, for sure, we promise, this time will be different”–only to see it pulled away at the last minute.
In the meantime, they are constantly hounded to be more accountable for the care they deliver, to fill out just another form, to document their encounters, to get Read more »
*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*
September 22nd, 2011 by Happy Hospitalist in Health Policy, Opinion
Tags: Accountability, Concierge Hospital Plan, Costs, Employers, Health Insurance, Hospitals, Insurance Premiums, medicaid, Medicare, Reduced Pricing, Special Amenities
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Ask yourself this question: Would you pay 20-30% less in insurance premiums if it meant you were locked into one hospital system for your health care? I would. That’s what one hospital system in Massachusetts is offering to provide. It is, essentially, a concierge hospital plan. You or your employer will pay a set premium, which the hospital is offering at a 20-30% discount, and you get all your health care needs in their system, only going to a competing hospital system if they are unable to provide your necessary services.
What a great idea. In fact, it’s an idea I have thought about previously for Happy’s hospital. Why shouldn’t Happy’s hospital offer direct premiums to large and small business employers in our city in exchange for reduced pricing? I’d sign up. My health insurance premiums cost over $12,000 a year. In the eight years of my practice, I’ve probably sent over $100,000 to health insurance companies and realized less than $10,000 in expenses.
It’s a concept who’s time has come. In fact, direct concierge hospital plans also offer patients and their employers the opportunity for tiered pricing for special amenities (flat screen television service, pet therapy dog service, dialysis spa, designer ostomy covers, wine vending machines, free soda machines, gourmet cookies, closer parking, door-to-door service, and 24 hour special access to their physicians and nursing staff).
No more worries about Read more »
*This blog post was originally published at The Happy Hospitalist*
September 22nd, 2011 by Elaine Schattner, M.D. in Opinion
Tags: Busy Schedule, Convenience, Diet, Education, Exercise, food, Health Benefits, Healthy Eating, Healthy Lifestyle, Lifestyle, Long Hours, Med Students, Medical Education, Nutrition, Physician's Lifestyle, Physicians, Residency, Stress
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Last week I wrote a simple post on eating yogurt with fresh fruit for lunch. It wasn’t until later that I realized why it’s a medical lesson.
It happens that yesterday morning I was up and out early. I saw a former colleague walking along the street. He’d gained weight, and walked slowly. I thought about how hard he works, and what a good doctor I know him to be. And yet any citizen or patient might size him up as heavy, maybe even unhealthy.
The problem is not that he’s uneducated or can’t afford nutritious foods. He knows fully about the health benefits of losing weight and exercise. The problem is the stress and long hours of a busy, conscientious physician’s lifestyle.
When I worked as a practicing doctor and researcher at the hospital, I rarely ate a nutritious breakfast or lunch. My morning meal, too often, consisted of Read more »
*This blog post was originally published at Medical Lessons*
September 22nd, 2011 by Jessie Gruman, Ph.D. in Health Policy, Opinion
Tags: ABIM Foundation Forum, ABIM Medical Professionalism Blog, Advertising, Bargain Shopping, Beliefs, Doctor Patient Relationship, Experience, Health Care Reform, Jessie Gruman, Lower Cost, Medicare, Motivation, New Responsibilities, Patient Participation, Patient Protection and Affordable Care Act, Uncertainty, Uwe Reinhardt, Variability
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Every day in the U.S. countless experts discuss plans and policies to contain the cost of health care using words and concepts that run counter to our (the public’s) experiences with finding and using care. Most of us ignore the steady stream of proposals until one political party or the other crafts an inflammatory meme that resonates with our fears of not getting what we need. At which point, we leap into action online, in town meetings and in the voting booth. As Uwe Reinhardt noted in his Kimball Lecture at the recent 2011 ABIM Foundation Forum, researchers and policy makers “cannot even discuss the cost-effectiveness of health care without being called Nazi(s).”
Our discomfort with the array of private and public sector proposals to improve health care quality while holding down costs should not be surprising. Most of us hold long-standing, well-documented beliefs about health care that powerfully influence our responses to such plans. For example, many of us believe that:
… if the doctor ordered it or wants to do it, we must need it.
… talking about less expensive treatments makes us feel that others are trying to bargain-shop our care and that scares us.
… clinical care does not vary much among our own doctors and hospitals.
… when we talk about the “quality” of health care we are referring to Read more »
*This blog post was originally published at Prepared Patient Forum: What It Takes Blog*
September 22nd, 2011 by Dinah Miller, M.D. in Opinion
Tags: Abby Goodnough, Alprazolam, benzodiazepines, Controlled Substances, Dose, Drug Abuse, Drug Supply, Halt, Ms. Mink, New York Times, Prescriptions, Psychiatry, Psychology, Public Clinics, Seven Counties Services, Stimulants, Xanax
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I’m posting this because Roy fell asleep at the wheel and missed the Xanax article on the front page of yesterday’s New York Times. In “Abuse of Xanax Leads a Clinic to Halt Supply,” Abby Goodnough writes about a clinic where they’ve stopped prescribing Xanax because to many people are abusing it. Goodnough writes:
“It is such a drain on resources,” said Ms. Mink, whose employer, Seven Counties Services, serves some 30,000 patients in Louisville and the surrounding region. “You’re funneling a great deal of your energy into pacifying, educating, bumping heads with people over Xanax.”
Because of the clamor for the drug, and concern over the striking number of overdoses involving Xanax here and across the country, Seven Counties took an unusual step Read more »
*This blog post was originally published at Shrink Rap*
