DocM,
I just heard that Bert never made it out there. What a shame, as he has so much to share on all of this. I'll tell all of you Branson Folks that almost all of the PCP's in small and cetainly Solo practice should try and get involved with this IMP movement thing. Here is a great bunch of folks that all have come to basically the same conclusion about the insanity of the present dysfunctional employer based health insurance model of healthcare, and are trying one practice at a time to save themselves and their patients from it.

Now Nancy and I made an honest assessment of the situation. Almost everyone there has a way or reason to be able to live on a fairly modest amount of income from their practice. Almost everyone there had spouses with another job whose job probably at least doubled their income if not better, and that spouses job probably supplied bennies including a health insurance policy for them and their familys. Well there is at least $10-$12K saved for themselves and the practice a year right there. Where as whatever Nancy and I pull out of the practice is for both of us combined.

I'm not a school teacher pulling down good money with bennies, an engineer, some mid-level manager myself. Well I am but for us not for some decent outside employer. I think if many of the IMP folks actually had to feed their entire famly and handle all of their other expenses and debts like we do on only the practice they would be much more disheartened and strapped like we are. Now obviously this is a generalization as no two people or practices are the same, but so many of them have this extra cushion built into their lives, while we are flying without a net and barely staying afloat.

But the perspective of trying to bust thru the garbage and actually remember why they became docs, trying to hold strong to certain basic ideals, and find ways out from under the oppressive thumb of the repressive and greedy carriers is wonderful to see and be around. But it was funny how much I already knew and how in many ways the things that guys like me and Wayne know as NYS practice managers actually had me in the position of advicing and explain things to many other practices and docs. Like a certain NYS carrier, comp, disablity, no-fault and a few other things as well.

And here is a phrase we need to spread around the country and personally I feel there are probably a whole bunch of places that fit this basic concept that until this weekend, Nancy and I had never heard, one that the AMA, the AAP, the AAFP nor the medcial society never speak to and that is what they refer to as "Dead Zones". Much like certain areas of the ocean that have been so polluted, that nothing can grow, these are areas of the country that the carriers have done such incredible damage to healthcare and providers that basically almost no providers can make a decent living and almost no practice can survive. The fees are so low and the managed care so oppressive that nothing can grow. CNY with 70% one carrier that has now converted with the unfair control of the market, have converted all of their products into managed care products is soon going to be if we are not already, such a dead zone.

And they are one of the first that I have ever seen that have real data on the average payments for various codes around the country. It is just sickening to see how different payments are from place to place. No wonder PCP's are going under all over the place.

Anyway, I think we need to bring more of our AC people together we the IMP's people. So many AC'ers are probably sort of IMP already and just don't know it yet, don't have a name for it yet. So many of us really are. And this needs to be a thing of momentum and numbers and the sharing of ideas, support, solutions. And we need to stand together against this aweful tide and push back, all while surviving at the same time. And viable and sustainable model of practice, that supports the best in patient care.

As Larry and I were saying this afternoon, there is so much money being spent on healthcare and yet PCP's especially are not getting their resaonable share, we are not able to get to the spigout to get life sustaining water.

Hope you are all having a great time out there for the rest of us. Please post all the great things you are learning, suggesting, and what Jon seems to be interested in. We are all very curious. Have a safe trip home one and all, and try to know where the storm cellars are.... "Auntie M, Auntie M!!!"

Paul

"Beware of the Medical Industrial Complex"
"The Insurance Industry is a Legalized CARTEL"