My internist just sent out a notice saying that he was leaving medicine. He has over 20 years of experience in internal med. No reason was given for the career change in the notice. One less doctor to care for more insured in the area I live in.

I didn't get to keep my doctor as promised by the Great One but I can only guess that the ACA may have had a role in the doc choosing to leave medicine.

(12-30-2014 10:49 PM)UM2001GRAD Wrote:  

(12-30-2014 10:45 PM)Machiavelli Wrote:  I think Owl is off on his zero sum game comment too. The cost curve is flattening and we are becoming more efficient because of it.

Owl should vote in the poll above. Then he can explain to all the other right-wingers why he's okay with individual mandates.

I've made it clear that I favor Bismarck, which has its own approach that doesn't really fit any of your choices.

(12-31-2014 05:10 PM)Owl 69/70/75 Wrote:  

(12-30-2014 10:49 PM)UM2001GRAD Wrote:  

(12-30-2014 10:45 PM)Machiavelli Wrote:  I think Owl is off on his zero sum game comment too. The cost curve is flattening and we are becoming more efficient because of it.

Owl should vote in the poll above. Then he can explain to all the other right-wingers why he's okay with individual mandates.

I've made it clear that I favor Bismarck, which has its own approach that doesn't really fit any of your choices.

It seems like that would fall in option #2.

(12-31-2014 03:57 PM)dawgitall Wrote:  

(12-30-2014 10:53 PM)Fo Shizzle Wrote:  

(12-30-2014 10:45 PM)Machiavelli Wrote:  I think Owl is off on his zero sum game comment too. The cost curve is flattening and we are becoming more efficient because of it.

My costs rose Mach. My Doc told me this afternoon that his paperwork has increased and he is being ordered to follow ACA directives that are unnecessary and cost his patients more. How do "mandating" unnecessary procedures and tests make the system efficient?

Doctors, like everyone else hate paper work. They also hate the transition to electronic records. It costs money consumers time and requires learning something new. But in the long run it is much more efficient, saves money, leads to fewer duplication of tests and procedures, allows doctors to make more informed decisions and saves lives. Don't mistake gripping about mundane requirements for an informed condemnation of reform.

I'd bet my house that it doesn't lead to fewer duplication of tests. The local hospital that I work with owns another local hospital about 30 miles away, but they cannot see each other's tests. So if you go to the ER at one hospital on Monday and get labs, X-rays, etc then you can go to the other hospital the next day and have the exact same tests. I also see it in my own practice where we need labs in a patient but have no clue if their pcp has drawn the needed labs recently.

(12-31-2014 03:57 PM)dawgitall Wrote:  

(12-30-2014 10:53 PM)Fo Shizzle Wrote:  

(12-30-2014 10:45 PM)Machiavelli Wrote:  I think Owl is off on his zero sum game comment too. The cost curve is flattening and we are becoming more efficient because of it.

My costs rose Mach. My Doc told me this afternoon that his paperwork has increased and he is being ordered to follow ACA directives that are unnecessary and cost his patients more. How do "mandating" unnecessary procedures and tests make the system efficient?

Doctors, like everyone else hate paper work. They also hate the transition to electronic records. It costs money consumers time and requires learning something new. But in the long run it is much more efficient, saves money, leads to fewer duplication of tests and procedures, allows doctors to make more informed decisions and saves lives. Don't mistake gripping about mundane requirements for an informed condemnation of reform.

The paper work part may indeed in the long run be Ok after the learning curve is breached. I noticed though you had zero to say about the bigger problem...mandating procedures that may not be necessary. What happened to a physician being able to treat patients as they see fit? I thought the ACA was supposed to make HC less expensive?

(01-01-2015 12:00 PM)Fo Shizzle Wrote:  

(12-31-2014 03:57 PM)dawgitall Wrote:  

(12-30-2014 10:53 PM)Fo Shizzle Wrote:  [quote='Machiavelli' pid='11604013' dateline='1419997530']
I think Owl is off on his zero sum game comment too. The cost curve is flattening and we are becoming more efficient because of it.

My costs rose Mach. My Doc told me this afternoon that his paperwork has increased and he is being ordered to follow ACA directives that are unnecessary and cost his patients more. How do "mandating" unnecessary procedures and tests make the system efficient?

Doctors, like everyone else hate paper work. They also hate the transition to electronic records. It costs money consumers time and requires learning something new. But in the long run it is much more efficient, saves money, leads to fewer duplication of tests and procedures, allows doctors to make more informed decisions and saves lives. Don't mistake gripping about mundane requirements for an informed condemnation of reform.

The paper work part may indeed in the long run be Ok after the learning curve is breached. I noticed though you had zero to say about the bigger problem...mandating procedures that may not be necessary. What happened to a physician being able to treat patients as they see fit? I thought the ACA was supposed to make HC less

I would need to have more specific information to comment. There is a lot of misinformation out there and I don't want to contribute to that when I'm ignorant to any kind of mandated procedures.

(01-01-2015 10:13 AM)dfarr Wrote:  

(12-31-2014 03:57 PM)dawgitall Wrote:  

(12-30-2014 10:53 PM)Fo Shizzle Wrote:  

(12-30-2014 10:45 PM)Machiavelli Wrote:  I think Owl is off on his zero sum game comment too. The cost curve is flattening and we are becoming more efficient because of it.

My costs rose Mach. My Doc told me this afternoon that his paperwork has increased and he is being ordered to follow ACA directives that are unnecessary and cost his patients more. How do "mandating" unnecessary procedures and tests make the system efficient?

Doctors, like everyone else hate paper work. They also hate the transition to electronic records. It costs money consumers time and requires learning something new. But in the long run it is much more efficient, saves money, leads to fewer duplication of tests and procedures, allows doctors to make more informed decisions and saves lives. Don't mistake gripping about mundane requirements for an informed condemnation of reform.

I'd bet my house that it doesn't lead to fewer duplication of tests. The local hospital that I work with owns another local hospital about 30 miles away, but they cannot see each other's tests. So if you go to the ER at one hospital on Monday and get labs, X-rays, etc then you can go to the other hospital the next day and have the exact same tests. I also see it in my own practice where we need labs in a patient but have no clue if their pcp has drawn the needed labs recently.

If I'm not mistaken every facility has to go to electronic filing and there is more than one system out there so not every facility could communicate seamlessly with every other. However it seems unlikely that two facilities within the same system would be on different electronic filing systems. If they are then those administrators need to be fired.

(01-01-2015 12:24 PM)dawgitall Wrote:  

(01-01-2015 12:00 PM)Fo Shizzle Wrote:  

(12-31-2014 03:57 PM)dawgitall Wrote:  

(12-30-2014 10:53 PM)Fo Shizzle Wrote:  [quote='Machiavelli' pid='11604013' dateline='1419997530']
I think Owl is off on his zero sum game comment too. The cost curve is flattening and we are becoming more efficient because of it.

My costs rose Mach. My Doc told me this afternoon that his paperwork has increased and he is being ordered to follow ACA directives that are unnecessary and cost his patients more. How do "mandating" unnecessary procedures and tests make the system efficient?

Doctors, like everyone else hate paper work. They also hate the transition to electronic records. It costs money consumers time and requires learning something new. But in the long run it is much more efficient, saves money, leads to fewer duplication of tests and procedures, allows doctors to make more informed decisions and saves lives. Don't mistake gripping about mundane requirements for an informed condemnation of reform.

The paper work part may indeed in the long run be Ok after the learning curve is breached. I noticed though you had zero to say about the bigger problem...mandating procedures that may not be necessary. What happened to a physician being able to treat patients as they see fit? I thought the ACA was supposed to make HC less

I would need to have more specific information to comment. There is a lot of misinformation out there and I don't want to contribute to that when I'm ignorant to any kind of mandated procedures.

For instance...I have a thyroid condition treated with Synthroid. I have been taking this drug for over 25 years. In the past...I simply got my hormone levels checked every year during my annual checkup and if the Doc needed to adjust my dose he did it then. It only rarely changed ever in just tiny degrees. Now...I have to have it checked every 4 months per ACA guidelines. That is 2 more doctors visits and labs per year.