Comments on: American Medicine: Information is Power

By: Susan

Susan — Tue, 02 Oct 2007 02:39:22 +0000

Great post-and kudos to you for your response “I love the geriatric patient

By: Rob

Rob — Thu, 27 Sep 2007 05:16:11 +0000

Wolley:
Sorry I didn’t answer your question: No I would not accept less for less malpractice. As a primary care physician, I don’t have bad problems with malpractice. It’s just not a primary care issue in general. Plus, I don’t think it would ever be possible patients to give up the right to sue. I am not even sure if I think I would want that. True malpractice still happens. What recourse do patients have in that situation.

Medicare is no fun for us. It just pays pitifully. The only reason I keep it is because I love the geriatric patients.

By: Wolley

Wolley — Thu, 27 Sep 2007 05:09:17 +0000

“Medicare rated better than most of the major insurance carriers”? No kidding!

With the level of fraud in medicare, why wouldn’t many physicians love it?

By: mary

mary — Wed, 26 Sep 2007 07:28:54 +0000

I’m looking for a copy of the Family Practice Management of 6-14-2007 to read the article on insurance company payments to physicians. This was a survey of physician’s experiences with different companies, from one synopsis, Medicare rated better than most of the major insurance carriers. Could insurance companies be headed down the road of the unions back in the 50’s and 60’s? They buried Hoffa somewhere, how many will the insurance companies bury?

By: Wolley

Wolley — Tue, 25 Sep 2007 04:36:20 +0000

Got a question for you regarding malpractice insurance.

Would you be willing to trade a small portion of your fees to fund a no-fault type of insurance coverage, which would be purchased by each patient you see as they visit your office?

Patients would be automatically afforded the coverage but would waive their right to sue.

By: Rob

Rob — Tue, 25 Sep 2007 01:45:14 +0000

I don’t disagree, Wolley. Would I let physicians police themselves? Of course not. As a physician, I see lots of bad doctors out there. I honestly think the benefit of P4P will be that bad physicians are rooted out or exposed. I just think the system is much more efficient if the information is managed at the physician level rather than through manipulation by third-party payers. I am not a big fan of the government running things either, but that is not the point. It is not who pays for things, it is who manages the resources.

By: Wolley

Wolley — Tue, 25 Sep 2007 00:51:12 +0000

Agree with a lot of what you say Doc. But some of your problems exist in your own profession.

I use to underwrite medical malpractice for the oldest property/casualty company in the nation, (now a part of CIGNA). Can’t tell you how many incompetent physicians I saw. People who actually belived that they were competent in their specialties. Then there were ones like Dr.DeBakey in Houston, who was a pioneer, but was sued many, many times even in the face of signed releases. We never paid a claim, but we spent a fortune defending him.

And you surely don’t want government handling medical insurance. Just look at the fraud in Medicade in states like New York and Florida. In the billions.

And that’s another reason to look at members of your profession. Far too much fraud.

For me, I did a little research before moving to where we now reside, and I picked the physician I wanted to treat me. And I think I picked the right person.

By: rlbates

rlbates — Mon, 24 Sep 2007 13:25:15 +0000

Very frustrating.

By: Sandy

Sandy — Mon, 24 Sep 2007 12:19:03 +0000

If only doctors knew that the P4P measures aren’t determined by careful analysis of “quality,” medical research and patient outcomes. Number crunchers and marketing people are making a surprising number of the decisions. Sit in a meeting at a national insurance company when they’re creating their comp measures and rate charts — it’s sales and marketing staff with no medical background and the conversations are unbelievable. “How about 3 days…yea, that sounds good….” Doctors are actually working for the insurance companies, as they see it, and are merely helping them steer most members (generally more healthy than not to even get insurance coverage) to interventions, labwork, and prescriptions that MAKE the insurer money.

By: Dr. Smak

Dr. Smak — Mon, 24 Sep 2007 07:42:41 +0000

Dr. Rob,

A frustrating situation, and the balance of power definitely not in our favor. How do you propose action? It seems that we need to pool ourselves as ‘customers’ of the insurance companies so that we can influence the impending inanity. Doctors on the whole seem too apolitical.

Dr. Smak