Posted on 08/23/2014 1:34:04 PM PDT by Kid Shelleen
Dr. Sandeep Jauhar is mad as hell. American health care is in upheaval. On one side, overhead and malpractice insurance costs keep increasing, while salaries stagnate. On the other, patients believe that expensive drugs are better, more people are on government-run insurance that pays less, while private insurance fights every claim. Now doctors spend most of their time trying to game the system, requiring endless paperwork, protracted bureaucratic battles and “treadmill medicine,” seeing as many patients as possible in as little time. This problem will only intensify as millions join the ranks of the insured under the Affordable Care Act.
(Excerpt) Read more at nypost.com ...
Nailed it. I’m retiring as soon as I possibly can and will never look back
I remember when doctors really seemed interested in your health, one on one, so much so that they would come by your house to examine you and check on you, which also gave them the advantage of seeing you in your daily and natural environment.
Do I recall correctly that you are a hospitalist? Conditions untolerable even there?
“To hammer in this point, Jauhar quotes facts from the Commonwealth Fund: The US ranks 45th in life expectancy (“behind Bosnia and Jordan,” he adds) and compared to other developed countries near last in infant mortality and health-care quality, access and efficiency. We also have fewer physicians and hospital beds than average.”
Conservatives warned that ObamaCare would have a devastating impact on our nation’s health, but few understood just how devastating and how fast the results of ObamaCare would be seen.
Government needs to get the hell out of health care. Period.
“On the other, patients believe that expensive drugs are better . . .”
My experience has been the docs try to push the expensive pills to cure every ill during the 5 minutes allocated for a patient in today’s assembly line medicine. There is no time to evaluate symptoms, much less treatment alternatives. Plus patients taking multiple pills need to have a good pharmacist knowledgeable about drug interactions because the doctors and PA’s aren’t.
A doctor friend of mine says that the popular view that doctors drive Cadillacs is no longer true. “Now,” he says, they drive Tauruses.”
Yes and getting worse all the time.
Medicare keeps increasing demands for documentation and severity of illness and pushing everything towards obs stays. Not only does that kill the hospital, more importantly it leaves our patients out in the cold
There has to be a three midnight stay to qualify a patient for skilled nursing at DC, and they have to meet inpatient criteria all 3 days, or their rehab stay is on them, etc...
I spend more time keeping insurance companies happy and trying to play medicare/medicaid games than I do taking care of patients. And it breaks my heart when I can’t get around the insurance company to do the right thing for the patient. And ICD 10 comes out next fall....
We are rapidly headed toward single payor and the destruction of the best most innovative health care system in the world.
Then there is the pressure from the hospital to see more and more patients every day with fewer ancillary resources (nursing, PT wound care, etc) and by the way keep everybody happy so we get good HCAPS scores. I could go on forever.
This is what happens when you serve a system rather than a patient.
“Nailed it. I’m retiring as soon as I possibly can and will never look back”
Every doctor I know in their 50’s and even mid-40’s is looking to exit.
“The US ranks 45th in life expectancy (“behind Bosnia and Jordan,” he adds)”
A lot of this can’t be blamed on the medical industry. Those people, on the whole, certainly eat better (and less), and many more practice an ancient form of exercise called... “honest hard work”.
All spot on, but it brings up another point. Most groups whose income would be affected by changes in medical care had a seat at the table - except practicing physicians. This was, IMHO, for two reasons.
The first is because this administration doesn't like MDs. I have zero doubt about that. It's personal. The second is because the political drivers of all this knew that the group with the least power and ability to affect the political process were physicians. They didn't need to deal with them.
Pharmaceutical executives, insurance executives, administrators of large hospital systems, and even lawyers all had a seat at the table, and the way the law was written demonstrates this. Ironically, all of these groups, while trying their best to protect their interests, also got screwed in the process. They just weren't aware of it as much at the time, and some aren't aware of it now.
This leads back to your original comments about how the hospitals are pushing physicians. They are going to have a harder and harder time making ends meet, and in many cases, before they cut administrative costs they will cut services. They won't look upon it as cutting services, but it will be. Eventually, the number of 7 figure hospital administrators will decrease, but since they are the decision makers at this point, this will take awhile.
I grieve for medicine. When I got in to med school it was a dream come true, and I will always feel this way about my own life. That said, where we are in medicine today is very sad, and a world away from where thing were.
I grieve for what medicine was when I entered as well. I have a beautiful talented daughter who is a gorgeous classically trained ballerina with a near 4.0 at a rigorous academic institution that I cannot talk out of med school. She is in the application process as we speak. I wish I could talk her into something else where she will be happy, but she is as stubborn as her mother and father.....
Maybe her generation of physicians will turn this around. Who knows....
If things are that bad here, perhaps he should go home.
It will become like Cuba where female doctors become prostitutes because they can make more money at it.
My doc sees me for two to three minutes per visit and charges medicare for an “extended visit”, every time.
$130, medicare pays 80%, I pay 20%.
Those days are coming back. Just not for everyone. When doctors dump Medicare/Ocare and all forms of insurance and go on a cash-only basis, doctors won't have patients. They'll have clients. The best doctors will cherry pick the well-heeled paying customers and the rest of us can go to CattleCare. It's the only way they'll make money and do what they really want to do - treat patients.
My Wife agrees with everything you just said and she does go on forever about the BS coming down. The left destroys everything they touch.
I have been talking to docs in our field. All of them fly off to become hospitalists or connected with some corporation. No private practitioners anymore.
One doc today told me how he had to come in to work extra yesterday. He was so proud of his negotiating skills. He held out for 500 for four hours of work. Plus dictation. 125 per hour. I had to laugh. My friends were making 130 an hour in 1995 doing sys analysis and programming.
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