| | |
January 31, 2011 Another year has passed. I'm very grateful to the patients who have supported this practice and allowed it to make it through another year. Clinical reminders are a waste of time and effort. Big insurance company sends out a memo that Mr. or Ms. X has not had a colonoscopy and they need one ASAP. A day later the same insurance company sends Mr. or Mrs. X a letter stating their medication is no longer "preferred" and they will have to switch to a "formulary alternative". It doesn't matter that Mr. or Ms. X has been on the medication for 3 years. The same insurance company (or government agency) that acts like it cares so much about patients (via clinical reminders) has no problem denying services or medications. Pre-certifications, prior authorizations, formularies, capitations, denied stays, down graded stays, etc. these are all devices designed by insurance companies and health systems to "save costs". These things don't save money and don't improve care. One minute Levitra is the preferred erectile dysfunction medication the next day Viagra is the preferred medication and Levitra is not available. What changed? Price. Viagra became generic. Why continue to require an older short acting medication for a chronic disease when a long acting more potent medication is available? Because the short acting older medication is generic and cheaper. I am all for saving money. We live in a resource limited society. Not all new medications are better than older generics. In fact a lot of new medications aren't better than older generics. But don't act like you care (clinical reminders) while at the same time deny a patient the best care available (while finding weak medical data to justify sticking with an outdated therapy). I'd like to be more specific but then I'd get fired. (I'll be more specific after they fire me). I could go on and on about the hypocrisy in the administration of healthcare. I could go off on hospitals bending over backwards for JACHO or trying to become "Magnets". All the while theses same hospitals undermine their own nurses with not enough support and increased paperwork that does nothing to improve care. What do I know. I'm just a little family doctor running my own little store front office. I'm like the shop owner crying that Wal*Mart is running him out of business. From the time I set foot in med school until now it's been 20 years. A lot has changed. Change is inevitable as the saying goes. Each generation mocks change. The good old days are just that old. The business of medicine is a disaster. I sound like one of the crybaby doctors I trained under as I was coming up. But the practice of medicine is being eroded by sick notes, FMLA forms, administrators, think tanks, policy makers, patient centered home initiatives and paper work in general. I'm in it for Mrs. B, Mr. G and Mr. E among others who were my patients but passed on and their families still come to the office. I'm in this for little D, what a story. I enjoy what I do, for now. When I don't I'll quit. 2012 will be more of the same, me finding joy in practicing medicine while complaining about it at the same time. Oh well. Why stop now?!
Antibiotics for ear infections are of modest benefit according to an article in the Journal of the American Medical Association. { 2010;304(19):2161-2169. doi:10.1001/jama.2010.1651} | |||||||||||||||
This is the Blogchive section. Click on a link below to view a past blog.
| |||||||||||||||
BMI - Body Mass Index BEE - Basal Energy Expenditure calories in = calories out; change this equation to lose weight | |||||||||||||||
 | |||||||||||||||
Thanks for your support of this web site. Donations to keep it going are accepted and appreciated . You can also use this link to pay for your office visit or co-payment. | |||||||||||||||
| | | | | | | | | | | | | | | |