Why don’t doctors talk about prevention to their patients? Is it that they don’t have time, or don’t want to or is it that they don’t have the expertise? Doctors increasingly are coming under criticism for not advising their patients about “lifestyle” issues that are contributing to their illness. Yet, there is very little evidence that physicians are doing anything to respond to the criticism. Why is this?

A new organization has emerged to help mainstream medicine get with it on this all-important healthcare issue.The American College of Lifestyle Medicine is a relatively new national, professional, membership society for those involved in using lifestyle as a primary treatment modality for most common medical problems in America. ACLM represents and advocates for the practitioners and practice of effective, evidence-based Lifestyle Medicine.

ACLM is increasingly advocating for its members in terms of reimbursement, credentialing, regular news and educational events, practice model development and practice support services, etc. They are dedicated to the establishment of truly better and more rational healthcare built on dealing effectively with causes of disease and not simply treating downstream effects ad infinitum. Check them out at http://www.lifestylemedicine.org do you think that Doctors don’t talk about prevention and lifestyle? Is it because they are afraid to look like they don’t know what they’re talking about?? Give us your thoughts.

Last week Glenn Beck had about thirty physicians and medical students on the show. A clear divide on the opinions about healthcare reform from the medical students and the older physicians. Most all of the physicians currently in practice see the need for reform but strongly disagree with the government’s ability to run healthcare any better than the current system. Their complaints centered mostly around interference by the insurance company with the doctor-patient relationship; declining fees, etc., nothing we haven’t heard before. They are, however, mostly in favor of covering those who are currently uninsured. For some reason, they don’t realize that the cost of covering the uninsured will come out of their pockets. The medical students however, had no issue with a government run system, probably because they have not yet been out in the real workforce. As on philosopher once said, “anyone who is NOT a socialist before the age of 35 has no heart; anyone who IS a socialist after age 35 has no head!” Give us your take on healthcare reform. Where do you stand on the current proposals??

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?

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.

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?

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.

 

This is very scary for doctors. Who knows what is in there that will affect their practice of medicine and the requirements placed upon them as a small business. We have predicted from the beginning that three things are certain:

1. Your fees will go down. The $1 trillion price tag will be financed by healthcare providers.
   1. The red tape will increase. It will cost you more to run your practice.
   2. Your taxes will go up. A triple whammy for doctors.

Stay tuned, as we get the details we will share them with you. If any of you have read the bill or heard about issues that affect doctors, please let us know on our blog.

“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?

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.

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.