Jim, your post is like a flicker of light as seen from the depths of a mine shaft. I have to admit I was filled with some doubt as I sat here trying to frame my argument in a manner to convince Paul or Leslie that there is real hope. I know I sound like some fool, "If you build it they will come". But I am firmly convinced that we are at the threshold of a new age in medicine. We have (most of us our entire careers) been skewed by the insurance into what is right, what is real, what is ALLOWED. But along comes Jim and he finds that he can do ANYTHING, if it WORKS. His job depends on it being cost effective, but his employment situation is willing to listen to any evidenced based best practice that can be applied to the problems at hand.
I will tell you one more.
Glen Lopez, M.D. spent the day with me yesterday to shadow me as I saw patients with AC. Actually he worked as the 'scribe' for a couple of patients so he could take AC for a 'test drive'. He is a clinical Prof at UCLA and is involved in Diabetic Outreach in the Latino community. He has shown me a model practice that is entirely cash based, and I believe he will be fabulously successful with it. I believe he will make a comfortable living and be practicing true, evidence based medicine in a consumer driven model, (what the patient wants, not what the insurance is willing to pay or the hours and location the Dr. is willing to work). He will be bringing needed health care to uninsured patients and he will have a real positive impact on a large number of people. Who among us would not be happy to lay our head down at night knowing that we had done what our oath was framed around and knowing that P4P or "allowed" or "usual and customary" was LOCKED OUTSIDE the door to office?
Paul, Leslie I swear there is change coming, it won't all be bad, don't miss the train.
