8.08.2007

Bitching and Complaining - Play the trump card already

Multiple blogs have had recent posts regarding proper physician compensation, medicare cuts, universal health care, and the difficulties practicing medicine today. (As not to hijack their comments section I thought I'd just create my own entry). Seems to me the solution is simple...and stated so concisely by anon1151 on kevin's blog:

The solution is simple. Don't take Medicare. Don't take Medicaid either. End of story. It always amazes me that docs bitterly complain about reductions in reimbursement from public and private payors, yet continue to take them year after year.I wonder- Are any of the docs on this board truly planning to dump Medicare if reimbursements decline? The answer is most likely none.As long as most docs are willing to take the cuts, they will keep reducing them. It's a race to the bottom, and we aren't even close to the end.Docs are trained to be so risk-averse, that they will take any cut for fear of losing even the most meager returns. In other words, get some balls or stop complaining.
posted by Anonymous : 11:51 AM

I have to say that...I agree.

Doesn't seem like a "complicated" or "difficult" situation at all. The physicians hold the trump card, and would rather bitch and whine than play it. Just say "no."

With regard to the threat that all docs will leave clinical medicine...
Why do physicians believe this? If you're a bad businessman in one field, what makes you think you'll be any better in another? Making money is making money, no matter what industry.
# posted by Anonymous : 8:41 AM

I agree with Anon841. If you're too weak, too chicken-shit to advocate for yourself, and your practice...your livelihood, what makes you think that (as a group) we'd be successful doing anything else?


-caveat-
I understand *individuals* leaving clinical medicine for one reason or another may be a great idea. And, sure, their lifestyle may improve...yadda, yadda, yadda. And, I constantly provide caveats to individuals, because, as an individual you're not quite as strong, you're more vulnerable, and really, can only bitch, complain, and try to motivate others to become angry enough, and fed up enough...to encourage others to do the same. When a certain threshold is met, change will follow. I know this, and am not suggesting that individual doctors jeopardize their (even suboptimal) situation and become a martyr at the expense of their families. That wouldn't be wise - and there is a better way.

However, for doctors as a group to think that either 1) an empty threat to leave clinical medicine, or 2) waiting for even a substantial number of docs to leave the bedside, are viable solutions...further demonstrates their, um...what's the word?...*stupidity*!!

I see docs take all kinds of shit from HMOs and 'regulators' for very self-serving reasons - like pensions, guaranteed income, or vacation/sick leave benefits. Doctors don't refrain from telling medicare to fuck off, or the HMOs to shove it because they're nice...altruistic...or care about poor people. The reasons are more self serving - so don't believe the hype. If these docs cared about *patients*...they'd advocate for themselves, which would benefit their patients (or vice versa...either way, it's better than what's currently taking place). The reasons they don't...are a topic for another post, and mostly due to the past/older generations (afterall, the newbies haven't been around long enough to create this problem), their greed, arrogance, and passive-aggressiveness. Their complacency, and disinterest in managing their own trade. Their lack of a unified voice, and failing to hold their societies accountable (or forming new ones that are worth a damn.)

Instead of bending over, and taking it in the ass keeping silent....doctors should just say*no*. When that day comes...things will change. Not a moment sooner. No one is going to make things better for doctors while they sit silently in the corner, accepting bullshit from the purse-holders!!

Play the damn trump card already...

6 comments:

Toni Brayer MD said...

I agree with some of your writing on this subject but not all. Believe it or not, some of us do keep Medicare because of the patients. Medicare IS the insurance for old people and without it they would not receive care. There are no private insurers who will insure someone with multiple co-morbid conditions. Once you have a relationship with a patient, it is very difficult to say "No". I do resent my very wealthy patients who want to be treated like VIPs with Medicare as a payer. I believe people who can afford it should pay the full price of care.

Anonymous said...

Spoken like a newly minted doc who has never worked in the real world. Let's talk in 5 years OK. Of course as an ER doc you are shielded by a lot of the complaints that were made

signed: a doc who's been a doc since before you were in kindergarden in the early 80's.

ER doctor said...

Anon7:15 said - "Spoken like a newly minted doc who has never worked in the real world"


Perhaps....

Forward progress will be made by new ideas, young energy, and sufficient outrage.

It seems, the ‘sufficient outrage’, is the rate-limiting factor here. If we can get enough new (and old) docs pissed-off enough…I believe things will change.

I’m still a student…enlighten me. What are the obstacles that are “so impossible to overcome?” Then, together, we can figure a way to overcome them…. ;)

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hck said...

Spoken like a newly minted doc who has never worked in the real world. Let's talk in 5 years OK. Of course as an ER doc you are shielded by a lot of the complaints that were made..
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