I would love to bill for my services by 15 minute block, like an attorney or accountant. IMHO, it really wouldn't affect patients one bit, since the RVS codes (99XXX) would probably not be changeable. But PAYING MY RATES for the other trivialities, the ones that detract from patient care and make your blood boil, would EAT ALIVE those blasted insurers and managed care companies. Wishful thinking.
Anyhow, has anyone seen any "Change That Works" yet? Let me know...I just don't want to miss it.
Doesn't matter what Obama does now anyway. Much like global warming, the primary care crisis is already too late to stop. The comparison between the two is apt. Almost 10 years ago, family practice residency positions were going unfilled, and less than half of internal medicine residents headed for primary care (it's now down to 20%). The media and our national leaders are still wringing their hands, and then the latter pass new rules to let Medicare and the insurers stick it to us.
I was at a CME talk on Type 2 Diabetes last week, and, as you may know, there are 23 million diabetics already, and 57 million pre-diabetics. At present rates, one of three kids born in 2000 will be a type 2 diabetic some day. Crunch those numbers, plus the fact that half the endocrinologists and half the internists in practice today are over age 50, and we should probably put the money toward building dialysis units and nursing homes.
I will take no pleasure in saying "I told you so" when the meltdown comes. I want someone like me, to take care of me and my family when I'm older.
