Texans do the right thing
Texans narrowly pass Prop. 12. If you are not familiar with Prop 12, read RangelMD – Regarding proposition 12; Trial Lawyers = Roaches
15 minutes
Wow! I wish that I had written this piece. Kudos! I’m Sorry, Your Illness Is Coded for Only 15 Minutes. Please read the entire article. Here is a taste:
Whatever happened to simple doctoring? For me, and for many other physicians I know, it has evolved into a complex balancing act, impossible to pull off, as we try to give patients the care and attention they need while struggling to maintain income and personal time under a host of new pressures. Sometimes it seems as if everybody is losing out. And with Medicare poised to lower doctors’ fees an additional 4.2 percent in 2004, it’s only going to get worse.
The daily squeeze hit me hardest the morning I saw a likable 68-year-old patient of mine waving at me through my waiting-room window. I’d been treating him for years, but he didn’t have an appointment and I barely recognized him with his newly bald head, yellowed skin and shaking hands. My office staff wanted to turn him away because the day’s schedule was already packed, but I sensed his desperation and made time for him. In the examination room, he told me that his oncologist had informed him bluntly that his cancer had spread and then dismissed him. I was the man’s internist, his gatekeeper to the medical world, and he had returned to me – not for expertise, but for warmth.
I ended up spending an hour with him and told him that he could come in again any time, with or without an appointment. And I felt good about this – until the swelling crowd in the waiting room reminded me that my other patients had what in their eyes were equally important problems and equally urgent claims on my ever-shrinking time.
The pressures are fierce for doctors to compromise their professionalism, their humane instincts, for business reasons. The Medicare Payment Advisory Commission suggested last year that the United States needs a payment system that more accurately reflects doctors’ rising costs. Most doctors would agree. While it is true that we still make a decent living, at the same time we must hire more and more staff members to handle certifications, pre-certifications and referrals while also accepting lower payments. And with the new fee reduction almost certain to filter down from Medicare to the HMOs the way such reductions have done in the past, it will become increasingly harder to stay level.
This is powerful stuff. I rant about these problems regularly, but this article really does a great job of explicating the problem. Oh, and did I remind you to please read the whole article?
