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Maintence Fee for the Priveledge of seeing a Dr

Health Care 2005

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#21 mjtian

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Posted 31 October 2005 - 04:13 PM

Quote

It's particularly ridiculous given that, as I found out recently, if a doctor works with an HMO they get a certain amount of money per month WHETHER THEY SEE THE PATIENT OR NOT!

HMO also limit the amount of work that a physician can do on a patient and tells the physicians how much they can charge.  In my mind HMOs are horrible.  They are in it only to make a profit.

Darth, as to your physician's surcharge, thats unfortunate.  You may want to consider switching to a new doc.  Today's health care is so expensive mainly due to the cost of medical malpractice insurance.  Many of the physicians today are earning less that those a generation ago.  The family practice doc that I worked with in July said his Mal practice insurance was $18,000/ year.  He has NEVER been sued in his 38 years of practice.  I can't imagine what an OB/GYN have to pay today!
"I have missed more than 9000 shots in my career. I have lost almost 300 games. On 26 occasions I have been entrusted to take the game winning shot... and missed. And I have failed over and over and over again in my life. And that is why... I succeed" -Michael Jordan

#22 bakuninmeow

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Posted 31 October 2005 - 07:30 PM

Darth: Pardon my saying so, and partially repeating already-given advice, but, talk with someone at your PPO as soon as you possibly can, and, if need be, a half-ways decent attorney versed in medical contract law, if you can find one about this matter.

Find out what your options are under the law, before you do anything else.

I personally hope that this can be resolved to the benefits of yourself and your children.

Cheers, D.

#23 rponiarski

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Posted 01 November 2005 - 12:25 PM

darthsikle, on Oct 31 2005, 04:19 PM, said:

No one asked him to go to school.  He chose to do it.  I look at Dr's financials every day of the week to rent them space.  I'm tired of hearing how a Dr's insurance tripled from $100,000 to $300,000 per year.  Bid deal.  The firm's PROFITS dropped from $1.7M to $1.5M.  Poor babies....

<{POST_SNAPBACK}>


If you are tired of hearing about how doctor's costs have increased, while the reimbursements they get have been slashed, then do something about it. Call you congressman/woman and let them no you are tired of medical costs rising without apparent end. Let them limit lawsuits or insurance company profits and see if things don't improve a lot.

Oh, by the way, when was the last time that you lowered the rent you charge doctors for space? Another cost that someone has to pay, isn't it?
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#24 darthsikle

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Posted 02 November 2005 - 11:30 AM

rponiarski, on Nov 1 2005, 05:25 PM, said:

If you are tired of hearing about how doctor's costs have increased, while the reimbursements they get have been slashed, then do something about it. Call you congressman/woman and let them no you are tired of medical costs rising without apparent end. Let them limit lawsuits or insurance company profits and see if things don't improve a lot.

Oh, by the way, when was the last time that you lowered the rent you charge doctors for space? Another cost that someone has to pay, isn't it?

<{POST_SNAPBACK}>


I could never agree to limit lawsuits and insurance company profits.  That's unamerican.  I am all for doctor's finally having to work for a living.  Maybe they can buy a new car every three years instead of two.  Maybe the vacation home can wait another year.

I have lowered my rents.  It's called the market.  When other buildings charge less, so do I.  That's what is happenening to doctors, the marketplace.  If HMO's are so bad...stop accepting it then.  Stop whining.
Goodbye.

#25 Cheile

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Posted 02 November 2005 - 02:00 PM

rponiarski, on Nov 1 2005, 10:25 AM, said:

darthsikle, on Oct 31 2005, 04:19 PM, said:

No one asked him to go to school.  He chose to do it.  I look at Dr's financials every day of the week to rent them space.  I'm tired of hearing how a Dr's insurance tripled from $100,000 to $300,000 per year.  Bid deal.  The firm's PROFITS dropped from $1.7M to $1.5M.  Poor babies....

<{POST_SNAPBACK}>


If you are tired of hearing about how doctor's costs have increased, while the reimbursements they get have been slashed, then do something about it. Call you congressman/woman and let them no you are tired of medical costs rising without apparent end. Let them limit lawsuits or insurance company profits and see if things don't improve a lot.

Oh, by the way, when was the last time that you lowered the rent you charge doctors for space? Another cost that someone has to pay, isn't it?

<{POST_SNAPBACK}>


sorry, no sympathy here.  they chose to be a doctor.  and if they think they're going broke, let THEM go to their congressman/woman and complain.  the patients shouldn't have to do their legwork for them.

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#26 rponiarski

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Posted 02 November 2005 - 08:02 PM

darthsikle, on Nov 2 2005, 12:30 PM, said:

I could never agree to limit lawsuits and insurance company profits.  That's unamerican.  I am all for doctor's finally having to work for a living.  Maybe they can buy a new car every three years instead of two.  Maybe the vacation home can wait another year.

I have lowered my rents.  It's called the market.  When other buildings charge less, so do I.  That's what is happenening to doctors, the marketplace.  If HMO's are so bad...stop accepting it then.  Stop whining.

<{POST_SNAPBACK}>


So it is all right to limit doctor's fees, but not insurance company profits or lawyers fees. Interesting. As for doctor's having to "work for a living", may I suggest you don't know a lot of them, or the ones you do are in a huge minority. I don't buy a new car every 2 or 3 years; my wife and I both have used cars. I work a regular 45 hour work week, plus at least once a week I'm on-call 24 hours and am often woken up at 3 or 4 in the AM. Don't have a vacation home and usually only take about 2 weeks off a year; I don't work, I don't get paid.

Glad that you are feeling market pressures. My neck of the woods office space just costs more, no  matter how many empty offices there are out there. I accepted the market; you haven't. Your doctor raised his fees, you don't want to pay it, find another doctor who doesn't charge them. After a while, he may stop charging them as he will lose too many patients.

And as to whining, I'm not. Just trying to show another perspective. And I stopped accepting HMO's about 5 years ago. Cut my income significantly, but I sleep better at night... :)
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#27 rponiarski

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Posted 02 November 2005 - 08:19 PM

Cheile, on Nov 2 2005, 03:00 PM, said:

sorry, no sympathy here.  they chose to be a doctor.  and if they think they're going broke, let THEM go to their congressman/woman and complain.  the patients shouldn't have to do their legwork for them.

<{POST_SNAPBACK}>


Not asking for sympathy, just understanding that there can be another point of view. Yes, I asked to be a doctor and am happy to be one. But my voice alone, or even that of all my collegues (we have written many, many letters) aren't enough. Unless the American people say something, the healthcare system in this country will continue to deteriorate, with more uninsured and higher total costs. National health care? I don't personally have a problem with it, but it will never happen unless the people say something.

Me, I will continue to make a living. Work harder, more hours for less, sure, but I can deal with that. My father, who was also a doctor, thought it was a great profession and so I followed his footsteps. Neither of my kids want to follow in ours, however, and I don't blame them a bit...
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#28 mjtian

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Posted 03 November 2005 - 01:12 AM

Quote

I could never agree to limit lawsuits and insurance company profits. That's unamerican. I am all for doctor's finally having to work for a living. Maybe they can buy a new car every three years instead of two. Maybe the vacation home can wait another year.

Darth, I have to disagree.  We all have our calling.  Some of us are destined to be a police officer, fireman, business man and some of use choose to become physicians.  There is no doubt there are greety physicians out there.  But a few rotten apple does not mean that all of us are out to get people.  

I volunteered for 2 years in highschool and 2.5 years in college.  I stayed in and studied for my pre-med exams, believe me they were brutal, while my other friends were out partying.  While my friends are getting paid $65,000 as an engineer, I am still paying $26,000 in med school tuition.  When I graduate, I have to work 100 hour weeks for a minimum of 3 years at about $40,000/year while being $200,000 in debt.  When you are sleeping at night, I am on call.  

I am not asking for sympathy as I know that I will eventually be rewarded financially and there is also job security in medicine.  However, there are plenty of jobs out there that earn plenty more than physicians.  And most of them do not face the threat of loosing everything in one law suit.  Most of them also do not pay $20,000 - $100,000 a year in insurance incase someone sues.  In the state of Missouri, a malpractice law suit can take everything from a physician and leave him/her with only $5.00.  That is the reson why many of the physicans I work with are moving across the state to Kansas becuase KS has a cap on mal practice.  So not only is missouri losing good physicians, it is also losing tons of Tax dollars from personal property and real estate.  Is that right?  

Most of us do not make anything until we reach 30.  While our friends live out their lives in the 20s we devote our time to save lives and make a difference in someone's care.  Perhaps I am a little selfish as I thrive on the fulfillment I get by seeing someone recover from an illness.  In my mind, there in nothing in the world that can give me the satisifaction when I saw my AIDS patients come in with open sores and spiking fever and leave with almost complete recovery after 2 weeks in the hospital.  Or when someone comes up to me when he was getting ready to be discharged, shake my hand and tells me I will one day make a good physician.  Afterall, I do not know any other career that can constantly challenge me mentally while still offer the gratification of know I made a difference in someone's life.
"I have missed more than 9000 shots in my career. I have lost almost 300 games. On 26 occasions I have been entrusted to take the game winning shot... and missed. And I have failed over and over and over again in my life. And that is why... I succeed" -Michael Jordan

#29 bakuninmeow

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Posted 03 November 2005 - 01:36 PM

It seems to me that a national single-payer health care system, while not perfect, would be better than what we currently have now, which is essentially rationing by price and insurance availability.

Also, some sort of effective system for sanctioning medical incompetence, neglect and gross malfeasance, other than lawsuits alone, is needed as well.

Perhaps, a combination of monetary fines, licence suspensions or bans, and, in particularly egregious cases, where permanent injury, disfigurement or death has resulted because of a medical practitioner's carelessness, criminal sanctions, including, especially in the case of a patient's death, imprisonment for substantial periods of time.

Combined with a variant on the Continental European system, as practised in France and Germany, among other countries, of setting strict monetary values on the loss of an appendage, limb, organ, etc, due to medical malpractice, and we could have, while imperfect, a much more rational and equitable health-care system than we currently do in this country.

Incidentally, by medical practitioners, I mean not only doctors, but nurses, orderlies, hospital administrative staff, and employees at all levels, but especially at the executive levels, of pharmaceutical companies, as all of these people contribute to the further betterment, or detriment, of a patient's welfare.

Cheers, D.

#30 darthsikle

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Posted 03 November 2005 - 01:50 PM

rponiarski:

Sorry, didn't realize you were a doc.  You are right, I should not have painted such a broad stroke against all doctors.
Goodbye.

#31 rponiarski

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Posted 04 November 2005 - 01:16 PM

[quote name='mjtian' date='Nov 3 2005, 02:12 AM']
[quote]
Most of us do not make anything until we reach 30.  While our friends live out their lives in the 20s we devote our time to save lives and make a difference in someone's care.  Perhaps I am a little selfish as I thrive on the fulfillment I get by seeing someone recover from an illness.  In my mind, there in nothing in the world that can give me the satisifaction when I saw my AIDS patients come in with open sores and spiking fever and leave with almost complete recovery after 2 weeks in the hospital.  Or when someone comes up to me when he was getting ready to be discharged, shake my hand and tells me I will one day make a good physician.  Afterall, I do not know any other career that can constantly challenge me mentally while still offer the gratification of know I made a difference in someone's life.
[right]<{POST_SNAPBACK}>[/right]
[/quote]

Welcome to the club. There are great satisfactions in medicine, as well as great sorrow. I'll never forget the first patient who died under my care. He was severely thrombocytopenic (no platelets to coagulate his blood) due to his leukemia. Ended up bleeding out one night when I was on call. You learn real early that you are not g-d and only human. :humble:

It is good to see someone still with all the gusto and enthusiasm that a new doctor brings. Me, I am a bit jaded after more than 25 years in the business...
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#32 rponiarski

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Posted 04 November 2005 - 01:20 PM

darthsikle, on Nov 3 2005, 02:50 PM, said:

rponiarski:

Sorry, didn't realize you were a doc.  You are right, I should not have painted such a broad stroke against all doctors.

<{POST_SNAPBACK}>


No problems. After a while you get used to it and I try not to make a big deal of it. Fact is, whenever I hear Dr. Poniarski, I turn around half expecting my father to be behind me, may he rest in peace... :humble:
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#33 mjtian

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Posted 05 November 2005 - 12:54 AM

Quote

Welcome to the club. There are great satisfactions in medicine, as well as great sorrow. I'll never forget the first patient who died under my care. He was severely thrombocytopenic (no platelets to coagulate his blood) due to his leukemia. Ended up bleeding out one night when I was on call. You learn real early that you are not g-d and only human. 

It is good to see someone still with all the gusto and enthusiasm that a new doctor brings. Me, I am a bit jaded after more than 25 years in the business...


Thanks for the kind words and advise.  I guess I am lucky so far to have not have to experience a dying patient.  Partly is because I am still a student with limited experiences, the only patient that coded when I was on service belonged to another member of the medicine team.  

Medicine does have a way of humbling you.  I will never forget the man I rounded with the team one morning in the ICU.  His recent hoarsness was not larygitis, but rather throat cancer.  Knowing his chances were awful, it didn't takes me long to appreciate allot of the everyday things we too often take for granted.
"I have missed more than 9000 shots in my career. I have lost almost 300 games. On 26 occasions I have been entrusted to take the game winning shot... and missed. And I have failed over and over and over again in my life. And that is why... I succeed" -Michael Jordan

#34 Nick

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Posted 05 November 2005 - 10:56 AM

I have a question for those in the medical profession.  Florida voters recently passed an amendment that instituted a "3 strikes" rule against physicians--basically after 3 malpractice incidents, they lose their licenses.  There was another amendment that forced medical establishments to disclose malpractice suits and such.  How do you all feel about such things?

#35 mjtian

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Posted 05 November 2005 - 12:51 PM

Quote

I have a question for those in the medical profession. Florida voters recently passed an amendment that instituted a "3 strikes" rule against physicians--basically after 3 malpractice incidents, they lose their licenses. There was another amendment that forced medical establishments to disclose malpractice suits and such. How do you all feel about such things?

Nick,

           Thats a great question.  I am not familiar with the law, but I am a little reserved.  I think it is too "general" to include all malpractice law suits.  Again, I have no idea with the details, but one of my friend's father is a surgeon and according to her, he gets sued every year.  Some of the examples she told me were laughable.  But if the law deals with pure negigence, 3 chances may be too much.  I recall several years ago, a surgeon was sued because he left the operating room to goto his bank.  So I think it should be based on a case by case situation.  

mjtian
"I have missed more than 9000 shots in my career. I have lost almost 300 games. On 26 occasions I have been entrusted to take the game winning shot... and missed. And I have failed over and over and over again in my life. And that is why... I succeed" -Michael Jordan

#36 rponiarski

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Posted 05 November 2005 - 01:55 PM

Nick, on Nov 5 2005, 11:56 AM, said:

I have a question for those in the medical profession.  Florida voters recently passed an amendment that instituted a "3 strikes" rule against physicians--basically after 3 malpractice incidents, they lose their licenses.  There was another amendment that forced medical establishments to disclose malpractice suits and such.  How do you all feel about such things?

<{POST_SNAPBACK}>


I am very leary of this law. First of all, most malpractice suits are of the type where there is a bad outcome and the patient or his/her family figures it's the doctor's fault, so they sue. They usually don't win, but many are settled by the malpractice insurance carrier as it is cheaper to settle than fight it in court.

Now consider the fact that some specialties get sued right and left, such as neurosurgeons or OB/GYN's. When they are sued, does each suit count as a "strike"? What about settled suits, where there was no liability admitted, but monetary compensation was paid. Does that count?

Don't get me wrong; there are doctors who are incompetent and shouldn't be practicing medicine. That's as true in medicine as in any field. There just should be a better way than that Florida law...
Richard M. Poniarski
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