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Why Would Any Doctor Accept Medicaid? - Better Health

Why Would Any Doctor Accept Medicaid? - Better Health | the treating physician | Scoop.it
Better Health is a network of healthcare professional blogs, offering commentary on news, research, health policy, healthcare reform, true stories, disease management and expert interviews.
Diane Haugen's insight:

As this article so plainly demonstrates, Medicaid reimbursement for physicians is less than minimum wage.

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Fixing our broken health care system: Sometimes David wins

Fixing our broken health care system: Sometimes David wins | the treating physician | Scoop.it
You couldn't invent a worse health care system than the nightmare we have created in the U.S.
Diane Haugen's insight:

We've long known the combined political clout of the medical-industrial complex has destroyed rational health care.  Dr. Allen Frances provides nice overview of the problems unholy alliances bring to the U.S. health care system.

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Dr John M

Dr John M | the treating physician | Scoop.it
cardiac electrophysiologist, cyclist, learner
Diane Haugen's insight:

O.K., O.K., you may be tired of hearing my chant that check list medicine can't measure value.  It's always nice to find who someone agrees with you.

Dr. John Mandrola: "There is a lot of talk about rewarding value in US healthcare. Don't believe any of it. It's not happening. Not even close. This is a post about the real world–where I practice medicine...."

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Letter From One Of Our Readers | Authentic Medicine

The above picture is of Dr. Grady Snyder.   I saw this article and knew it was something you'd be sure to be interested in. Primary care is highly ...
Diane Haugen's insight:

Where has the care in "healthcare" has gone.

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Delusional Thinking

Jurist reports that the North Dakota House of Representatives passed SB 2368, the so-called "fetal pain" bill and it is expected that the governor will sign it.
Diane Haugen's insight:

Legislators practicing medicine without a license.

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Ex-Practitioner | Authentic Medicine

Ex-Practitioner | Authentic Medicine | the treating physician | Scoop.it
Here is a nice piece from the Wall Street Journal.   For those that can't read the link, here are some highlights: But never have I seen so many good ...
Diane Haugen's insight:

The many reasons your friendly family practice physician is now raising Christmas trees.

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Blaming Physicians for High Cost of Health Care

Blaming Physicians for High Cost of Health Care | the treating physician | Scoop.it
I've written before on this blog about the propensity to blame physicians for the never-ending spiral of our health care costs.
Diane Haugen's insight:

Douglas Farrago, M.D., on his Authentic Medicine blog suggests a number of reasons it is so easy to blame physicians for the high cost of health care.

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ACOG on North Dakota’s Legislation | The Treating Physician

Diane Haugen's insight:

Remove the physician from medicine and what you get is...

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The only religion that my patients see me practice is medicine

The only religion that my patients see me practice is medicine | the treating physician | Scoop.it

It came to my attention that a medical student was refusing to have anything to do with contraception as it was against her religion.

 

 

 

 

 

 

 

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How You Can Help ProPublica Investigate Health Care Quality

How You Can Help ProPublica Investigate Health Care Quality | the treating physician | Scoop.it
Be part of the patient safety conversation, get regular updates and share stories or views...
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Walk Away From The Table | Authentic Medicine

Walk Away From The Table | Authentic Medicine | the treating physician | Scoop.it
The single most powerful tool for winning a negotiation is the ability to walk away from the table without a deal. Harvey Mackay in Swim With The Sharks...

 

Having just written a lengthy post on the draconian reimbursement policies of insurance companies and Medicaid and Medicare, I couldn't resist adding this assist from Authentic Medicine.

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Our Health Care System Wastes $750 BILLION Per Year

Our Health Care System Wastes $750 BILLION Per Year | the treating physician | Scoop.it

WASHINGTON (AP) — The U.S. health care system squanders $750 billion a year.... Once again, a litany of where the money goes, but very unhelpful suggestions as to how to fix the problems, such as "For doctors, it means getting beyond the bubble of solo practice and collaborating with peers and other clinicians."

 

Anyone who suggests corporate physicians cooperate with non-corporate physicians has not been in the trenches.  It's the fast disappearing independent practitioner -- the treating physician, if you will -- who has the ability to provide the kind of patient care the reformers put on the pedestal. Yet these same reformers seem unaware of what corporate medicine has done to derail the very kind of physician care the report idolizes, but then labels those who provide this kind of care a "bubble of solo practice."

 

The problems are obvious.  Clearly, the solutions are not.  There is no real admission on the part of health care reformers as to what has acutally caused these health care problems.  Only "bubbles" of fantasy which bear little cause and effect relationship to the proposed solutions.

 

Corporate medicine makes decisions based upon the bottom line.  Before the derailment of real health care by corporate medicine, physicians made decisions about patient care with the best interest of the patient in mind, not the bottom line.  As long as health care decisions are controlled by the bottom line, denying needed health cannot be avoided. 

 

There is no escape from denying needed health care, whether it's called rationing or socialized medicine, if the decision is controlled by the bottom line.

 

Let's not abandon health care reform, but let's stop trying to force the bottom line to do what it cannot do -- to operate in any fashion which would allow physicians to make medical decisions in the best interest of their patients. 

 

 

 

 

 

 

 

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The journey from family practice to urgent care

The journey from family practice to urgent care | the treating physician | Scoop.it
I left Maine to come to Virginia to work in an urgent care center. It was not how I pictured myself when I trained to be a family doctor 18 years ago.
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How 10 leading health systems pay their doctors

Available online 16 December 2014 Note to users: Corrected proofs are Articles in Press that contain the authors' corrections. Final citation details, e.g., volume and/or issue number, publication year and page numbers, still need to be added and…
Diane Haugen's insight:

There's a common notion that physicians respond to offers of money.  Money drives them.  But when administrators try to devise ways to pay extra for "performance," that is, rushing patients through the encounter to show how "efficient" they are, and at the same time somehow tack on to this notion that quality of care improves, most physicians can see the emperor has no clothes.  The big question is why those regulating health care can't see this.

 

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Dear hospital information technology staff… | EdwinLeap.com

Diane Haugen's insight:


ERs run 24/7. Any EMR should have 24/7 tech support to be called an EMR, much less installed in a hospital.

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I’m feeling like a broken record on pay for performance | The Incidental Economist

I’m feeling like a broken record on pay for performance | The Incidental Economist | the treating physician | Scoop.it
UPDATE: Edited cause I totally misread an indicator! This time it's obstetric quality metrics. "Association Between Hospital-Level Obstetric Quality
Diane Haugen's insight:

Once again Aaron Carroll of the incidental economist notes the need for relevant quality measures in those rewards for good outcomes.

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The Illusion of Control

Politicians really don't represent their constitutents when they sink into the practice of gatherieng their votes with single issue legislation.

Diane Haugen's insight:

 http://www.thetreatingphysician.com/2013/04/21/the-illusion-of-control/

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Comedy From The North Dakota Capitol Building

Comedy From The North Dakota Capitol Building | the treating physician | Scoop.it
North Dakota's top politics and media website.
North Dakota's most influential political blog.
Diane Haugen's insight:

North Dakotans can't touch the state's oil fund, only investment counsellors.

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Again, Justice William O. Douglas Said it Best

I raised the issue in my first post quoting Justice William O.
Diane Haugen's insight:

Discrimination in granting unemployment benefits in North Dakota.

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Playing Chicken with the Supreme Court

Playing Chicken with the Supreme Court | the treating physician | Scoop.it
I can't claim the title here of playing chicken with the Supreme Court. This is Joanna Grossman's phrase in her post "What's the Matter with North Dakota and Arkansas?" but I thought it well worth repeating.
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The Legislative Can-Can

Dr. Jen Gunter\'s comment noting the irony of North Dakota\'s stance on abortion and smoking is well taken...I have never seen the amount of smoking in a general population that I see every day in North Dakota.  Especially among young...
Diane Haugen's insight:

Perhaps it's too much to look for consistency in legislative decisions, but reasonableness might be a goal worth emulating.

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You’re Not Like Them | Authentic Medicine

You’re Not Like Them | Authentic Medicine | the treating physician | Scoop.it

Dear Doug,

I just wanted to write to you about the medical profession from the viewpoint of an outsider. True, I have an MD degree and have worked for years mostly in urgent care, but I admit that I don’t fit. I have officially been told that.

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The Fallacy of Treating Health Care as an Industry

The Fallacy of Treating Health Care as an Industry | the treating physician | Scoop.it
The Institue of Medicine calculates that the U.S. system wastes $750 billion annually, but the practice of medicine and approaches to reform are uniquely immune to standard economic analyses.
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The Best Way to Bring Down Health Care Costs

The Best Way to Bring Down Health Care Costs | the treating physician | Scoop.it

Justin Graves talks about collection agencies, out-of-network physicians and dentist charges and suggests consumers need more help in learning about the pitfalls and proactively preventing bad results.  The difficulties he experienced should be corrected, but they are not problems which health care cost transparency can fix.

 

Problem #1: Collection Agencies.

 

These are out of control, with little regulation so consumers have little protection of downright felonous activity. Even if a consumer can, with great effort, demonstrate that a charge cannot be collected, the collection agency can peddle the debt to another agency and the whole process starts all over again. It's called "flipping."  Trust me.  I have  had the same uncollectible erroneous debt recycled over ten times in a five year period, and there is no protection from this kind of harassment.  It should be outlawed by the states, since regulation of collection agencies is left to individual states.

 

Problem #2:  Advance Knowledge of Fees.

 

Any discussion of health care costs needs to clearly distinguish between the fees dentists charge and the fees physicians charge. 

Dentists fees are much freer of the "adjustment" physician fees undergo by insurance companies, Medicare, and Medicaid.

 

Mr. Graves says upfront pricing should be mandated.  It doesn't need to be mandated.  Call any physician's office and  you can find out the cost of a visit.  The physician's receptionist can also tell you whether the practice is an "in-network" provider for that insurance company. If the practice is not in the network, your own insurance company can tell you what the cost will be.

 

If you have insurance and are an in-network provider, that $170 charge (Mr. Graves doesn't tell us what the price of the office visit was) would be "discounted" by the insurance company by as much as 50 percent.  That is, the physician has signed an agreement to take whatever that insurance company pays to be an in-network provider.  The physician cannot charge the patient for that discount.  The physician has to eat it.

 

Add this to the Medicare notion that rural providers can provide health care for much less than urban providers, and you get urban physicians paid significantly more than rural physicians for the very same care, and still discounted for that 50 percent.

 

So, of that $170 charge, had the physician of Mr. Graves been in the insurance network, the cost of the visit could have been reduced to as litle as $95.  If the physician practiced in a rural area, the $170 charge would likely have been considered too high, and the insurance company would have reduced the price of the office visit before cutting the reimbursement to the physician.

 

There are more and more physicians who are refusing to join insurance networks because if they do not, they can charge what it actually costs to provide that office visit, and the patient has to pay the difference. Because dentists are less wedded to insurance companies than physicians, dentists often are able to collect the full cost of their care from the patients.

 

While it's true the cost of health care in this country is too high, transparency of costs does not recognize the very real, very serious dysfunction introduced into our health care system by insurances, Medicare, and Medicaid physician reimbursement practices.

 

Health care reform will remain ineffective until these draconian reimbursement practices are put on the table and addressed.

 

 

 

 

 

 

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Diminishing primary care leads to excessive health spending

Diminishing primary care leads to excessive health spending | the treating physician | Scoop.it
Health care spending is overwhelming America’s economy, but the subtler truth is that this excess has been largely facilitated by subjugating primary care.
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