May 15, 2012 Recent News

Physicians

Hospitals

Healthcare

Physicians

The Association of Medical Colleges has announced that there will be an increase in medical school admissions to raise graduates by 30% by 2016.  This is to have more physicians to care for the increase in patients if Obamacare is deemed legal.

Medscape reports that physicians now in practice are growing more frustrated and are having lower incomes currently.  They believe, probably rightfully, that Obamacare, if legal, will decrease incomes further by the use of bundled payments, etc.  The percentage of physicians in the 24,000 polled that would choose Medicine again has dropped 14% since 2012.  Those that saw the greatest decrease in income were general surgeons. Males continue financial dominance over female physicians due to the types of medical field chosen and work life balances.  Physicians is private group practices earn the most followed by solo physicians and bringing up the rear are employed physicians.  Physicians have more and more paperwork.  Now over 1/2 of physicians spend over 10 hours a week on non-productive paperwork. The physicians have said 2/3 to 1/3 that they will not reduce the amount of tests ordered in order to conform to insurer guidelines.  Only 3% currently are in ACOs with an additional 5% to join in the coming year.  

About a month ago I had an insurance company call me to make sure my information was current and this happened again today by Humana.  When I asked why they are calling they said so their patients could get appointments.  I explained that their negligence in their databases was one of the reasons I retired in 1997.  Where have they been for the last 15 years?        Top

Hospitals

Last newsletter I spoke about Carolinas HealthCare System actively suing patients for non payment of bills  and getting home liens.  Now the NAACP and other like organizations are "telling" the system to stop suing patients.  Carolina will continue doing what they are doing, collecting money for debts owed.  

If you haven't heard Minnesota is going after Accretive Health, a Chicago based company, that works for hospitals in the state collecting money.  Now Chicago's new mayor Rahm Emanuel, is asking the Minnesota Attorney General to stop the investigation.  The Attorney General basically told Da Mayor to butt out.

In another VA scandal, there seems to be at least one a year, the nurses are being investigated.  This follows patient deaths in two different states.  The nurses in a Manhattan hospital did not know what would happen if a patient became disconnected from a heart monitoring machine.  The same poor nursing was the cause of deaths in Denver.  On investigation there was poor nursing knowledge in almost all areas of the hospitals.  The VA will now insert competency training.  Just al little late.  

Over 80% of hospitals in the country are not meeting the EMR goals.  This speaks volumes about the electronic medical community.        Top

Healthcare

Patients have no say as to whether they are admitted to a hospital or are on observation.  They don't even know the difference.  I am not convinced that physician know the consequences of the decision which is heavily influence or dictated by the hospital.  The major difference is if they are Medicare it is either covered by Part A or B.  If it's hospital and Part A the medications are covered as part of the admission.  If it is observation it is under outpatient and Part B.  Here meds are not covered and the bills may be very high.  The USA Today article about this emphasizes the hospitals charge their outrageous prices for these meds and the patient has to pay.  A patient can be in the hospital on observation for several days.  When they get out they have never been told they were not actually hospitalized and will be responsible for the 20% physician co-pays and all the meds at very high fees.  Even Part D may not cover all the meds given to them in the observation unit of the hospital.  Hospitals use this to increase revenue and to get away from the inpatient DMGs of Medicare.

In something good started by President Bush and expanded by Obamacare, the patient outlay for pharmaceuticals has decreased.  The doughnut hole is slowly closing and more meds are now generic. 

The law of unintended consequences has reared it's head in the CMS ruling curtailing blood boosting drugs has led to a significant increase in blood transfusions in dialysis patients.  This is almost as expensive and much more dangerous for the patient as the medications.        Top                           

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  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.