If your doctor is unhappy, your care will be compromised. Your doctor is frustrated and angry with your insurance company and Medicare for setting values on their services to you. Next time you see your doctor, give him a big hug, and tell him you understand his frustration and anger. Perhaps, as a solution, he might take an early retirement and get out of the new medical jungle.
WHY IS YOUR DOCTOR ALWAYS ANGRY
If your doctor is unhappy, your care will be compromised. Your doctor is frustrated and angry with your insurance company and Medicare for setting values on their services to you. Being conscientious, he spent more time with you and solved most of your health problems and avoided costly tests and referrals.
In the past, most doctors loved being a doctor. Today, your doctor spends more time fighting insurance and government agencies, and less time caring for you their patient. He is constantly staying late in the office taking care of mindless paperwork only to find your insurance company denies your payment.
A recent Aetna national survey and another in the Journal Health Affairs 2009, showed over two third of doctors feel the current Obama care environment is detrimental to the care they deliver and see the quality of their care will decline over the next five years. Eighty percent fell they can’t make clinical decisions based on what is best for you, but must base their treatment on what your payer is willing to pay. They overwhelming found getting reimbursed were getting very complex and burdensome.
Administrative constraints take over 3 weeks of their time and they spend $70,000 in extra staffing per year for all the interactions of the various health plans.
THE INSURANCE JUNGLE
Your doctor tries to avoid new Medicaid and Medicare patients because the government insurance programs have become a tangle of frustrating paperwork. Even an act as fundamental as writing a proper prescription for you is dictated by the variability in different services and limitations your insurance company places on you.
YOUR DOCTOR’S DILEMA
It is difficult for your doctor to give you the proper care for your particular coverage. Different drug companies have financial agreement between their plans. Only certain drugs are on your plan’s formulary of listed covered drugs.
Instead of spending time coordinating your care he must deal with formularies and obtain prior authorizations for everything he must do. He must get a prior ok from your health plan for a procedure, test, or referral. Asking over and over again, he must ask for permission to write out a prescription that he feels you need. None of these every day services are reimbursed or compensated.
In addition to seeing you (average 18 patients a day), he must answer numerous telephone calls (average 24 per day) from insurance companies, pharmacies, and referral doctors, answer emails (average 17 per day), refill your prescriptions (average 12 a day), review your lab tests results (average 20 per day), review Cat scans, MRI and X-rays (average 11 per day), review reports from other consultants, visiting nurses, physical therapists, and other doctors and hospitals (average 14 per day),
MALPRACTICE DILEMA
All good doctors practice defensive medicine today. Without any change in tort reform in the Obama care reform bill, your doctor does not want to embrace any of the new 32 million additional new patients that will consume a large amount of his precious daily time.
You enter the hospital with bronchitis, and your doctor will call in an infectious disease doctor to find what antibiotic would be best, a cardiologist to see why your chest hurts when you cough, a CT scan, and even a cardiac catherization.
Over testing becomes the standard of care. It is so ingrained that your doctor doesn’t even realize he is doing it. All equivocal tests lead to more tests. Any insignificant finding requires another study. They can’t miss anything anymore. No one wants to get sued.
These extra tests and procedures protect everyone against possible malpractice litigation. Besides, you the patient demand everything to be checked, and your doctor does not want to be perceived as a low quality doctor. This defensive medicine is the price we Americans must pay for healthcare.
Your doctor is now on a time clock. If he works for a hospital, they set the number of patients he must see daily, and the maximum time he can spend with you.
In California, to reduce unnecessary emergency room visits, the 21 million natives who have HMO plans will be assured their doctor sees them within 10 business days. If the patient says he has an urgent problem that does not require prior authorization, he must be seen within 48 hours. (Rules to go in effect this January.)
ELECTRONIC HEALTH RECORDS
You now see your doctor using his computer and not looking at you as he logs in and goes through a long series of screens with long lists of options. If e picks the wrong option, you get the wrong drug or test, and this might spell disaster.
This certainly distracts him and leads to a lower quality of care for you. Before he enters a medical order, you might want him to check if you have any drug allergies, but it becomes very unwieldy for him to ask every patient these basic questions.
The system is designed for great billing outcomes, not clinical outcomes.
Being frustrated with the new technology, your doctor may just call in his new employee, a newly certified nurse aide, who just finished a crash 3 month program after failing to find another engineering job. He will work out the bugs and take care of the details of your medical care. After all, the clock is ticking and your doctor must stay on the hospital schedule, or he may be looking for another job.
Next time you see your doctor, give him a big hug, and tell him you understand his frustration and anger. Perhaps, as a solution, he might take an early retirement and get out of the new medical jungle.
RELATED POSTS
Visit www.drneedles.com for more discussion of controversial medical issues and the use of complementary medical acupuncture as an adjunct to your western medical treatment.
No comments:
Post a Comment