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
# 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?
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.)
Play the damn trump card already...