Thursday, April 17, 2008

What Savior?

Where will all of the primary doctors come from? Serious question – not rhetorical. Despite the assuagements from various people that the PCP is and will be filled by foreign medical graduates who’ll be more than happy to work in rural environments, I’m concerned.

For instance, many of the senior foreign residents in the Medicine program at my hospital are talking about taking hospitalist jobs when they finish. I’ve yet to hear one who has discussed going into private practice.

Not one.

And why is that? Because docs are greedy, money-grubbing, unethical whores, worshipping the almighty dollar in a gluttonous orgy of padding profits and ordering unncessary exams while Rome burns (or something)? Or is it because the government, that same government that plans on swooping in and “saving” American healthcare, is actually the etiology behind all of this?

Think about it. Medicare is the main stimulus for insurance reimbursements for everything from major to minor insurance companies. “Do as I’m doing, follow, follow, me” should be the mantra of Medicare as they cut payments and dare docs to retaliate. Private insurance companies take heed, and follow similar cut backs in payment - rather than acknowledging that their reimbursement schedules are messed up.

So congress, rather than being smart about cost-effectiveness, believes that in order to balance their budgets (oxymoronic term if ever there was) they have to pay hard working doctors – who've spent more than a decade getting an education – less and less. We're now seeing the deliterious effects that years of this foolhardy maneuvering has caused; removing office-based, primary care out of resident’s minds.

Further insult comes from beauracratic nonsense that, while not completely government controlled, is basically just a few votes shy of becoming part of the FDA or some other monolithic entity. Of course I’m speaking of the idiocy known as JCAHO and all of the ridiculous limits and strangleholds they place on patient care disguised as “safety measures” which only leaves the physician spending hours digging through minutia and dead-ends in order to "meet standards".


Yet, millions of Americans are being dupped into believing that they must have universal coverage in order to get healthcare – and they’re buying it hook, line, and sinker. It has taken center stage over most every other consideration during the recent campaign speeches. The economy? Iraq? Ha, mere annoyances compared to this impending "disaster".

It infuriates me to see people who are highly qualified physicians avoiding the work that their residency was initially designed towards. I don’t bemoan them. Hell, I’d being doing the same thing. What I find sickening is the idea that the government will fix this. That the good ol’ US of A can be saved by lawyers and career politicians who know as much about medicine as they’re able to maintain party neutrality and an open mind. Ha.


Anonymous said...

As a mere frugal, elderly non-medical citizen who would no more expect free or lower-paid treatment from a doctor than I would demand free or cheaper groceries from the local markets, I absolutely agree with you. The insurance companies and Congress are all bloodsuckers, cheating doctors and hospitals, meddling in medical decisions for the citizens.For what it's worth (not much because they too easily buy votes from nincompoops) I've told my reps in Congress I'll vote against anyone who supports Medicare cutting payment to doctors.

Old MD Girl said...

The problem is, if you pay doctors little enough, all the smart people will do something else. Not universally, but enough so that a lot of people will get a lot worse care.

tracy said...

i love my Internest....really kind, listens, takes the time, ....etc. Did i mention he is also ..."cute"...? i don't know how he does it all...but i'm glad he does and i let him know how thankful i am for him. Now, watch him go become a hospitalist, like the last really wonderful Internest i had did...sigh.

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