November 24th, 2010 by DrRob in Better Health Network, Health Policy, Opinion, True Stories
No Comments »
Hey there, big, smart, good-looking doctor…
Are you tired of being snubbed at all the parties? Are you tired of those mean old specialists having all of the fun?
I have something for you, something that will make you smile. Just come to me and see what I have for you. Embrace me and I will take away all of the bad things in your life. I am what you dream about. I am what you want. I am yours if you want me…
Seduce: verb [trans.] attract (someone) to a belief or into a course of action that is inadvisable or foolhardy : they should not be seduced into thinking that their success ruled out the possibility of a relapse. See note at “tempt.”
(From the dictionary on my Mac, which I don’t know how to cite.)
If you ever go to a professional meeting for doctors, make sure you spend time on the exhibition floor. What you see there will tell you a lot about our system and why it is in the shape it is. Besides physician recruiters, EMR vendors, and drug company booths, the biggest contingent of booths is that of the ancillary service vendors.
“You can code this as CPT-XYZ and get $200 per procedure!”
“This is billable to Medicare under ICD-ABC.DE and it reimburses $300. That’s a 90 percent margin for you!”
This is an especially strong temptation for primary care doctors, as our main source of income comes from the patient visit — something that is poorly reimbursed. Just draw a few lab tests, do a few scans, do this, do that, and your income goes up dramatically. The salespeople (usually attractive women, ironically) will give a passing nod to the medical rationale for these procedures, but the pitch is made on one thing: Revenue. Read more »
*This blog post was originally published at Musings of a Distractible Mind*
November 17th, 2010 by DrRob in Better Health Network, Humor, True Stories
No Comments »
I did a little “self care” earlier this week. I did it by not caring for myself. I went to the doctor.
I was sitting in the waiting area for my appointment and saw the mother of one of my patients. “Why are you here?” she asked. “I have a doctor’s appointment,” I replied. She got a curious look on her face, asking: “Don’t you doctors just take care of yourselves? I thought that was what doctors did.”
We do take care of ourselves. In fact, we do it far more often than we should. Being your own doctor allows for a lot of denial. When you spend your day advocating healthy lifestyles after you had trouble finding pants that would fit in the morning, denial is necessary. “Do as I say, not as I do.”
I realize that this is hypocrisy — that is why I was at the doctor on Monday. My patients have noticed my expanding waistline, commenting on it more than I would wish. Certainly my pants get in the way of denial as well, not forgiving the fact that I have been under a whole lot of stress. Pants don’t accept excuses.
So I found myself in the unfamiliar experience of being the patient. Instead of closing my mind and emotions to my own body, I had to frankly assess what I was doing to it. Standing on the scale was as frank of an assessment as I would ever want. Read more »
*This blog post was originally published at Musings of a Distractible Mind*
November 13th, 2010 by DrRob in Better Health Network, True Stories
No Comments »
I have taken on the task of writing 50,000 words for a novel in November (NaNoWriMo) and would have to carve time out of work or family [my posts are decreased by this new hat]. I can only wear so many hats.
But I am here, and my writing has been far more enjoyable than I expected. This is the time when it is easy to hit the wall (we get daily encouraging emails from successful writers to get us through this time), but I’m okay so far. I am writing about a doctor who encounters a very unusual patient. I am writing in the first-person, which was a good choice, as I know the first person of a physician intimately and stand no risk of getting those details wrong. Read more »
*This blog post was originally published at Musings of a Distractible Mind*
November 8th, 2010 by DrRob in Better Health Network, Health Policy, Opinion
No Comments »
“So, what do you think about the election?”
“So, what do you think about Obamacare?”
“What do you think about this healthcare situation?”
I get these questions throughout my day. My patients are mostly suburban and white, so their view is overall on the conservative side. Yet I have found that few see the results of the election as a hopeful sign for healthcare. I don’t either.
Anyone who reads this blog regularly knows that I am a “flaming moderate” when it comes to politics. I don’t have much faith in anyone who identifies too strongly with one party of the other. I am really angry with congress and their lack of gonads to work on really coming up with solutions. Interestingly, my patients, regardless of their political leaning, agree with much of what I say. Here are the things they all seem to agree with:
1. Congressional politics is hurting us. Members of congress (both sides are equally guilty) are more focused on what is good for their party than what is good for those who they represent. If a democrat is elected to this district, I expect him/her to represent all of the people in that district, not just the democrats (the same is obviously true for republicans). This doesn’t mean they must lose all of their ideology, but ideology should be a means, not an end. The reason to hold an ideology is to come to solutions to problems with that ideology as a vehicle. The goal is to help the people you represent through your ideology, not bang them over the head with it. Read more »
*This blog post was originally published at Musings of a Distractible Mind*
November 2nd, 2010 by DrRob in Better Health Network, Health Policy, News, Opinion
1 Comment »
The top vote-getting answer on my poll about what people feel about the election: Different lunatics, same asylum. We are getting jaded by our system. Being the “flaming moderate” that I am, I find it hard to hear the substance of the rhetoric on either side, just the shrillness and rancor of the voices.
From the physician’s perspective, it is very hard to know who to favor in this election. The democrats seem to love lawyers and hate tort reform, and they also favor an expansion of government. The republicans love big businesses and “free market,” accepting the bad behavior of insurance and drug companies as “the market working itself out.” They both seem hell-bent on sticking it to the other party at the expense of getting anything done — and this in a time of crisis for our industry.
The results of this playground brawl between the two gangs of bullies is that all of us wimpy kids (the ones without power) end up lying bloody in the dirt. Here are the facts as I see them about healthcare in our country:
1. It costs far too much. The top item on the agenda needs to be cost control. The only way to control cost is to stop paying for things that are unnecessary or for which there is a cheaper alternative. I know that’s not simple as it sounds, but so much of the discussion is about coverage and how things are paid, while the real issue is not who pays, it’s what and how much gets paid. Read more »
*This blog post was originally published at Musings of a Distractible Mind*
