As the reality of MACRA (Medicare Access and CHIP Reauthorization Act of 2015) looms, the pressure is on small practices to survive. CMS plans to penalize 87% of solo physicians and reward bonuses to 81% of practices with more than 100 physicians. It is time for passive resistance, defined as protesting against a law using peaceful methods such as refusing to obey or refusing to leave a building. I vehemently refuse to leave the building.
My county with a population of 260,000 has NO psychiatrist. Not one. Many states all over are experiencing the same provider shortages. Can you grow psychiatrists somewhere at an accelerated rate, like that clone army in Star Wars, and drop them randomly by plane throughout the United States? That would be a good start. They could be raised to believe indentured servitude is their destiny.
We should pay physicians for time spent engaging patients in conversation, instead of rewarding them for checking boxes on a computer screen. Physicians were trained to care and comfort people, not chase blood pressure numbers and pain scale scores. Changes masquerading as meaningful have only increased physician workload. We are widgets in the ever expanding assembly line. Do you think the MIPS will give us more time to practice medicine? If you believe it will, then I have a bridge to sell you.
In my humble opinion, that type of communication provides tremendous value. Paying more to a physician who provides services that benefit patients directly is a metric worth tracking. If physician and patient can work together by rowing in sync on the same boat, maybe we could get those in control of the healthcare system on board with us after all. Medicine is not a one-way road. You are spot on about that.
Compensation at the “Big 5” ranged from $10.1 million for Humana’s CEO to more than $66 million for the CEO of United Healthcare in 2015. CEO compensation for Anthem, Aetna, and Cigna also fell within that range. Affordable health care has definitely helped people. But who exactly are we trying to help? I am not convinced it is the children growing up in America today.
Influenza is the seventh leading cause of death in children under the age of 14 in the United States. Illness can be life-threatening and needs to be taken seriously. A flu vaccine is developed each year to keep up with the ever changing strains that are circulating. This year 2015-2016, the strains circulating match the vaccine accurately. Last year 2014-2015, the vaccine was less than 50% preventative. I hope you find this information helpful.
A man called our office this week and asked what WE charge for co-pays. What the what? Copays and deductibles are what YOUR insurance requires you to pay according to your contract. They consider it “your investment” in your health care. We were asked the other day whether the copay really makes a difference in our bottom line. You bet it does! It makes up a significant portion of total income for our business and keeps us afloat.
While swiping our credit cards to fund this atrocity known as Maintenance of Certification, maybe your group could take a few moments to streamline your rigid and archaic application process? It is not exactly rocket science or is keeping track of so much money simply too exhausting?
Let us go back for a moment to ponder this ingenious idea of using an index card as a medical record tool. Low cost, top quality medical care is the Holy Grail for which everyone in the field of medicine is searching. Is it conceivable we already found it, used it for more than a century, and abandoned it in light of its simplicity? Possibly.
I believe in parent choice and do not believe in mandates when discussing healthcare. Patients must have autonomy. I use an alternative vaccination schedule when my vaccine-hesitant families request it. Mine evolved over time to complete most of the required vaccinations by the time a child is 2 years old. It is not “evidence-based”, the catchphrase we use to say something is scientifically proven safe and effective. However, it is rooted in something I value highly as a pediatrician – trust, open communication, and compromise.
