Guys,
Leslie just said in a perfect example exactly what I'm getting at. Do you really think these SOB's care about patient outcomes? They trade pts every 6 months to a year back and forth. Yes the HMO model was supposed to be a good thing that put primaries at the center of the whole deal, paying you well for your managment and gatekeeper function that would save lots of money for everyone else. But you guys are not voting members of their board, voting shareholder who are the owners of the company, so they did exactly what they do best. The cut you all down to nothing while keeping all the good stuff for themselves. As Leslie says, they changed the rules, increased the bullCCHIT paperwork, tied you up in knots, and you are still handcuffed by the same anti-trusted laws (No Leverage to fight back with) that they are free of to do as they please, screw you 6 way from Sunday.
So what makes any of you really "smart" analyticaly thinkers, students and practioners of science think that this P4P won't end up doing the same exact thing??? Please get a CLUE! They probably planned at least half of what we have today, and I'm sure that if we could execute supenas have get a look at their internal memos and the minutes of their board meetings, see their rollout plans, bug their board rooms, I'm sure we'd find that this P4P is no different. I'm sure they are already planning on using this P4P CCHIT to get you all on board, and once they've got the magic majority number of you by the
they plan on pouncing on all of you, to them turn the tables on you, change the rules, keep cranking it up over and over again, until you are dead. Heck most of us can't run our practices on the crap they pay us now unless we see too many patients. I feel any PCP office that sees more than 15 patients a day is not practing proper medicine. The average primary care visit in now 7 1/2 minutes!!! 7 1/2 minutes, like what kind of hiding issues, follow up to previous issues, digging and counceling and teaching can you be doing in 7 1/2 f'ing minutes??? Please Henry Ford has cranked up the assembly line to inhuman speed and now the SOB wants to know why the fenders keep falling off all the cars that are coming off the freakin' line!!! Give me a break.
Mark my words with history as stated by all of you above on my side, P4P will be the last nail in the coffin of Doctors making a living at primary care. In the not too distant future we will have nothng but factory sized practices with on doc supervising 10-20 mid-levels doing all the primary care. Heck even the AMA and almost every other doc in the system dis's you and has no resepect for you and your offices. I know I'm the guy who gets pissed on as they call demanding their referal even though both they and the patient are trying to get around the gatekeeper function you are supposed to be playing by getting a referal for a specialist visit even though the patient hasn't seen the primary to discuss the issue and get her blessing for this referal.
You guys are toast and either you can make a last stand to try and save medicine and your profession now, or down you will go. Anybody care to take me up on my sucker bet???
Nancy and I are starving our way to our convictions as we trying to come up with some way of still making a living doing something in medicine that does not allow her to be screwed into tons of paperwork for a lousy $50 level 3 visit. We are going to be doing the Suboxone therapy soon, totally changing the patients life and the lives of everyone around them, saving their carrier $25-$100K from revolving room ER visits, OD's, repeated trips to detox no less all the cash this will save society and the local and regional tax payers. But how much do you think they are going to share their savings with us??? Heck I bet the drug company whose product it is, is going to make as much if not more than she will, while we are the ones doing all the hard work dealing with these difficult patients and managing them and their negative behavior until they are well... Why can't they honestly share some of these savings with the doc willing to take on the hard work to save these people's lives and everyone, and I mean everyone lots of money???
As Leslie said a while back, "isn't it a shame that today PCP's need a schtick just to make a few extra bucks?" Just wait until they are done with you with all this P4P cchit. Why does everyone hyper-control us, but these carriers can make tons of cash, keep their books and their offices closed to the people and the gov't and get away literally with murder as they kill their patients with their terrible policies and procedures? Why can't we get that same immunity, not that we should. I want P4P for the medical industrial complex first, after we sceeze their
like they have done to yours, then and only then can they come back into my office and ask me if we have any more efficencies to be found.... Who makes more money, has better bennies and retirement plans, the average solo PCP or the a provider rep for a major insurance carrier??? I think I need to go gett measured for a few suits so I can go get a job on the other side of the street as a provider rep and treat you guys the way you all seem to be saying "bring it on" for....
Please my friends read the writing on the wall or we are all doomed! Please! Please, please....
Paul
