July 13th, 2011 by Stanley Feld, M.D. in Better Health Network
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The primary stakeholders in the healthcare system are patients and physicians. The incentives for patients and physicians to save money are non existent. The secondary stakeholders have taken advantage of non existent incentives to create a healthcare system that generates ever increasing costs.
Patients and physicians are the only stakeholders that can control costs. They initiate the use of the healthcare system’s resources.
Healthcare costs for medical procedures such as an MRI or CT scan have been found to vary by as much as 683% in the same town, depending on which physicians patients choose, according to a study by Change: Healthcare.
The implication is that individual physicians are responsible for the differences. Most physicians do not own MRIs, CAT scanners or PET scanners. Secondary stakeholders own the equipment. They price the procedures and profit from the equipment, not the physicians. Read more »
*This blog post was originally published at Repairing the Healthcare System*
May 5th, 2010 by SteveSimmonsMD in Better Health Network, Health Policy, Humor, Opinion, Primary Care Wednesdays, True Stories
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In medicine, hardly a week passes without the introduction of some new acronym, previously unspoken in the average practice, which then grows to prominence — take HIPAA, PECOS, CPT, ICD, etc. — the list goes on and on.
I believe that after 14 years of practice I’ve earned the right to introduce an acronym of my own: CRAPP. For the last several months, my partner and I have used this term to describe the volumes of denials, pre- and prior- authorizations (is there really a difference?), and faxes that seem to grow like weeds on the fertile planting grounds of our desks.
More specifically, in our office the acronym CRAPP stands for: Continuous Restrictive And Punitive Paperwork. To put it blithely, CRAPP could represent any document you wish someone had put on your partner’s desk instead of yours.
On a more emotional level, this acronym captures the visceral response I have whenever my attention is drawn away from my patients and redirected towards some nonsensical busywork — much like someone yelling at a golfer during their backswing.
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April 5th, 2010 by Stanley Feld, M.D. in Better Health Network, Health Policy, Opinion
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By Stanley Feld MD, FACP, MACE
Physicians in practice work hard and have little time for political and legal trickery. They assume their leadership will look out for their interests while they take care of patients.
The problem is that physicians do not have effective leadership, explaining the difficulties practicing physicians have every day with the healthcare insurance industry, hospital administrators, the government and the threat of liability. Most physicians are caring professionals who are not looking to rip off anyone. Physicians do expect reasonable compensation commensurate with their training, level of expertise and level of responsibility.
I recently presented a physician income survey to a group of corporate executives. The executives were astonished by the level of physician income relative to their level of responsibility.
The unanimous reaction of these corporate executives was the average physician’s income was that of a low mid-level manager. It is true some practice specialties earn more but the average income of practicing physicians is not commensurate with their knowledge and responsibility. Read more »
*This blog post was originally published at Repairing the Healthcare System*