Wow-Doctors dumping practices because of Barrycare
- Thread starter gulfshorespoke
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I am a practicing physician and I recall being involved in a thread a year or two ago with somebody bloviating about how happy we should all be that the new trend in healthcare would have us heading more and more in the direction of the VA model. Someone who has trained and worked in that system was obviously not as enlightened as the great statisticians that the proponents on this board were and are. The truth on the VA comes out and silence rains from these experts.
The system is in deep trouble. I have never seen physician discontent at the level it is now. People have a tendency to believe doctors are all just greedy or whiny because we will make less. It goes far beyond this. I have adapted my billing practices for fear of Medicare and Medicaid RAC audits which you can never win. They scare you into under billing for already poorly reimbursed service as a way to cut reimbursements indirectly. I had a chart audited and had 4 other physicians review it to tell me what level of care they would have billed. Guess what, everyone of the 4 said the same coding level I billed and Medicare still refused to pay the claim because of a single word I used in my documentation. I now don't even bother. Probably leave 30k on the table every year because I don't want to fight it.
I'm sick of the whole system. I gave up my entire 20's and early 30's either studying all day and evening and then spending most waking hours in various hospitals training so I could carry a loan debt the size of a nice home loan and now it seems the pie just gets smaller and smaller.
If I had another skill set other than the one I spent so much time learning and going into monster debt for, I'd change my career in a heartbeat.
I think the bottom line is that most docs are stuck. Someone who has been in practice 38 years can afford to walk away. The majority of us can threaten but at the end of the day I can't find another job that will at least allow me to pay my debts and have some quality of life financially.
I do believe you will continue to see fewer exceptional candidates attending medical school when they way the cost. If a person can see themselves doing nothing but practicing medicine then so be it. Thank God for those kids. The wave of mid level provider care is here and growing. I have no I'll will towards mid level providers other than the fact that I spent about 4 additional years getting priceless hands and eyes on experience that can't simply be replaced. A monkey can write a rx for a sore throat and be right most of the time. What they can't do is remember or recognize that something just doesn't look or feel quite right and follow their instinct that only is gained from countless hours and patient encounters. The care is not and will not be the same. Most people won't care because they won't recognize it until it's to late to turn back.
I need a tums.
This post was edited on 9/22 3:08 PM by Sherman Klump
This post was edited on 9/22 3:09 PM by Sherman Klump
The system is in deep trouble. I have never seen physician discontent at the level it is now. People have a tendency to believe doctors are all just greedy or whiny because we will make less. It goes far beyond this. I have adapted my billing practices for fear of Medicare and Medicaid RAC audits which you can never win. They scare you into under billing for already poorly reimbursed service as a way to cut reimbursements indirectly. I had a chart audited and had 4 other physicians review it to tell me what level of care they would have billed. Guess what, everyone of the 4 said the same coding level I billed and Medicare still refused to pay the claim because of a single word I used in my documentation. I now don't even bother. Probably leave 30k on the table every year because I don't want to fight it.
I'm sick of the whole system. I gave up my entire 20's and early 30's either studying all day and evening and then spending most waking hours in various hospitals training so I could carry a loan debt the size of a nice home loan and now it seems the pie just gets smaller and smaller.
If I had another skill set other than the one I spent so much time learning and going into monster debt for, I'd change my career in a heartbeat.
I think the bottom line is that most docs are stuck. Someone who has been in practice 38 years can afford to walk away. The majority of us can threaten but at the end of the day I can't find another job that will at least allow me to pay my debts and have some quality of life financially.
I do believe you will continue to see fewer exceptional candidates attending medical school when they way the cost. If a person can see themselves doing nothing but practicing medicine then so be it. Thank God for those kids. The wave of mid level provider care is here and growing. I have no I'll will towards mid level providers other than the fact that I spent about 4 additional years getting priceless hands and eyes on experience that can't simply be replaced. A monkey can write a rx for a sore throat and be right most of the time. What they can't do is remember or recognize that something just doesn't look or feel quite right and follow their instinct that only is gained from countless hours and patient encounters. The care is not and will not be the same. Most people won't care because they won't recognize it until it's to late to turn back.
I need a tums.
This post was edited on 9/22 3:08 PM by Sherman Klump
This post was edited on 9/22 3:09 PM by Sherman Klump
With all due respect Klump you don't know what you're talking about. I thought I would go ahead and post for sys and pilt as they will be here shortly to let you know how narrow minded you are, and that you couldn't me more wrong.
If the shoe fits.
Medicare spending grew 4.8% to $572.5 billion in 2012, or 21 percent of total NHE.Medicaid spending grew 3.3% to $421.2 billion in 2012, or 15 percent of total NHE.
I guess licensed access to a trillion dollar market with 4% annual growth just isn't lucrative enough. Talk about entitled. Some one is getting that money, and if it isn't you maybe you should try working harder.
Pilt I think a better argument could be made that the people who couldn't afford insurance before Obamacare, or can't afford it now, need to work a little harder.
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Posted from Rivals Mobile
Thanks pilt. You nailed it.
I grew up on a farm feeding livestock, hauling hay, hauling watermelons, hoeing peanuts and playing sports.
I know what a days work is and if you want to follow me around for awhile before you assume I don't work hard enough you might grt some insight to what you're talking about.
You missed the point completely. Working harder to make up for what is lower reimbursements isn't really a long term solution. We all have the same 24 hours in a day. Come see me though. I'll be happy to rush through your visit so I can see more people and give you the care you deserve and I'll make more money. It's a win for everybody.
I worked my ass off to get where I am like many on this board. The difference is that I don't want to see anybody rewarded less for the same or equal work they've done over time. Nor do I fail to recognize I am fortunate to be where I am. That doesn't change the reality of what's wrong with this system. It's not a zero sum game. You're right about one thing. The money is going somewhere, but the increase isn't going to the people providing the care for the most part. A recent report showed hospital administration salaries and cost going up at alarming rates. p>This post was edited on 9/22 6:36 PM by Sherman Klump
This post was edited on 9/22 6:42 PM by Sherman Klump
I grew up on a farm feeding livestock, hauling hay, hauling watermelons, hoeing peanuts and playing sports.
I know what a days work is and if you want to follow me around for awhile before you assume I don't work hard enough you might grt some insight to what you're talking about.
You missed the point completely. Working harder to make up for what is lower reimbursements isn't really a long term solution. We all have the same 24 hours in a day. Come see me though. I'll be happy to rush through your visit so I can see more people and give you the care you deserve and I'll make more money. It's a win for everybody.
I worked my ass off to get where I am like many on this board. The difference is that I don't want to see anybody rewarded less for the same or equal work they've done over time. Nor do I fail to recognize I am fortunate to be where I am. That doesn't change the reality of what's wrong with this system. It's not a zero sum game. You're right about one thing. The money is going somewhere, but the increase isn't going to the people providing the care for the most part. A recent report showed hospital administration salaries and cost going up at alarming rates. p>This post was edited on 9/22 6:36 PM by Sherman Klump
This post was edited on 9/22 6:42 PM by Sherman Klump
I am sure you work plenty hard, that was tongue in cheek. (interesting that people on this board find telling poor people who are upset about their earnings to work harder appropriate, but successful people upset about their earnings are victims. It's just odd) Maybe try not to admit to leaving what amounts to a year's salary for many people on the table in your story about not earning enough though.
My point was not that doctors aren't being squeezed, but blaming something that subsidizes your industry to the tune of a trillion dollars a year instead of such things like rapidly increasing administrative and executive salaries is misguided.
This post was edited on 9/22 7:42 PM by 07pilt
This post was edited on 9/22 7:49 PM by 07pilt
Yep, you nailed us. We are all the time railing on "poor people" to work harder. You are one phony pseudo - intellectual piece of work.
Pilt I sense a lot of frustration in you. I truly am sorry if you are struggling. People that know me well know that I don't want to see anyone struggling. Heck, that's the main reason I chose the career I did. I rarely post on these issues, or any other for that matter, because of the way it can come across.
The subject of this thread just struck a nerve with me. My apologies if I came across as a victim. I definitely am not. Merely frustrated with the direction I see my profession heading. The thing I struggle with is trying to balance working smarter instead of longer in order to maintain my income. I despise rushing patients through in order to make up for reimbursement challenges. I want to give myself and patients the time I need to make sure I don't miss stupid things.
Btw, the administration comment wasn't intended to be a single explanation, but rather an example of the trends that are occurring that are troubling and don't generally translate to any improvements in patient healthcare or availability to quality care.
Believe me when I say I know what it is to have more month than money. I would like to see everyone doing better. Not some better at the expense of others. I also want to feel that the value of what I do is not slowly eroded. I don't intend to be insensitive to the plight of others.
The subject of this thread just struck a nerve with me. My apologies if I came across as a victim. I definitely am not. Merely frustrated with the direction I see my profession heading. The thing I struggle with is trying to balance working smarter instead of longer in order to maintain my income. I despise rushing patients through in order to make up for reimbursement challenges. I want to give myself and patients the time I need to make sure I don't miss stupid things.
Btw, the administration comment wasn't intended to be a single explanation, but rather an example of the trends that are occurring that are troubling and don't generally translate to any improvements in patient healthcare or availability to quality care.
Believe me when I say I know what it is to have more month than money. I would like to see everyone doing better. Not some better at the expense of others. I also want to feel that the value of what I do is not slowly eroded. I don't intend to be insensitive to the plight of others.
I am all good. I am also a licensed professional in a trillion dollar industry. I have friends and family that are struggling though and your post just struck me as tone deaf. I would love to hear your perspective on the troubling trends and possible solutions. How many new doctors do we generate per year? Is that limited by willing candidates or by open slots at med schools?
Sherman, despite what anyone says, I respect and appreciate Dr's. I just have a hard time getting lots of anxiety about their financial plight when I see:
1. Such restricted medical school admissions (so much for free market capitalism);
2. Medical bills -- Note the recent story where a guy gets a $117,000 bill from a "backup" surgeon for one operation.
3. The time it takes to get in to see an expert, or for that matter, a good Dr.
4. On a personal level, so many of them are just so obsessed with status and perception and make bad financial decisions that whatever their business model is, it wouldn't be enough.
Every one of these pre-dated Obama. I'm not trying to snipe at an occupation I respect -- I'm sure not gonna go through medical school and residency and then deal with Dr's headaches and limited income to deal with the sick general public. My hat is off to you, and especially the good docs out there. But come one, guy ---- if we compare your 20 year revenue stream with a mid management corporate guy with a b.s., I bet you're doing pretty good.
1. Such restricted medical school admissions (so much for free market capitalism);
2. Medical bills -- Note the recent story where a guy gets a $117,000 bill from a "backup" surgeon for one operation.
3. The time it takes to get in to see an expert, or for that matter, a good Dr.
4. On a personal level, so many of them are just so obsessed with status and perception and make bad financial decisions that whatever their business model is, it wouldn't be enough.
Every one of these pre-dated Obama. I'm not trying to snipe at an occupation I respect -- I'm sure not gonna go through medical school and residency and then deal with Dr's headaches and limited income to deal with the sick general public. My hat is off to you, and especially the good docs out there. But come one, guy ---- if we compare your 20 year revenue stream with a mid management corporate guy with a b.s., I bet you're doing pretty good.
If he hadn't "massaged" his formulaic labeling of racists, to me, this was generally already a known commodity.
So, did just the money into the pockets of the greedy providers increase, or did they also so an increase in time and expenses?
I refrain from posting on these boards being a player parent but I could not let this go. I am surprised that no one else considered what actually has led to the increase in Medicare spending.
According to Medicare in 2011 the total number of Medicare beneficiaries was 49,000,359. This number includes aged beneficiaries and those on disability. The total number of Medicare beneficiaries in 2012 was 51,780,446 again including aged and disabled.
If you look at the increase in the number of Medicare beneficiaries from 2011 to 2012 you will see an increase of 9.46% yet spending only increased 4.8%. Now our liberal friends will try and point to spending as proof Medicare payments have increased but ignore the fact that more people are now receiving benefits. To me that is a completely dishonest depiction of reality. The reality is Medicare spending is increasing because our population is aging not because we are spending more per beneficiary.
Another alarming number is that the number of people receiving Medicare Disability is increasing fsster than the population that is aging into Medicare. Those receiving Medicare disability benefits increased at 9.58% while those aging into Medicare increased at 9.45%.
Medicare Enrollment Numbers
Not surprised that the usual suspects didn't notice this.
Your math is a little off though. the percentage increase in enrollees is 5.67%. Which amounts to a decrease of per enrollee spending of $86 or 0.7%. Regardless, the point wasn't that medicare spending was going up, the point was that the medical industry is subsidized to the tune of $1 trillion by the USFG and complaining that your $1 trillion subsidy isn't big enough isn't exactly seemly or very conservative for that matter.
I should also point out that medicare spending per enrollee has increased by about 6% annualized over last 20 years. As a "liberal" I believe strongly in medicare, but spending on it cannot grow faster than inflation indefinitely or it will start crowding out other industries. Strangely, the deficit denier is advocating reining in spending, and the more fiscally conservative bunch are for larger government spending.
