Jindal to cut reimbursement to physicians caring for medicaid... - Page 4 - TigerDroppings.com

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BBONDS25
LSU Fan
Member since Mar 2008
15876 posts

re: Jindal to cut reimbursement to physicians caring for medicaid...


He clearly wasn't referring to disabled persons in his first post. Your attempt to make it so shows the blaring weakness in your "argument".





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lsusaintsfan4life
LSU Fan
Member since Mar 2008
840 posts

re: Jindal to cut reimbursement to physicians caring for medicaid...


You have serious comprehension problems Wild. Just relax and read on.

It is not my problem if you (generalization Wild not you in particular) have made irresponsible decisions in life that have left you living in a bad situation. My group had to stop seeing medicaid patients after 23 years of providing a service to our fellow man. We were forced when we realized it was actually costing us money to see patients. Believe it or not, it costs money for me to provide my services.

My statement regarding working hard during college and making perfect marks were not directly at you but once again as a generalization of people. And you call me narcissistic?

I still care for multiple patients on medicaid but can only through a hospitalization. Look back at my words, I lost a lot of GOOD patients. I recognize that many people are in horrible situations through no fault of their own (Geauxs sis). I will do whatever I can to ease her situation. It is actually illegal for me to see medicaid any longer and my business could be shut down if I saw them in my office for cash. So I can't. I see a lot of patients for free as they do not have the ability to pay. My care never wavers and is alway top notch. Stop with the moanbitching and judgmental BS that you spew.






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Zach
LSU Fan
Member since May 2005
62853 posts

re: Jindal to cut reimbursement to physicians caring for medicaid...


quote:

Screw poor people.

Well, you've finally posted something I agree with. Medicaid should not exist. It's welfare. Welfare should not exist. It's theft.






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NC_Tigah
LSU Fan
Member since Sep 2003
50468 posts

re: Jindal to cut reimbursement to physicians caring for medicaid...


quote:

Screw poor people...and those who try to deliver health care to them (and are even forced too deliver care to them).
quote:

Look...I'm a doc...you're a doc. We're doing pretty well...so . . . . .

"Look...I'm a doc...you're a doc. We're doing pretty well"... so why should cuts in Medicaid bother you?
You're doing pretty well. Right?
The government isn't.

Why should taxpayers fund you when you're likely doing better than them? To each according to his need; from each according to his ability. You have a lot of ability. You have little need. Welcome to Obamamedicine, doctor.



This post was edited on 1/31 at 5:16 pm


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MDcajuntiger
LSU Fan
Denonvilliers' and parts outlying
Member since Sep 2007
998 posts

re: Jindal to cut reimbursement to physicians caring for medicaid...


quote:

Own them and tell the young woman to whom Geaux referred to take of herself. After all, it's not your problem, right?


To your opponents point, not all Medicaid patients are created equal. Even the most tender hearted/open minded amongst us would quickly realize that there are people abusing the system vs those with a true need. He is right, the great thing about our jobs is that the doctor gets to be judge and jury.


At the medical school I attended, there was a small sign in the corner of a small residents' conference room that read

"Some days there are just not enough hours in the day to the do the right thing"

There can be unintended consequences of "doing the right thing". Here is a quick real life example:

Surgeon who accepts Medicaid gets consulted by the busy hospital that has recently accepted the role of becoming the indigent care provider in the city. Said surgeon has to leave his busy clinic to see the consult in urgent/emergent fashion. The surgeon takes care of the patient in expedited fashion.

Consequences:

Surgeon may have to cancel/reschedule paying patients. Patients may become disgruntled and decide to see a different surgeon in town.

Consulting providers realize that few surgeons accept Medicaid, hence they are happy to send the bulk of their Medicaid patients and hospital consults your way (since it is very difficult to get patients in to good providers who see Medicaid).

Office of the surgeon gets overrun with the baggage of some of the Medicaid patients. Other strata of patients recognize this and distance themselves from the surgeon. Patients flee to another providers to avoid this hassle.

End result is the Medicaid accepting surgeon gets his practice overrun. His payer status shifts. He spends his days toiling in an inefficient manner for ever decreasing pay. Meanwhile his competing surgeons who have declined Medicaid patients are happily accepting his previously private pay/insured patients.

Medicaid surgeon's overall capital declines. He cannot support office staff that he may otherwise sustain. Overall office efficiency breaks down. Labs do not get followed as timely. Things get missed/overlooked. Patients do not get call backs. Lawsuits spring up from the litigious faction he has chosen to help take care because "it is the right thing".

Surgeon is unhappy/stressed 24/7 and his patients become the dog he kicks. At this point, his standing as a care provider is diminished in the eyes of his patients. Frustration ensues on all sides. Surgeon tries to compensate by seeing more people per day. Care gets crappier. Cycle continues...


I know lots of mental gymnastics are involved, but strangely, this is not far from the painfully sad truth. I do understand that other professions have stressful jobs and equal challenges. I am not trying to lament the hardships of MDs. The point I am trying to make is that if you had an option to make a volitional decision to avoid such exposure with a given profession, wouldn't you. There are very few among us who would not.

Another important truth. Money is important to physicians (shocking). The infrastructure for care that is expected by the public cannot be maintained without it.



This post was edited on 1/31 at 5:17 pm


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NC_Tigah
LSU Fan
Member since Sep 2003
50468 posts

re: Jindal to cut reimbursement to physicians caring for medicaid...


quote:

Surgeon is unhappy/stressed 24/7 and his patients become the dog he kicks. At this point . . .
At this point he needs to change fields
quote:

Money is important to physicians (shocking)
Sure, but if money influences quality or the nature of care provided, then the doctor should strongly consider a career change. The issue the doctor has is with government and government ripoffs, not with patients!

The scenario you describe is analogous to a man frustrated with his job and compensation, taking out those frustrations by beating his wife.
No excuse for that behavior.




This post was edited on 1/31 at 5:45 pm


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Diamondawg
Mississippi St. Fan
Mississippi
Member since Oct 2006
10734 posts

re: Jindal to cut reimbursement to physicians caring for medicaid...


quote:

but I guess they must not be EMTALA bound to treat Medicaid patient ED docs!
I didn't read the whole thing but I am guessing you don't know what EMTALA is, right?






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lsusaintsfan4life
LSU Fan
Member since Mar 2008
840 posts

re: Jindal to cut reimbursement to physicians caring for medicaid...


I disagree

I read this as a physician trying to do the right and noble thing getting sucked in and being worse for it. The harder he tries to help the "needy" the worse off he is.






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WildTchoupitoulas
LSU Fan
Member since Jan 2010
14584 posts

re: Jindal to cut reimbursement to physicians caring for medicaid...


quote:

It is not my problem if you (generalization Wild not you in particular) have made irresponsible decisions in life that have left you living in a bad situation. My group had to stop seeing medicaid patients after 23 years of providing a service to our fellow man. We were forced when we realized it was actually costing us money to see patients. Believe it or not, it costs money for me to provide my services.

My statement regarding working hard during college and making perfect marks were not directly at you but once again as a generalization of people. And you call me narcissistic?

That's a cop out. Look at the paragraph you wrote, to avoid taking it out of context:
quote:

While you were out having fun I worked 3 part time jobs and made straight A's. I paid for my pwn school. We both had opportunities and I chose to accept them and build upon them. There were 4 of us that grew up together. I'm the only one that got past 9th grade. Why? Because they didn't care. They took the easy way out.


"You" is not in the plural form, if it were, you would've said "We ALL", instead of "We both" which includes just you, lsusaintsfan4life, and I. Then you started talking about your siblings that you later refer back to with a plural personal pronoun - but it was third person. So you can tell me I have comprehension problems, but that's the way I see it.

And in light of this:
quote:

It is actually illegal for me to see medicaid any longer and my business could be shut down if I saw them in my office for cash.

...how can you assure me of this:
quote:

When your family member comes in and is in serious need. I will be there.

...?

You're just full of BS here.

I never said the medicaid system was perfect, I just called you out on some bull shite is all. You seemed to be coming in with a bunch of absolutes and presumptions. Maybe I got carried away, I apologize. The world seems a nicer place now that I sit on the front porch and sip a little toddy...






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BBONDS25
LSU Fan
Member since Mar 2008
15876 posts

re: Jindal to cut reimbursement to physicians caring for medicaid...


Stop whining.





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MDcajuntiger
LSU Fan
Denonvilliers' and parts outlying
Member since Sep 2007
998 posts

re: Jindal to cut reimbursement to physicians caring for medicaid...


quote:

I read this as a physician trying to do the right and noble thing getting sucked in and being worse for it. The harder he tries to help the "needy" the worse off he is.


You are correct. This was the intended message. Along with the fact that his patients are also worse off as a result.

NC Tigah points are correct also.

My group is in the process of no longer seeing new Medicaid patients. We will still see all comers in the hospital/ER setting (including no pay) as do most MDs across the country.

I just recently spent time looking at Medicaid patients I currently see that I will retain based on need and my experiences with them. I am even going to retain a particularly squirrely one that is so complex I am worried about her getting lost in the shuffle and having to start over from scratch with someone new (Tuberous Sclerosis patient with multifocal renal AMLs)






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lsusaintsfan4life
LSU Fan
Member since Mar 2008
840 posts

re: Jindal to cut reimbursement to physicians caring for medicaid...


Im not arguing with you bud. You got bent out of shape over your misinterpretation of my words. No problem.

I am both hard working and passionate about my practice and take it seriously. And I am there for anyone of need, regardless of ability to pay, that is hospitalized with an acute emergency. I applaud you for your hard work in the past and am glad that you are a giving person. I chose to give to those that I feel deserve a hand up not a hand out.

I am off to a dinner to further learn my field. Peace and love...






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WildTchoupitoulas
LSU Fan
Member since Jan 2010
14584 posts

re: Jindal to cut reimbursement to physicians caring for medicaid...


quote:

your misinterpretation of my words

w/e
quote:

I am both hard working and passionate about my practice and take it seriously.

I don't doubt it.
quote:

And I am there for anyone of need, regardless of ability to pay, that is hospitalized with an acute emergency...I chose to give to those that I feel deserve a hand up not a hand out.

I guess I just know too many people in need of medicaid and your comments made me wonder which of them might you consider weren't truly "needy" and yes, that bent me out of shape. Who are you to judge?

quote:

I am off to a dinner to further learn my field. Peace and love...









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NC_Tigah
LSU Fan
Member since Sep 2003
50468 posts

re: Jindal to cut reimbursement to physicians caring for medicaid...


quote:

his patients become the dog he kicks
quote:

I read this as a physician trying to do the right and noble thing
Really??






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lsusaintsfan4life
LSU Fan
Member since Mar 2008
840 posts

re: Jindal to cut reimbursement to physicians caring for medicaid...


Yes really

I practice parenteralism in medicine when needed. Sometimes I need to be a blunt, matter-of-fact jerk to get patients to take care of self. I have had alcohols vomit so much blood that it hits the side walls. I have banded varices and stopped it. When they wake up from their hepatic encephalopathy I show them their 3 year old daughter. And yes, people can actually "get it" occasionally.

So yes, really






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Waffle House
Virginia Fan
NYC
Member since Aug 2008
2177 posts

re: Jindal to cut reimbursement to physicians caring for medicaid...


I'm not sure why you expected him to take a cordial tone with you after you dropped into a conversation he was having with another MD and called him a selfish heartless bastard.






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MDcajuntiger
LSU Fan
Denonvilliers' and parts outlying
Member since Sep 2007
998 posts

re: Jindal to cut reimbursement to physicians caring for medicaid...


quote:

his patients become the dog he kicks quote: I read this as a physician trying to do the right and noble thing Really??


C'mon NC

Poorly worded on my part, but my point was that all parties involved were negatively impacted in the long run under the guise of "trying to do the right thing".






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Diamondawg
Mississippi St. Fan
Mississippi
Member since Oct 2006
10734 posts

re: Jindal to cut reimbursement to physicians caring for medicaid...


quote:

I practice parenteralism in medicine when needed. Sometimes I need to be a blunt, matter-of-fact jerk to get patients to take care of self. I have had alcohols vomit so much blood that it hits the side walls. I have banded varices and stopped it. When they wake up from their hepatic encephalopathy I show them their 3 year old daughter. And yes, people can actually "get it" occasionally.

I remember back in the day they treated varices with ironically, an alcohol sclerosing procedure and sometimes a Blakemore tube ?? and we would put a football helmet on the patient and tape the tube to the facemask so it would not move in the esophagus.






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NC_Tigah
LSU Fan
Member since Sep 2003
50468 posts

re: Jindal to cut reimbursement to physicians caring for medicaid...


quote:

I practice parenteralism in medicine when needed. Sometimes I need to be a blunt, matter-of-fact jerk to get patients to take care of self.
Parenteralism?
Chelation?
or TPN?

or advisor?

Whatever your intent, I'd guess patients becoming "the dog you kick" is not a part of parenteralism.

Is it?






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NC_Tigah
LSU Fan
Member since Sep 2003
50468 posts

re: Jindal to cut reimbursement to physicians caring for medicaid...


quote:

my point was that all parties involved were negatively impacted in the long run under the guise of "trying to do the right thing"
Absolutely.
And trust me, I'm extremely sympathetic.

But never at the expense of ""kicking"" patients.
Sorry!

Blame the government, if you'd like. Blame Insurance.

But do not blame patients who were told they had a pact with a payor






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