We are a commune of inquiring, skeptical, politically centrist, capitalist, anglophile, traditionalist New England Yankee humans, humanoids, and animals with many interests beyond and above politics. Each of us has had a high-school education (or GED), but all had ADD so didn't pay attention very well, especially the dogs. Each one of us does "try my best to be just like I am," and none of us enjoys working for others, including for Maggie, from whom we receive neither a nickel nor a dime. Freedom from nags, cranks, government, do-gooders, control-freaks and idiots is all that we ask for.
My freedom in practice is to see people anytime I want or can, to work whatever hours I want to, to follow no imposed treatment protocols, to set my own fees and to provide as much charity as I wish, and to help anybody I chose to.
Nobody tells me what to do or how to do it. Maybe I'm a dinosaur. I'll see patients on a Saturday or Sunday if need be.
A quote from the article:
Once they work for hospitals, physicians change their behavior in two principal ways. Often they see fewer patients and perform fewer timely procedures. Continuity of care also declines, since a physician's responsibilities end when his shift is over. This means reduced incentives for doctors to cover weekend calls, see patients in the ER, squeeze in an office visit, or take phone calls rather than turfing them to nurses. It also means physicians no longer take the time to give detailed sign-offs as they pass care of patients to other doctors who cover for them on nights, weekends and days off.
Most hospitals exacerbate these strains by measuring the productivity of the physician practices they purchase in "Relative Value Units." This is a formula that Medicare already uses to set doctor-payment rates. RVUs are supposed to measure how much time and physical effort a doctor requires to perform different clinical endeavors.
I read the article the other day in the WSJ. I think it is very wrong. Hospitals are not stupid. Neither are MDs. So there are incentives to stick around and to see more patients. My son, a Family Physician employed by a hospital, can testify to that. And it takes away a huge amount of stress and time from running the mechanics of a practice's business side so they can concentrate on patient care. And they do "care", both the doctors and the hospital. This trend started well before Obamacare. This particular criticism of Obamacare is not correct. If we do not get things right we are going to lose the struggle for freedom.
You base your entire argument on your son.Seems as though you might be a little prejudiced. Medical practice will suffer as it becomes less personal and and more easily CONTROLLED by the all powerful Federal Government. Control of everything
is the goal. Guns, education, transportation, food, utilities and communication. Total state control inches closer and closer everyday.
annieoakley says I "base my entire argument on my son's experience." No, he is an example. I am a physician also and interact with many other physicians. I have an MBA son who works in the industry. The article is wrong. Go find out for yourself. Physicians are paid on the basis of "RVU" production. Productivity. Ever hear of that?
Do you fear that the gov't will impose strict practice laws so that Doctors CAN'T practice as they see fit? for example requiring they take insurance or a certain number of government insured patients? I feel that hospitals already are too regulated this way and that in a few more years this will be congress's new "fix" to the system.
From what I've heard and seen, the trend for doctors to be employees has been going on for awhile and it's been gathering steam in the last few years. From my distant view, it seems that malpractice insurance may be one of the main drivers, but it isn't much of a stretch to expect that Obummercare will just exacerbate the trend.
--a few years ago, Texas proved your point. We couldn't keep doctors in the poorer counties, esp along the Rio Grande River, in ''The Valley'' as it is called. Too many carpetbagger lawyers exploiting the poor folks, too many jackpot juries.
So the legislature (which by hard law and custom too meets only every other year, and for three months only) passed a wee little tort reform --not draconian, but predictable.
With a cap on awards, malpractice insurance costs dropped like a stone, and quickly the valley as well as the under-served areas scattered all over, filled right back up with doctors.
That's what the accursed free market does to people!
You know Doc, what you want in freedom to practice is what many of us want in freedon to work or freedom to live our lives.
Help us, how do we preserve what freedoms we have left and how do we regain those lost?