Posted on 03/28/2014 5:34:06 AM PDT by afraidfortherepublic
I have never been a VA employee physician, but have treated hundreds of veterans through contract services with the VA. Unfortunately, my observation is that the VA system is an example of socialized medicine at its worst. What normally takes days in private practice routinely takes weeks or months at the VA.
It’s not just doctors being screwed.
About a third of hospital nurses’ time is spent on documentation, rather than patient care. Obviously you need documentation - medications and care given, patient actions and condition, but a third of the time is ridiculous. This is not counting unpaid time - new nurses, and nurses who were swamped by a high patient load or events often spend two or three hours after their shift finishing up their documentation. Don’t even try to get paid, you’ll be told how you need to be more efficient, get written up, lose your job. So, there are some super-efficient nurses, and there are nurses who will cut what corners they can out of patient care, and go home at 730.
My guess is that at least half of medical costs in this country are for the paperwork alone. Insurance companies like to boast that 85% of their fees go to patient care. But the hospitals and providers take that 85% and spend a huge chunk of it on insurance paperwork, government paperwork and CYA.
You have your aides and techs being screwed - 14.50 an hour for soul-draining, back-breaking work. Can’t find Americans for that? Lots of Jamaicans, Africans, Filipinos in the world.
Patients screwed of course. Taxpayers screwed.
Everyone being screwed except for hospital and insurance administration, lobbyists and politicians and government workers.
You're lucky he's still taking insurance...
In the 4 doctor office I’ve been going to for years two of the m have decided to retire this year and once has gone into administration.
I have worked in hospitals/medical laboratories for decades. The number of tests we receive are being cut (don’t ever believe that wellness tests are growing)and our reimbursement for the tests we are still getting is being cut. Obamacare is a total disaster. I am truly afraid our medical infrastructure will be unsalvageable when Obama finally exits the national stage......if we can ever pry him out of the WH.
Similar strategy: Shrink in solo private practice in underserved area, end of career boutique practice, but still mostly take commercial insurances, and no EMR - now, or ever, for multiple financial and patient-care reasons.
My specialty is one in which one can still work late into life, and one in which one continues to improve over the years by gaining more and more of the subtle knowledge one needs to do it well. But I’m considering several early retirement options, and will certainly quit once they force me into the EMR.
Local VA and possibly military hospital work here may see me through for a few more years, but my main strategy if I just want semi-retirement for a few more years will be to go back to locum tenens work, which I did, and enjoyed, when I was much younger. Between overall attrition for better-paying or more respectable specialties, there are few of us shrinks left now, so demand and compensation for locums docs is high in this specialty.
“I just got a letter from my cardiologist who is,as it happens,a senior staff member at one of the world’s most famous hospitals.In short,the letter stated that due to financial pressures brought about by OsamaObamaCare,he’s forced to charge each of his patients a $1,500/yr “retainer” fee (my word) in addition to the standard insurance reimbursements and co-pays”
If he is a MediCare Participating Physican your cardiologist is also going to be Department of Corrections #32123445. He will be doing jail time as “retainers” are illegal under MediCare rules and most state administered MediCaid regs
As it happens some of my kin are physicians.
They claim over 90% of Medicare/aid could be done at NO CHARGE if there were no paperwork. They would be ahead.
The ophthalmologist tells of a simple procedure that cost less then $10 but only 80% + effective spray; replaced by a better(?) $1000 procedure 90%+ effective but requiring a direct injection to the eye. A multi course treatment often abandoned and sadly they go blind!
Everything figured in;time, sterile gowns, equipment...they receive about half of cost.
The Affordable Care Act is not affordable and not about care.
It is meant to destroy the insurance market forcing socialized medicine and to make PA people standardized and unionized and make most of the care a treatment menial wok by unionized clinical workers operating under an “if code 17-2356b apply compress #7 “ type standard of care.
Medical care as we knew it is going away.
” Unfortunately, my observation is that the VA system is an example of socialized medicine at its worst. What normally takes days in private practice routinely takes weeks or months at the VA.”
I was Chief Medical Resident at a V.A. in the early 1980’s, and you are right.
But in spite of their inefficiencies, if I introduce a bit of excellence into one small part of the system and benefit patients to whom we owe much, I would be satisfied.
Obamacare bump for later......
Or perhaps he is being careful about entering his findings/treatment information because he has to sign the government forms.
My understanding is that the AMA does not represent most doctors, that only about 15% of doctors belong to the AMA.
For that $1500 retainer fee, he could see patients every three months in the office and not have to deal with insurance companies except for exacerbations.
If he has 500 patients that he sees four times a year, on the average, that’s 2000 office appointments, nice long half-hour appointments. He needs an office manager, a medical assistant/tech, salaries and benefits rent, equipment, insurance, training - which should take up about half that $750,000 a year. That leaves half his time or more for hospital income.
Concierge practices that also charge co-pays - that take on the expense of dealing with insurance companies when they don’t have to - it seems to defeat the purpose AND to be a patient rip-off. My opinion.
(Malpractice insurance apparently is not that expensive in most states, see this article: http://truecostofhealthcare.org/malpractice)
Ours did the same thing, only it is $1800 per year.
My doctor did the same thing but they are not calling them retainers. Mine joined an organization called MDVIP. If you want to be a patient of his under this organization it is $1800 per year on top of insurance.
My Disgust-O-Meter is pegged out...
Most doctors loathed Obama. The AMA only represents about 25% of docs and they are the academics and admin types.
I went Galt and am practicing overseas.
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