241–250 of 372 posts
You think that is bad. Try working with an attorney, they charge you to read your email and not respond at all.
Earlier quoted context omitted.
Trust me, they are all aware of this. The problem is that, for the majority of doctors now, they do not own or control their clinics. They are either: 1)employees of the health system or 2)partners or employees of a provider's group that essentially contracts with the system to provide doctors. The doctors themselves have no real control over how their clinics operate outside of contractual negotiations.
That's the problem. The doctors should form employee owned co-ops and be sure profiteering administrators and suits aren't the ones running things.
A 15 minute email from my lawyer costs about $150, I don’t see why we should be outraged about $25? It’s much harder and more expensive to become a doctor.
Unless your lawyer is an equity partner, he's not getting much of that $150.
In the US, the median doctor makes almost 75% more than the median lawyer...
10 appointments a day, 30 mins each.
You have to write /everything/ down the patient tells you. You often have to go over the 30mins because some patients need it. You need to follow up to order extra tests, you need to occasionally google something.
You skip lunch often. You need to find time to reply to messages from previous patients. Nurses will mess up something or a patient will show up late. Want to see patients past 5? The nurses have left and you can't legally 'bill' or code the appointment without the nurses.
day is over and you review tomorrow's patients. You read through their histories. Now you check the messages. There's between 5-45 a day. You see a lot of patients.
Then you're told that your department isn't bringing in enough money. They want you to see 11 patients a day. The reason? They didn't bill people correctly. For the past year.
A lot of doctors quit.
In some countries in Europe, if you have private insurance they'll pull off the "call charge" trick as often as they can. Need to make or reschedule an appointment? Make a call. Did some blood test and need the results? Call to get them. They call you to tell you they can't make the appointment and need to reschedule? You still get charged. If it's not a call it's a fake shot. Fake disinfection charge. And so on. The…
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Which is almost ~2% of GDP alone...
0.1% of credit card payments are fraud: https://www.federalreserve.gov/newsevents/pressreleases/othe...
That's a more typical number.
Something is extremely broken with US healthcare.
The interesting thing is that every side seems to be losing.
The winners are certainly not average doctors.
Compared to the size of the market - health insurance is one of the worst insurance businesses.
Hospital administration is also not a great business.
The hospitals are poorly run. Please hate your hospitals management more. Or if you are a good manager, convince some friends to run a hospital. Imagine 10 appointments a day, 30 mins each. You have to write /everything/ down the patient tells you. You often have to go over the 30mins because some patients need it. You need to follow up to order extra tests, you need to occasionally google something. You skip lunch o…
The hospitals are poorly run. Please hate your hospitals management more. Or if you are a good manager, convince some friends to run a hospital. Imagine 10 appointments a day, 30 mins each. You have to write /everything/ down the patient tells you. You often have to go over the 30mins because some patients need it. You need to follow up to order extra tests, you need to occasionally google something. You skip lunch o…
Around here, doctors have been mostly forced to work for hospitals now, because IMO doctor practices can't afford malpractice insurance, clerical staff to deal with all the insurance paperwork, computer systems, and computer software licenses. There are also huge groups of specialty doctors working together to avoid having to work for hospitals. Here it's urology, dermatology, and gastroenterology. In my experience these doctor group operations are run even worse than the hospitals: they have a monopoly on their specialty and know it.
If the provider doesn't bill, problems from the patient's perspective:
1. Some patients are reluctant to message when they should, because they don't want to impose when they know the provider isn't set up to charge. Same "Should I send this?" problem.
2. Providers end up needing zealous triage/gatekeeping/diverting on messages, so more messages might end up handled with more generic responses.
3. Providers might have incentive to shift messages to billable nurse calls, just for fiscal sustainability, turning a message into phone tag and/or long hold times.
Personally, I'd prefer to pay for good message responses. (Initially I assumed I was, but the charges didn't seem to show up on the EOBs/bills.) Much like with a lawyer, but maybe priced lower than the effective rate for minutes with patient in an in-person appointment (since messages do have more async flexibility, and lower office overhead).
I worked for a mature healthcare company and much of our marketing centered around healthcare provider surveys of doctors and nurses. The results were unsettling. Extremely high rates of burnout, typically due to administrative overhead. Horrifying medical error rates. Doctors should be compensated for the amount of time to send an email. Every other industry is capable of restructuring support to satisfy demand. It'…
> what would it take for the healthcare industry to restructure itself to actually function? I can't quote it precisely, but here's a gist from The Glass Bead Game: > Intelligence can find its own way, the teacher's job is to address stupidity. Overlooking the crudeness here, I think it's a good idea, and translates to medicine. Most of us are not qualified to define good care, but we know bad care when we see it. On…