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A survey by LocumTenens showed that if universal health insurance is initiated 11% of the 1400 physicians interviewed would change professions and another 9 % would retire. Therefore the profession would lose about 20% and there would be a major healthcare physician shortage. This is a warning to government officials that they must take into account physician reaction to reduction of their autonomy and income earning potential.
The Boston Globe had a letter to the editor regarding primary care and the way the patient is treated due to the understaffing. The writer talks about the crowding of patients which stress out the physician and the long waits which do the same for the patient. The writer had some feel good answers with nothing concrete to say.
A VA physician in Texas that oversaw a post traumatic stress disorder wrote an email to those under her stating that they should make more diagnosis of adjustment disorder instead of PTSD since they don't have the time to do the necessary tests for PTSD. The VA repudiated the email and reprimanded the physician. This is not politically correct, morally correct nor medically correct. The email was leaked to the VoteVets.org.
Dick Armey, the past House minority leader, wrote an oped article in the Wall Street Journal regarding the Republican party response to health care. He recommends the party act like Republicans and fight for consumer choice, individual responsibility and provider competition. He especially went after the Democrat in Republican coats, Senator Grassley who has done more capitulation on healthcare than anyone else.
The Wall Street Journal called the People's Republic of Massachusetts' medical law the "new big dig". The editorial flails the law as not being universal as promised and is of course well over budget. The article finished by saying how thankful the country should be to see how not to do health care.
The Boston paper had an article the next day saying how the increase in their "insured patients" have caused a major problem with no primary care physicians able to care for them. Some patients have to go to clinics in other towns or wait almost a month for an appointment.
An article in the Wall Street Journal states rightfully that physicians do not know health charges. It also details how the physician must play the 5 digit game just to get paid. As an aside I was at a meeting recently when the presenter stated that the hospital we were at asked an uninsured patient who needed radiation for cancer treatment for $95,000 up front for the hospital. The physician was willing to treat for free. I suggested that the patient present to the emergency room where the only way his bleeding from the tumor could be stopped and the patient stabilized was to do radiation under EMTALA. Following the treatment the parties could negotiate payments.
The Wall Street Journal also had a story on the exodus of physicians to Texas due to tort reform. It talked about the bogus silicosis and asbestosis claims that were made and how now only well under 1% have made it to court due to the need for pulmonary function testing.
CMS has started only accepting NPI for its claims. The problems have started with physician claims being denied even though the correct numbers are in place. Others denied because a middle initial was not used. The normal denial rate is approximately 6%. The rate is now 24%. For Medicaid it went from 4% to 26% rejection rates. For Blues it doubled from 3% to 6%. There are some states that still don't have the processes in place to take care of these claims.
The British Health Service has barred ties, long sleeves and jewelry including fake fingernails. This is to help prevent disease transmission. The US says Bah Humbug. There is no evidence that ties that are almost never cleaned carry germs and hand washing cures everything.
In Czech it costs about $1.85 to see a physician or for a prescription and about $4 a day for a hospital room. Too much. The Czech court will rule on the fee soon. A fee was already overturned in Hungary, where bribery of physicians is the rule. The Czech's do admit they spend much more on their pets than they do for themselves. Since the copay has been in effect there have been a large decrease in prescriptions and physician visits.
The Czech High Court has backed the government's right to charge copays for healthcare. Top
The physicians of the People's Republic of Massachusetts are getting feisty. The physicians at Beverly Hospital have taken a vote of no confidence against its CEO, Stephen Laverty. They are frustrated by his management or lack of same over many years. This was an accumulation of lack of communication with the medical staff. The owner of the hospital states the CEO has their backing which means either he changes or he's out. The CEO must get input from the medical staff when they make significant changes and Laverty didn't. The same thing happened at two hospitals in California, Community Health in Ventura and John Muir in Walnut Creek, both with physician uprisings and executive mud. John Muir then decided to cancel its Pediatric contract but didn't tell the physicians until the day after the contract expired, even though the contract had a 30 day clause. This left one of the two hospitals with no pediatric ED backup and the other hospital that does the OB with no pediatrician to see the unassigned newborns without volunteers. This tells alot about their thoughts of quality of care and their ethics.
The Florida Hospital System of 7 hospitals and 5 outpatient offices has signed a contract for a new exclusive radiology group. Part of the new group includes part of the old private group that provided the services to the system since 1968. They had no meeting of the minds in the recent contract negotiations. The system is currently stating the change will be seamless however they do not have enough radiologists at present to cover all the bases. Those remaining with the private Florida Radiology Associates will hope to contract with other hospitals and providers.
The CNA has lost a hospital. The nurses at St. Agnes Hospital in Fresno, California has rejected the union by a fairly wide margin. This is unusual for the activist organization.
The Wall Street Journal has a report on "nocurnalists". These are the physicians than man the hospital during the night shifts where most of the poorest results derive. The article ends with the statement that the patient should never accept being told that there is nothing we can do at this hour. It states that this includes going to the CEO in the middle of the night.
St. Agnes Hospital of Fresno, California has stopped its elective cardiac surgical program due to postop infections. The stopping was voluntary while the state investigates the cause.
The Marion, Illinois, VA is again doing surgery but only minor outpatient ones. The surgeries at the facility stopped in 2007 after a high death rate was found. Later reviews showed problems with quality management, credentialing and leadership. Top
The South Carolina Medical Society is fighting the Medical Board over the Board's decision to place on it's web site the med mal payments going back seven years. This, the physicians rightly say, is unfair since physicians would not have settled cases if they knew the settlements would become public. They have no objections to the information being placed on the site going forward. There is a state law that requires the Board publish physician med mal histories but exactly what is to be published is left to the Board. It should be noted the Board has been the subject of public scorn by an organization that only cares about numbers and not accuracy.
Texas physicians are not buying into the EMR product. About 1/3 are now using some form of EMR but about 1/4 want no part of it due to unreliability, cost or insufficient benefits. Only 1/3 of those that are using EMR report are very satisfied, another 45% are somewhat satisfied and the remaining 20% were dissatisfied. Not a glowing recommendation.
Aetna's pact with physicians stopped last year. They voluntarily extended it one year and have now stated that physicians may leave the network with no cause and a 90 day notice along with continuing to allow billing for 120 days post service. The insurer also pledged that there would be no all-product or gag clauses and would continue to use the current medical necessity definition. Top
DISCLAIMER: Although this
article is updated periodically, it reflects the author's point of view at the
time of publication. Nothing in this article constitutes legal advice. Readers
should consult with their own legal counsel before acting on any of the
information presented.