So ironic, just complaining to my receptionist. Spent a whole hour on two PAs. One was to Tennessee (I am in Maine) to approve an MRI of the brain for a 7 yo with chronic headaches, getting worse and now fever and vomiting. I even tested him for Covid-19. Got the MRI and propofol sedation and set up in 48 hours, because pediatric sedation and MRI care. I mean you friggin' pay your $1,000 a month for our "wonderful private insurance" and they won't pay for a procedure when needed. Usually, I get this when it is for a knee or shoulder.
I am about 15 for 15 on peer-to-peers. They key is just being nice. Plus, the brain tumor (if it is -- which it won't) would be all on them.
The curbside consults are a great point. Being able to talk to them at rounds. And, they would "have" to consult on an inpatient within 24 hours. I remember when I would admit a patient with 8 ear infections and the consult would be in two months. S. pneumo being resistant to even high-dose amox, sometimes required hospitalization with IV Rocephin. Then consult ENT who would see that patient, agree then schedule them for a week later.
The whole key is concierge medicine or the IMP. No insurance bullshit. Plus, the guy I am leasing from is doing that. He has no issue with the Corona thing. Plus, he has done Skype from his phone from Paris so no need to even be here.
I think the key is that doctors never got together like a union to stop this bullshit. You don't see this with attorneys, but then are kind of set up to deal with this stuff. But, where was the AMA when this all started 15 years ago?
