somarco

GA Medicare Expert
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Atlanta
The average wait for new patients to see a physician is 26 days, and that's for mostly healthy people. In a medical emergency, the situation can become even more frightening: Twenty-two percent of acutely ill patients 65 or older who sought medical attention had to wait six days or more for an appointment

Nearly 70 million Americans on Medicare, many with chronic conditions, can expect longer waiting times for medical care.

Even being an established, well-connected doctor doesn't always help. One colleague of mine, working at a major medical center in the South, recently decided to move with his family to the Northeast. But as the process was underway, his wife was diagnosed with cancer. Even though she'd already received a diagnosis, and even though they were using the same insurance company, the insurer refused to cover her oncology treatment until she got a referral from a new primary care physician.

Despite being a prominent doctor himself, my colleague could not find a single physician willing to take his wife on as a new patient. The family was forced to go back to their previous state so his wife could receive care. Fortunately, she is doing well, but my colleague asks, "How do people do this without the connections we have?"

In reporting this story, I spoke with dozens of physicians, the vast majority of whom vented their frustrations with the current state of medicine. But just as tellingly, almost all of them also refused to talk to me on the record, fearing that speaking out could cost them their jobs.

Part of what's driving this is the growing trend of private equity firms and corporations, such as CVS Health and Amazon, purchasing hospitals and private practices. One major medical group, (that would be UHC/Optum) with about 90,000 doctors in some 2,000 locations across the country, has spent billions of dollars acquiring physician-owned practices, home health centers and surgical centers. This past April, the Physician Advocacy Institute reported that just shy of 80 percent of all doctors were employed by hospitals or corporations, up 200 percent in just over 10 years.

Physicians told me they are burned out. Simply put, they are being asked by the business world that owns their practices to do medicine, at times, in ways they view as not in the patient's best interest. Meanwhile, those who cling to their independent practices are finding it impossible to hold on given the financial pressures on them.

Millions of American workers are currently employed in health care in some capacity, many in government, for insurance companies, or in corporate oversight. But in the end, it is often doctors on the front lines, bearing the blame and anguish when diagnoses are wrong or treatments go badly.


Interesting article that places much of the blame on corporate ownership of provider groups yet neglects to mention UHC/Optum by name . . .
 
Part of what's driving this is the growing trend of private equity firms and corporations, such as CVS Health and Amazon, purchasing hospitals and private practices. One major medical group, (that would be UHC/Optum) with about 90,000 doctors in some 2,000 locations across the country, has spent billions of dollars acquiring physician-owned practices, home health centers and surgical centers. This past April, the Physician Advocacy Institute reported that just shy of 80 percent of all doctors were employed by hospitals or corporations, up 200 percent in just over 10 years.


Interesting article that places much of the blame on corporate ownership of provider groups yet neglects to mention UHC/Optum by name . . .
The other thing that happens when most of the physicians are employees of a hospital system is that, at least around here where we have 4 systems that employ almost all the local doctors (except for vanity surgery, sports medicine and due to an unusual set of circumstances, GI) many of the hospital systems refuse to allow outside of their system doctors order anything that requires meds.

I have suffered from that on a personal level as my PCP is not connected with one of those systems. I have 2 MD's who will re-write his orders for me so I can get the the tests done there that require contrast, or my port cleared if it is clogged (the last one is a real pain as it requires a clot buster injected and if the order for the port flush came from my PCP they won't clear it since he can't order the clot buster - sigh). As a result I have a standing order, renewed annually, from a provider in the system for a port flush as then if it turns out to be clogged it can then be cleared without any further orders. My other tests I send a copy to them and they rewrite the order.

Shouldn't have to be like that but the systems are protecting their turf as if medical care wasn't a public good and rather they are operating in a for profit, control the market, oligarchy way. To top it off if venture capitalists bought a practice (or whatever) the only way they make money is cut costs (in a variety of ways, some of which may actually make sense, others do not for the long term success of the "business") and sell it at a higher rate. That increases health care costs as the buyer usually then has debt to pay off.
 
They start a practice $250K in debt.
They balance Medicare by cutting the abysmally low reimbursement rates.

Next question?
I was going to rant about this, then I saw your response. Short simple and to the point. I can't add anything more of value.

Anyone who disagrees, doesn't understand basic economics, or the healthcare system.
 
Medical care is a business . . . so are grocery stores, gasoline stores, restaurants, insurance agencies/carrriers and so forth.

If they cannot operate profitably they close.

Profit is not the problem but is an economic fact of life.

Personal service industries, and especially those that cater to necessities of life, need to find a way to take care of their clients without causing harm.
 
Medical care is a business . . . so are grocery stores, gasoline stores, restaurants, insurance agencies/carrriers and so forth.

If they cannot operate profitably they close.

Profit is not the problem but is an economic fact of life.

Personal service industries, and especially those that cater to necessities of life, need to find a way to take care of their clients without causing harm.
You are right they all have to break even. A for profit though has higher expenses as they have to pay the shareholders (and usually give bonuses to the top executive team or at least the CEO). Non-profits and government hospital systems are required to sink any "profits" back into the system and not give bonuses. And, of course, they have no shareholders. So yes profit is part of the problem when it comes to costs because their costs are higher thus they need more money coming in per patient.
 
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Medical care is a business . . . so are grocery stores, gasoline stores, restaurants, insurance agencies/carrriers and so forth.

If they cannot operate profitably they close.

Profit is not the problem but is an economic fact of life.

Personal service industries, and especially those that cater to necessities of life, need to find a way to take care of their clients without causing harm.
I don't think anyone here is going to disagree with you.

But, to have this discussion without at least acknowledging the single largest distorter in the industry (The Federal Government), is being intellectually dishonest.
 
The average wait for new patients to see a physician is 26 days, and that's for mostly healthy people. In a medical emergency, the situation can become even more frightening: Twenty-two percent of acutely ill patients 65 or older who sought medical attention had to wait six days or more for an appointment

Nearly 70 million Americans on Medicare, many with chronic conditions, can expect longer waiting times for medical care.

Even being an established, well-connected doctor doesn't always help. One colleague of mine, working at a major medical center in the South, recently decided to move with his family to the Northeast. But as the process was underway, his wife was diagnosed with cancer. Even though she'd already received a diagnosis, and even though they were using the same insurance company, the insurer refused to cover her oncology treatment until she got a referral from a new primary care physician.

Despite being a prominent doctor himself, my colleague could not find a single physician willing to take his wife on as a new patient. The family was forced to go back to their previous state so his wife could receive care. Fortunately, she is doing well, but my colleague asks, "How do people do this without the connections we have?"

In reporting this story, I spoke with dozens of physicians, the vast majority of whom vented their frustrations with the current state of medicine. But just as tellingly, almost all of them also refused to talk to me on the record, fearing that speaking out could cost them their jobs.

Part of what's driving this is the growing trend of private equity firms and corporations, such as CVS Health and Amazon, purchasing hospitals and private practices. One major medical group, (that would be UHC/Optum) with about 90,000 doctors in some 2,000 locations across the country, has spent billions of dollars acquiring physician-owned practices, home health centers and surgical centers. This past April, the Physician Advocacy Institute reported that just shy of 80 percent of all doctors were employed by hospitals or corporations, up 200 percent in just over 10 years.

Physicians told me they are burned out. Simply put, they are being asked by the business world that owns their practices to do medicine, at times, in ways they view as not in the patient's best interest. Meanwhile, those who cling to their independent practices are finding it impossible to hold on given the financial pressures on them.

Millions of American workers are currently employed in health care in some capacity, many in government, for insurance companies, or in corporate oversight. But in the end, it is often doctors on the front lines, bearing the blame and anguish when diagnoses are wrong or treatments go badly.


Interesting article that places much of the blame on corporate ownership of provider groups yet neglects to mention UHC/Optum by name . . .
Don't forget the legal issues and costs.

The long time doctor in the picture who has finally decided to retire because of malpractice insurance cost of almost $100,000.00 per year.
 
The average wait for new patients to see a physician is 26 days, and that's for mostly healthy people. In a medical emergency, the situation can become even more frightening: Twenty-two percent of acutely ill patients 65 or older who sought medical attention had to wait six days or more for an appointment

Nearly 70 million Americans on Medicare, many with chronic conditions, can expect longer waiting times for medical care.

Even being an established, well-connected doctor doesn't always help. One colleague of mine, working at a major medical center in the South, recently decided to move with his family to the Northeast. But as the process was underway, his wife was diagnosed with cancer. Even though she'd already received a diagnosis, and even though they were using the same insurance company, the insurer refused to cover her oncology treatment until she got a referral from a new primary care physician.

Despite being a prominent doctor himself, my colleague could not find a single physician willing to take his wife on as a new patient. The family was forced to go back to their previous state so his wife could receive care. Fortunately, she is doing well, but my colleague asks, "How do people do this without the connections we have?"

In reporting this story, I spoke with dozens of physicians, the vast majority of whom vented their frustrations with the current state of medicine. But just as tellingly, almost all of them also refused to talk to me on the record, fearing that speaking out could cost them their jobs.

Part of what's driving this is the growing trend of private equity firms and corporations, such as CVS Health and Amazon, purchasing hospitals and private practices. One major medical group, (that would be UHC/Optum) with about 90,000 doctors in some 2,000 locations across the country, has spent billions of dollars acquiring physician-owned practices, home health centers and surgical centers. This past April, the Physician Advocacy Institute reported that just shy of 80 percent of all doctors were employed by hospitals or corporations, up 200 percent in just over 10 years.

Physicians told me they are burned out. Simply put, they are being asked by the business world that owns their practices to do medicine, at times, in ways they view as not in the patient's best interest. Meanwhile, those who cling to their independent practices are finding it impossible to hold on given the financial pressures on them.

Millions of American workers are currently employed in health care in some capacity, many in government, for insurance companies, or in corporate oversight. But in the end, it is often doctors on the front lines, bearing the blame and anguish when diagnoses are wrong or treatments go badly.


Interesting article that places much of the blame on corporate ownership of provider groups yet neglects to mention UHC/Optum by name . . .
Thank you for posting this.

I usually don't get to read these articles but because of the discussions here I made the time to read that one when I saw the cover of the newspaper. I was wondering if I could figure out some way to post it here, now I don't have to.

I have been considering attempting to change doctors because of driving challenges to get to my current physician's office, after reading the article I consider myself fortunate to be a patient in an established medical practice.
 
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