Tuesday, January 29, 2013

The Current State of Medical Care – A Doctor’s Perspective





Read this and weep.

I add one caveat. Socialized medicine, if that is what you want to call it needs to be made competitive by been regulated on a State by State basis at least. There will still by national associations to use when appropriate.

Otherwise the present US system is disgusting. Today, all Canadians have medical care and most if not all Canadians are happy. The only twist needs to be the availability of private clinics for those who wish to jump queue for certain procedures.

In short, the Canadian system can be made somewhat better but presently costs half as much to deliver one hundred percent.

That same system flew my sister in law and attending family from Regina to Toronto for brain surgery with the best talent available. They do as much for an Eskimo having a difficult delivery above the Arctic Circle. It may not be paradise but it is certainly not the hell that the American system is for at least 100,000,000 Americans.

A legitimate comparison leaves an investigator in a rage.



The Current State of Medical Care – A Doctor’s Perspective

Dr. Shawn Tassone, Guest Writer
January 8, 2013


A recent study of over 1,000 family practitioners stated that close to 70% of primary care providers would be either retiring or leaving medical care within the next 5 years.  While this is disturbing, what I found more disturbing is the responses to this story on google.  Most, if not all of the responses were blasting the medical professionals for being whiners and for making too much money.  Is that what patients are truly upset about is that their doctor is making too much money.  Obviously, people are entitled to their belief systems, but what a horrible system in which to operate.

Doctors are whiners?  The real reason that I will see 44-50 patients per day is because people call my office and need to be seen; does this make the patient a whiner?  I would say no, this means that the patient feels the need to see a doctor and on our end, we try to work them in so that this service can be provided.  In a socialized format, this phone call to be seen on the same day will be a thing of the past, and with lower numbers of doctors practicing medicine, there will be less appointments.

I am not starving to death and I never have complained about my income.  I can tell you that I have spent 4 years in medical school, 4 years in residency, and 2 years in fellowship (all after college), to get where I am today, and yet, there seems to be a culture in this country that 10 years of postgraduate work should not be monetarily rewarded, or if one makes money then this makes them a greedy or bad person somehow.  I am always fascinated how people make money in this country.  I know many people that did not graduate from college that are making more than me, and I do not belabor them; I wonder how they did it.

Medical reimbursements have not increased substantially in the last 10+ years, while hard costs for running an office, employee payroll, medical malpractice, and cost of equipment have increased substantially.  The main cost at my office is payroll and employee benefits and this increases yearly.  The reason for this increase is that we have wonderful employees and we pay them in order to keep them.  My main postulate is that we take care of people.  We make money as physicians and we give money back.  The truth of the matter is that money seems to be how people are judged in our society, and I am not sure this is a true measure of a person’s worth.

Medical care in this country is beyond sick, it is in the throes of death and will not be recovering.  Who is to blame?

* The doctors for making too much money?  If that were the case then why would more than 70% of primary care physicians be leaving medicine in the next few years.  I would think that the promise of a lucrative income would keep them plugging away.  The truth is that the work loads and patient dissatisfaction with their own casts is pushing physicians out of medicine.  The volume of paperwork is a monster that has consumed many medical practices and this is worsening.  Money is not worth the paper it is printed on….literally.  Physicians don’t make too much money, they are burned out trying to get the payments from insurance and buried under mountains of paperwork.

* The patients for not taking better care of themselves?   Unfortunately, one of the reasons we are one of the least healthy countries in the world is not because of our medicine, it is because of our nutrition.  When drive through burgers are cheaper than fresh produce, this is a problem.  When the main portion of a diet are aspartame, corn syrup, and meat byproducts (whatever those are), then this is a problem.  We have expensive medical care, no doubt, but we use it too much.  Patients are plagued by rising medical insurance costs and many of them have no idea what their plans even cover.  Medical insurance is only good in this country if you don’t get sick.  Patients should be rewarded for being the right weight and for being healthy.  Health insurance should also be there for patients when they need it.

* Frivolous lawsuits.  While lawsuits are definitely warranted in cases of gross negligence, the amount of frivilous lawsuits yearly is laughable.  Similar to the woman that burned herself on coffee from McDonalds and won multiple millions of dollars (now we have warnings that our coffee is hot) for something that seemed common sense.  We want to blame someone when complications happen.  Unfortunately, medical care is not perfect, because the people giving the care are human.  We have a robot for surgery.  The robot is still run by a human being.

* Insurance companies.  You pay the premiums, they deny procedures.  You drive out of the state where you reside and your coverage stays behind (ridiculous).  Have you ever really sat down and read your policy?  Do you know what they pay for if you go to the emergency room?  Do you know what your copay is for a visit at the doctor’s office.  Did you know that copays and premiums have been skyrocketing for years and reimbursements for procedures and physician visits have not……..where is this money going?  If the insurance companies would spend more time paying for legitimate healthcare that you have subsidized with your premium payments, rather than spending money on trying to find a reason for denial, it would more than likely save money.

The main point of this essay, is to point out the fact that our medial system is ready to die and I think we need to let it go.  I might get raked over the coals by colleagues for this, but if Obama wants to socialize medicine, I say let it be.  I am very suspicious that socialized medicine will work and I am not for paying higher taxes, but I think the current system is disgusting.  If socialized medicine means that patients are happy, this in turn will truly help me sleep better at night.  I think consumers should be happy with the product they receive, and while I feel that physicians are doing the best we can, the patients are not happy.  Physicians let managed care take over in the 80′s and we should jump on the grenade created by the current state of affairs. Medicine is controlled by bureaucracies and socialized medicine would be the biggest bureaucracy of them all.

The question would be, once medicine is controlled by Uncle Sam, will we be a healthier nation?  Will we be able to regulate something that has been removed from the public sector.  How many jobs will be lost just in the private insurance sector?  These are questions that need to be evaluated.

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