Well all of the physicians and surgeons that are in private practices that we are associated with are "sick" over Obamas re-election because it will likely mean we will all be forced out of private practice. Forced into large groups, hospital groups which will cause our patients to wait weeks if not months for appointments, require that we spend less time with each patient and if we do chose to stay in private practice we will be forced not to accept new Medicare or Medicaid patients as our reimbursements will be too low to cover our operating costs and/or provide us any profit at all. It is so sad that voters did not fully understand the ramifications of re-electing Obama. The entire Obamacare legislation was set up for failure in an attempt to establish Universal Coverage; as they will claim it is the only remaining alternative. Fortunately, my husband and many of his associates at the Hopsitals for which he is on staff are close to retirement and won't feel the full effects of ObamaCare. But, the new graduates that are in debt to the tune of $100-500,000 and forced to borrow up to $200,000 to set up a private practice or accept poor wages as employees of group practices or the VA hospital system are totally screwed. Good luck to those of you that supported ObamaCare, you will get what you voted for and you will see how poor this Legislation was written and you will see your taxes, tax penalties for non-insurance, loss of group health coverage and increase in premiums rise.
That is bull a Registered Nurse could do a good portion of basic primary care duties treating a minor leg infection or treating a routine UTI is basic work, a LPN should oversee them and could do primary care that is more complex leaving MD's to handle more difficult or specialty cases which with their high level of training is what they should do. And for women a Nurse-Midwife can handle issues to. If the patiant load can be shifted to using MD's for only cases where their expert skills are more called for it would be better for the system. And who says a private practice is best medical groups and other options would be as good for the new MDs they would get a salary and other benefits and could under the new models be key parts of health care teams, working with others to provide patiants the care they need. I would say the main issue is the cost of educating doctors a real issue states should address perhaps they could have reduced costs if the doctor agrees to practice in his home state for say ten years making the degree itself very inexpensive to get.
Thank God you aren't in charge of regulating Health Care. "That is bull a Registered Nurse could do a good portion of basic primary care duties treating a minor leg infection or treating a routine UTI is basic work". #1. you need to be examined by a licensed physician, he/she orders necessary tests and/or treatment including giving you any drug prescriptions necessary. A Nurse or LPN is not able to give drug prescriptions nor are they able to diagnosis illnesses, or are they able to read x-rays or ultrasounds or any other diagnostic test, nor are they able to order any tests. They are only able by law to perform tasks under the direction and supervision of a licensed physician. So your entire statement is both unintelligent and totally wrong. And, why should a physician not be allowed to charge what he/she determines is a reasonable cost for their services when every other Professional is allowed to do so? Unless they are paid to attend Medical School and then upon graduation they become an employee of the the U.S. Government, the Federal Government should not be allowed to "set their fees". I believe what the Government is doing is called "price fixing". That isn't legal. It is obvious that you have no understanding of how health care is administered, the cost of equipment, the cost of developing new drugs, treatments, surgical instruments or the cost of providing treatment/surgery to patients. And, as far as shrinking the number of private practices; I for one don't want to wait hours to see my doctor or months to get an appointment. I find that seeing a doctor who is in private practice is a much better overall experience and enjoy their ability to spend quality time with me. I won't even seek treatment from a doctor or surgeon that is part of a large multi-specialty practice as I have found it to be a very bad experience and believe the quality of the care provided is not up to par.
Change the laws and add a specialty primary care nurse option, problem solved. These paraprofessionals would be working under an MD or LNP. I just feel its basic plumbing order the standard tests, read the results and treat is most primary basic care for complicarted cases I would move up to a LNP then up to an MD or Specialist MD as needed. States decide this they license medical providers so they could do that. Also what about open the borders any experienced Cuban doctor could do primary care and you know this how complicated is diabetes care here compared to China or India or Greece or Russia I would think an MD with a degree from a GAAP recognized school and five years of practice could do the same job as a general practice doctor. And would work cheaper. As for practice side the ACA is moving to a team model not private practice where an MD works with others including LNPs and other sorts of providers to give care, the private practice is unlikely to last when people move to medical homes as they are considered. And billing at hospitals will be consolidated with these practices to ease paperwork. I for one think this is better say a patiant has complex issues and needs three MD specialists its far better to do that in one place coordinated by a nurse specialist in that and with support people like nutritionists and even mental health providers in the mix. I do know one thing being on the bottom of the food chain I have a leg infection now and due to lack of money am using bought in the mail amoxcillin 500 mg pills human medication capsules for aquarium use to treat it and thankfully its working well, since its my only option right now. Seeing any ER would have been prefered or better medical management of my conditions which for me in non-existant that makes my infections more likely to happen. I can't even work all out so if I do need to go to the ER I will count as a charity case or they won't bother to try and collect. The ACA for me will mean I can work again and get either into Medicaid or maybe an exchange if I earn enough for that, and any model like you seem to support that ignores the poors needs is not something I can support. And voted for Obama/Biden it was really my only chance to get medical care. I don't care how they screw up doctors old ones can leave and we can fill those slots with other options and foreign MD's if needed later on in the end things will work out I'm optimistic unlike you. It may take getting used to and work to get to that point. I know this about health care for the poor its (*)(*)(*)(*), doctors and the system is putting profits ahead of serving the people who need help and ignore their duties to help others. I like doctors my grandfather was one and in his day he expected to live in the middle class level for his life similar to a good established union man, have job security and heal those in need and didn't put the almighty dollar ahead of his moral obligations as a healer. And drug companies at the time sought fair profits but not to the point of gouging a new drug that came out in his time a new antibiotic was sold at a modest markup of 22% the cost to make, it sold well and they made money and patiants got access to a fine new drug at a reasonable price. What happened to that picture in this nation?
pity the repugs wouldnt let him have true universal single payer healthcare. blame them for the half assed result
This statement is an insult to the Health Care Profession. Do you want them to work for free? Do you believe a plumber, electrician, Lawyer, accountant should make more per hour than someone that is responsible for your health, your life? The only way to get the result you and other dems want IS universal health care and for the federal government to employ all health care providers and own all clinics and hospitals. Until that time, providers are small businesses or limited partnerships or corporations and as such can charge a fee for the service they provide that covers their costs and earns them a profit equal to their education, experience and specialty training. If it were not for the interference of the Federal Government and Medicare and Medicaid low onset of PPOS, HMOS and the like we would see physician and hospital fees be more competative as they compete for patients. And, if patients/insured did not expect health insurance to cover Every cost, unlike how the medical insurance system operated in the early years(as true insurance), the premiums would not be so high. When you pay for none of the medical care provided you, you have no skin in the game and abuse the system. If you could purchase only the coverage that you truly need, premiums would be lower. If you paid cash for ordinary office visits for check-ups, colds and preventative care, the fees would be less as the cost of providing the treatment and administrative costs would be lower. At this point, if you want Universal Health Care, move to another Country, but remember that many providers flee to the U.S. to practice and many patients flee to the U.S. for their treatment. You have a right to your beliefs, but please don't say that Doctors and Hospitals are greedy and don't care about patients. My husband and the Hospitals he admits his patients to have provided too many patients care and surgery for free inorder to save their lives and limbs. They expose themselves to frivolous law suits everyday while they attempt to treat their patients and improve their lives. But, they like all professionals deserve to be paid a fee that reimburses them for their education, training and expertise. Good lord, people pay thousands of dollars out of pocket to vets to save their pets, pay plumbers and electicians over $50.00/hour +service call fees, pay lawyers hundreds of dollars "per minute" to represent them and give them up to a half of the money awarded by juries if they win a case taken on contingency. People like you and the other posters that demonize doctors make me sick. And, medical debt bankruptcy is the biggest hoad perpetrated on citizens. I have worked in health care administration for hospitals, doctors and nursing homes and I have "never" seen a case where any of them have failed to work with a patient that didn't have the income to pay their bill. I have seen them work out payment plans for as low as $10.00/month without interest and seen doctors and hospitals write off up to 100% of the amount owed as a loss when the patient had no insurance or ability to pay. So get real. Stop the bull. And, learn the facts and stop relying on results of a poorly constructed study by the very liberal Harvard University and if you don't believe their study was flawed look up the Congressional hearing on this inaccurate research, the only research that they base the "medical debt biggest cause of bankruptcy". (i am sorry if this post has problems as I suddenly experienced a technical problem when attempting to post it)
To "tkolter", para-professionals already perform their job under the direction of a licensed physician. No need to establish a "new specialty" as you propose above. And, to "gabriel1", the Republicans had absolutely nothing to do with the PPAC(obama care) as they were not allowed to participate in writing it, amending it and finally even being able to vote on the legislation/act through the normal process a bill is suppose to follow as posted on the Congressional website. The Democrats circumvented the normal legislative process. So anything that comes from Obama Care, good or bad is all on the Democrats. Including the lies regarding how it will lower premiums and assure that the uninsured gain affordable coverage. I am going to post the negative effects of PPAC that Patients, Hospitals, Doctors and Surgeons are already experiencing in a new thread.
Not true you can make LNP's who have masters degrees as is standard in primary care nursing primary care providers proper without supervision needed, if they need to have a person see a MD then they would just refer them like any primary provider would. If the case is a common one they should be as good as an MD. And I would love to see us take in MD's from other nations on a fast track to fill the need limited to general practice only this could also be done by regulation changes. (Fair guidelines will need to be set but that is not complex if the party went to any first world nations medical program or a good system like Cuba and India have for medical training.)
We should not favor any person who can hurt our economic structure but in case Obama he has done lot of work for making our country strong and efficient. For this reference we should not be opposition of him
Now that more Americans will have coverage, there is more incentive for them to go to the doctor's office, get better health advisory, and pursue good health practices. Ultimately this means doctors will make MORE money contrary to the lies of the America hating far right delusionals.
They just don't want to work in a group setting with other professionals for the good of the patiants, many of these private practice doctors are selfish and look down on other options such as LNP's that are encouranged under Obamacare. My dad is a fine example he has six doctors and other professionals in four practices and no one is talking to anyone else, I told him to find a group practice to place all this care in one place.
