A recent study found that doctors are leaving the profession twenty years earlier than other professionals. The author cites lack of trust and dislike of the doctor by patients as the main reason. There are many reasons for this, among them: the increasing litigious nature of our society; reporting and public investigations of physician mistakes; the advent of the “quickie” office visit; the unfounded expectation that the doctor is perfect are among a few. Where are we headed if this trend continues? We already are seeing a decline in the number of physicians practicing in America. This gap is being filled by an increasing reliance on foreign doctors, “physician extenders” including Nurse Practitioners, Physician Assistants, etc. The care of American patients is gradually being turned over to non-physician healthcare providers. Will they be trusted more than doctors? What do you think?
ShareArchive for December, 2009
Changing patient attitudes and physician self-esteem may be on a collision course. I was reading an old study from 1988 that found that the patients who are most troubling to doctors are those who pose a threat to the physician’s sense of professional integrity. Patients who are disrespectful, critical or demeaning are far more irritating than those who disregard the doctor’s instructions or who cannot pay their bills, the study found. They also found that patients who provoke an emotional reaction in their physicians may unwittingly interfere with the physicians diagnostic accuracy and treatment decisions. They write. “If a doctor’s self esteem relies too much on his professional self-image, he’ll be vulnerable to patients who seem rejecting in some way. Read the rest of this entry »
Surveys are indicating some pretty strong shifts in patient attitudes toward doctors and healthcare in general. Will doctors be able to respond to their needs or will they require the patient to conform to their outdated ways?
Trend #1: Surveys report that between 60%-75% of patients get most of their healthcare information on the web. They even shop for their doctor online. Are you changing the way to communicate with your clients to respond to this trend? Have you established your online presence?
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Senate Democrats won their first test vote last night and it seems they are almost assured of passing some form of healthcare “reform”. The critics are coming out of the woodwork primary because of all the side deals that have been made to get to the 60 vote requirement and the fact that nobody can claim that they have read the entire bill. The AMA, Unions, and other groups that previously supported the bill have now backed off. Read the rest of this entry »
“When doctors sit in the lounge all they do is complain about how miserable their lives are. I can’t stand to go in there anymore”, stated a thirty year veteran surgeon. Why are doctors so dissatisfied? And more importantly, why don’t they do anything about it?
Survey after survey shows that a large percentage of doctors are unhappy with the practice of medicine. Results range anywhere from 40-70%. It is not the clinical side of medicine but rather the healthcare system itself, the red tape, the loss of control that troubles them.
How did it get this bad? It was a slow creep that eventually resulted in physicians selling their souls to the system. It all started when physicians allowed their pay to come from a third party, first the insurance companies, then the government. When it first began, it seemed like a good idea. Doctors could bill whatever they wanted and get paid in full. In the beginning, insurance companies worked a lot like auto insurance, patients would pay most of healthcare costs out of their pockets and insurance would pay the big bills.
In time it became clear that the system could not sustain itself. Physicians and hospitals did not realize how they were shooting themselves in the foot. They thought there was an endless pot of money to absorb their ever increasing billings. That was not the case. The solution to the increasing cost crisis was managed care. Here’s how it worked: play doctors off of one another, get them to accept discounted fees and give the patients an incentive to stay “in network”. That was the beginning of the end for doctors.
So here we are today. Doctors have surrendered control to the insurance companies, and now increasingly, to the government. The best they can do is beg congress to limit cuts in Medicare fees. The system is now so vast and consuming that most physicians feel there is no way out for them.
Yet, a small group of proactive doctors believe it doesn’t have to be that way. Physicians all over the country are finding ways to get back control of their professional lives. They are reshaping their practices to become more cash oriented, bringing back the doctor-patient relationship. There are lots of other ideas being tested.
We’d like to hear what you think. Are you standing by, allowing the system to absorb you even further or have you found a way to bring life back into your practice? We’d like to hear from you.
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With a suffering economy and massive layoffs, embezzlement is on the rise and doctors are a major target. Why are doctors so vulnerable and what can be done to lessen their risk? First, doctors are busy and they don’t have time to closely watch the administration of the office. Secondly, for some reason, doctors tend to give under-qualified staff too much responsibility. They either underestimate the complexity of running a healthcare practice or they just don’t want to pay for the level of expertise it requires. Because of this, the necessary systems to professionally manage an office and reduce the risk of fraud generally are not in place. Thirdly, even when a problem is suspected, many doctors want to ignore it, hoping that the problem just goes away. We recently worked with a doctor where it became clear that a long-time employee was stealing cash from the practice. Because he feared that he wouldn’t have anyone to run his office if he fired the employee, he refused to confront her and just changed where he kept the cash. Here’s a couple of recommendations to lower your risk of becoming a victim: First, realize that your running a business. Healthcare is 16% of the U.S. economy…it is BIG business. Also, the facts that even your best employee can turn on you if times get tough in their life. Don’t be naive. Lastly, put systems in place to prevent stealing and fraud. Professional accounting systems have been designed for this purpose. They are not costly to implement and are a must for even the smallest of healthcare practices.
Many years ago I was listening to a doctor friend talk about his colleagues and was struck when he said “You know, very few doctors are leaders. They follow each other like sheep. They train us that way in medical school, we are not trained to think for ourselves.” Since that day, I have heard this idea stated repeatedly by those who manage and sell to doctors. Doctors never want to be the first ones to try something, they say. They want everything tested by someone else, someone else to take the risk and confirm that it works before they dive in.
Why is this? Like my doctor friend stated, doctors are trained this way in medical school. Some have said that going to medical school is like getting a lobotomy. Doctors are not trained to think. They are trained to memorize and systematically process information to a conclusion.
If this is true, what does this mean for healthcare reform? It probably means that solutions for our healthcare problems won’t come from doctors. Someone else will determine their fate. If this is true, it will be tragic. Physicians are on the front line and should know better than anyone how to solve this crisis. They either don’t have the time, or the inclination, or like my doctor friend said, are not inclined to be leaders.
What do you think?
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One of the main complaints registered by doctors on the Glenn Beck forum was the intrusion of insurance companies in their lives. Many physicians were outspoken about how screwed up the system is because of a third party payer. We could not be more in agreement with this conclusion. However, the public and most doctors are addicted to the insurance drug. They have no idea how to get along without it. Patients expect everything to be covered (and somehow don’t get that full coverage causes exorbitantly high premiums) and doctors don’t have any idea how to run a cash medicine practice. But the tide is turning. Estimates are that nearly 20% of family practice physicians are looking at going cash. New models for cash medicine are emerging. PriceDoc is one that allows patients to bid for doctor services. Conceirge medicine is gaining ground. Medical societies are being created that focus on lifestyle medicine for cash. We think the 80/20 rule applies. 80% of physicians will stay in the old system and go along with whatever the government imposes on them (and keep complaining) and 20% will look to innovative strategies to change, such as moving to cash. Let us know your thoughts on this topic.
Sixteen highly regarded physicians representing many fields -cardiology, oncology, general surgery, internal medicine, and others, assembled at the Grand Hyatt in New York City to discuss the impact of the currently proposed health bills on their patients. As reported by Betsy McCaughey of www.defendyourhealthcare.us, here are the main concerns addressed by these physicians:
- Most are expecting more mandated guidelines for treatment. The general consensus is that guidelines dumb down treatment; they are always for average care and NO patient is average, their situations are always unique.
- Doctors are getting blamed now for keeping people alive too long. How can they honor the Hippocratic Oath and live in the new system that is sure to ration care? “We’re the bad guys. We’re responsible for keeping people alive to 85. So we’re going to try to change healthcare because people are living too long? It just doesn’t make sense.”
- Healthcare reform will be a gigantic invasion of privacy into the medical conditions of all Americans.
- Government is in the process of duplicating everything that managed care did for the last 15 years that was reviled by everybody and which we fought very hard to overcome.
Tell us what you think about their comments. We want to hear from you.
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There’s been a rash of shows over the last month talking to doctors about healthcare reform. Results of a survey from Investors Business Daily was released in October stating that 45% of physicians will consider quitting if the current healthcare reform bill was passed. Opponents sited flaws in the survey however, it has been found in many surveys of physicians that as many as 60% have said they would quit medicine and seek another profession if they could make as much money. The problem is that most physiciaans cannot find a job that pays as well as medicine. What do you think? How dissatisfied are you with your career? What part of it is most dissatisfying? Are you considering quitting? Let us know your thoughts.
