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re: Gotta Love Doctors Offices
Posted on 9/10/22 at 12:08 am to Chipand2Putts
Posted on 9/10/22 at 12:08 am to Chipand2Putts
quote:
should run much more like the airline industry,
I think the trend is more towards the TEM(Threat, Error, Management model) than the airlines per say, it's my understanding that at least hospitals are adopting this model
quote:
A 777 is the same in Charlotte as it is in Atlanta or Chicago?
when it's static yes, after brakes released, not so much
quote:
Will you at least concede that humans are more highly varied and imperfect than machines?
absolutely, but what you docs seem to be implying is "let me do my doctor thing and let the chips fall where they may," as if some miracle has been performed, all of the ultimate responsibility for all of the ancillary stuff really falls under who is in charge, the job isn't over when the procedure is complete, got to tie up all loose ends
1
Posted on 9/10/22 at 12:14 am to Chipand2Putts
quote:
I’m not sure what med schools teach business management.
when I was at LSU the law school and med school had business-oriented courses for just this reason
quote:
Did flight school include scheduling and baggage service?
willing to bet I could do a pretty good job of either
Posted on 9/10/22 at 12:15 am to Chipand2Putts
quote:Because paying more money is how you turn "NO ONE" into someone. And paying more again is how you get rid of someone shitty and get someone less shitty.
NO ONE wants to do their job, so why pay a premium?
Don't you get what you pay for?
Posted on 9/10/22 at 12:20 am to 777Tiger
I don’t know much more about what doctors or pilots do than what I read on the internet or see on tv or movies.
I’m lead to believe that both are highly trained and highly competent, some more than others.
Both have to deal with tons of mind numbing (to them) shite and a few very tense moments. These moments are highly unpredictable.
Most want to run a tight ship and serve their customers (or patients well).
But most doctors have as much say in their daily schedule as a pilot does in theirs’. They just show up and do their job.
I’m lead to believe that both are highly trained and highly competent, some more than others.
Both have to deal with tons of mind numbing (to them) shite and a few very tense moments. These moments are highly unpredictable.
Most want to run a tight ship and serve their customers (or patients well).
But most doctors have as much say in their daily schedule as a pilot does in theirs’. They just show up and do their job.
Posted on 9/10/22 at 12:22 am to Chipand2Putts
quote:
They just show up and do their job.
pretty much
Posted on 9/10/22 at 12:28 am to Korkstand
This is a fine argument if everyone is paying
Many patients in most practices aren’t paying
And most GP, fam med, peds, OBGYN, would not survive without these patients that aren’t paying. These are public health services funded by state and federal government. hospitals with icu, nicu, trauma, and other highly specialized services would not exist without federal funding.
The job of most physicians would be much easier if they only had to take care of people who really cared about their health and well being, or people that cared (or even had the means) to pay for their services.
Many patients in most practices aren’t paying
And most GP, fam med, peds, OBGYN, would not survive without these patients that aren’t paying. These are public health services funded by state and federal government. hospitals with icu, nicu, trauma, and other highly specialized services would not exist without federal funding.
The job of most physicians would be much easier if they only had to take care of people who really cared about their health and well being, or people that cared (or even had the means) to pay for their services.
Posted on 9/10/22 at 6:56 am to TDFreak
The fee for service payment structure is the problem with healthcare in this country. It is the root cause at every single issue we have. Every. Single. One.
Posted on 9/10/22 at 7:07 am to tigerfoot
quote:
Quit taking medicaid.
You have the option of concierge medicine.
Posted on 9/10/22 at 7:15 am to LSUfan4444
quote:
The fee for service payment structure is the problem with healthcare in this country. It is the root cause at every single issue we have. Every. Single. One.
Nah. Third party payments for standard office visits and routine medications + legislation around that has done it.
Quality metrics and “quality” payments do very little to improve actual care of patients. They push a lot of paper around and create more administrative hoops and sort of pull the rug out from under the small, independent folks to get them on the corporate medicine teat, because they can add layers of bureaucracy to push the papers around, tack on “facility fee” charges, add very little value to care, and increase the cost of everyone.
I say this as someone who has remained independent and gotten pretty decent paydays for my “quality” as well. And the quotes aren’t to say I don’t deliver care that is high quality. I say that because it’s a matter of clicking buttons that are generally meaningless and things I (and most of us) were doing anyway.
Posted on 9/10/22 at 7:29 am to Hopeful Doc
The only thing quality metrics have done is prop up the billion dollar EHR industry
Posted on 9/10/22 at 7:34 am to Chipand2Putts
quote:
The only thing quality metrics have done is prop up the billion dollar EHR industry
Nonsense. It also created a new middle man - the ACO, which is an additional billion dollar industry.
Posted on 9/10/22 at 7:36 am to Hopeful Doc
The only way FFS can work is by limiting the amount of providers, systems, hospitals. It's abused, overused and a feeding ground for the scum of the earth to charge for necessary services. With provider and patient payments tied to health outcomes and not services provided primary care providers who actually were successful with quality metrics (and not just "doing it" but actually successful at it) would make more money and work less with a healthier patient population.
Posted on 9/10/22 at 9:31 am to LSUfan4444
quote:
With provider and patient payments tied to health outcomes and not services provided primary care providers who actually were successful with quality metrics (and not just "doing it" but actually successful at it) would make more money and work less with a healthier patient population.
Peoples health I would think is ultimately largely on the patient. In people with diseases that aren’t due to their poor lifestyle they would tend to be very sick and have poor outcomes.
So you are basically incentivizing doctors to treat patients who aren’t really sick
Posted on 9/10/22 at 9:40 am to TDFreak
quote:
Gotta Love Doctors Offices
Why do they schedule appointments at 8am when the doctor doesn't get there until 9? My kids' pediatrician did that, which explained why I always had to wait well over an hour every time I went at 8, even when I was the first one called in the waiting room.
But they had a sign saying if you were 15 minutes late, they cancelled the appointment and still charged you for the visit.
Posted on 9/10/22 at 10:42 am to Marciano1
quote:
Why do they schedule appointments at 8am when the doctor doesn't get there until 9? My kids' pediatrician did that, which explained why I always had to wait well over an hour every time I went at 8, even when I was the first one called in the waiting room.
But they had a sign saying if you were 15 minutes late, they cancelled the appointment and still charged you for the visit.
OK!!! I'll fess up. It's because we can! Doctors don't get the pay, respect or drug company benefits of years past. It's our passive aggressive way of spreading the love. I'll even stand outside looking in the window at someone checking their watch. I usually start in the room right by where I park, so they can hear me rumbling up. Sometimes we even make eye contact through window. If they give me arse eyes, they get to wait 10-15 more minutes. If they don't, they still get to wait the same time, but I smile when I come in the room.
Posted on 9/10/22 at 11:06 am to gumbo2176
quote:
I get the first available appointment I can get and being retired
If you're retired take the latest appointments. Working people don't need your old arse slowing down rush hour traffic in the morning and taking up an appointment slot when they need it so they can get back to work.
Posted on 9/10/22 at 11:08 am to Korkstand
quote:
So the ones who show up have to pay for it with their time wasted?
Liberal policies in a nutshell.
Posted on 9/10/22 at 11:37 am to Hopeful Doc
Wow, late to the party on this thread but it’s been super interesting from start to finish. The interesting thing is that both sides in this are right. We docs can be terrible time and business managers AND there are so many things related to good care that prevent us being on time. Just yesterday I had to reschedule some patients and had some more urgent wait because I had a surgery take 3 hours longer than planned. I apologized to everyone and did not have one complaint. I think it’s because I’m still independent and have tried hard to have good relationships over the years. I think people for the most part really want to work with us docs and mutual respect is the key. You can’t really get to this point if both parties don’t do the work to foster the good relationship. I don’t charge for no shows but will discharge repeat offenders. Fee for service is not the problem, third party payment and corporatized medicine is. Don’t think I could practice in a corporate walk in clinic or ER where there is no chance to create that relationship. One thing I know is that it is going to get worse before better for both patients and docs. Keep the faith!
Posted on 9/10/22 at 12:46 pm to TDFreak
No necessarily defending MD’s being unable to manage their business, but I will say many times it’s out of their control.
In the hospital, often a surgeon has to schedule an urgent case, but the surgery schedule is full. We sometimes find a gap and say, for example, we have an opening at 2:00. Then they say, “damn, that’s right in the middle of my office schedule.”
To which we say, “how urgent is this case?” Then they say ,”fine. I’ll take it.”
If it’s truly emergent, they get a cut.
In the hospital, often a surgeon has to schedule an urgent case, but the surgery schedule is full. We sometimes find a gap and say, for example, we have an opening at 2:00. Then they say, “damn, that’s right in the middle of my office schedule.”
To which we say, “how urgent is this case?” Then they say ,”fine. I’ll take it.”
If it’s truly emergent, they get a cut.
Posted on 9/10/22 at 1:08 pm to Tigers0891
quote:
If you're retired take the latest appointments. Working people don't need your old arse slowing down rush hour traffic in the morning and taking up an appointment slot when they need it so they can get back to work.
You can kiss my old crusty arse. Just because I'm retired doesn't mean I have nothing better to do during the day.
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