Doctors in most practice settings have very little control over the quality of care these days, believe it or not. Several factors converged. One was an unintended side effect of anti-kickback and anti-fraud laws like the Stark Law preventing ownership of healthcare facilities by the physicians who practice there to prevent the temptation to provide superfluous and unnecessary tests for the sake of extra billing money.
This opened to door to corporate ownership, and doctors gave up too much of their autonomy and control, becoming “mere” corporate employees like the rest of us. The corporations deliberately understaff and just push more and more and more patients onto doctors, nurses, respiratory therapists, everyone all across the board are being expected to take on more and more. Which of course degrades the quality of care.
It’s the corporations keeping the excess profit generated, not the physicians. Physicians have finally started seeing what’s going on and unionizing (at least up here in Massachusetts - University of Massachusetts and Mass General Brigham are both major hospital systems where resident doctors have unionized.) And it’s the resident (“junior”) doctors who are currently on strike in the UK.
Honestly, we need to get hospital ownership out of corporate hands and back into the hands of the providers who are motivated to take care of patients. We need to figure out better mechanisms for regulating fraud
A friend who is a recently new medical Dr. also told me about an unintended (well—lobbyist intended) consequence of Obamacare (USA specific ofc). Basically the bill included a clause requiring providers to use electronic healthcare records. This was supposed to be partially so that the hospitals could coordinate patient information better but that bit didn’t work because everyone implemented their own system and the systems largely don’t talk to eachother. But who now gets a tidy copy of all the patients’ charts? Their insurance companies ofc! Insurance companies are using the more detailed info to reject reimbursements if the chart doesn’t include extremely specific language the insurance company can say “that wasn’t documented to standards” and just not pay for it. If providers (doctors as well as hospitals) want reimbursements they have to keep up with all this language specified by the insurance companies and make sure they train everyone on the updates about once every six months. Obviously this puts more strain in smaller systems (and economically disadvantaged ones) that don’t have the money to basically hire lawyers to keep up with the documentation required in order to receive reimbursement. It’s absurd to me our doctors are having to put so much time into paperwork (and apparently having to wait 15 seconds between every click in the EHR databases but that’s almost a separate issue).
I’m fully aware of why, but it doesn’t change the fact, that I as the end user, get FAR less care than I did 5 years ago. AND I keep paying more and more and more every year for even less care.
I mean yes, I’m not contesting that. But laying responsibility for that at the feet of doctors is not going to fix the problem when corporations are the problem
Doctors in most practice settings have very little control over the quality of care these days, believe it or not. Several factors converged. One was an unintended side effect of anti-kickback and anti-fraud laws like the Stark Law preventing ownership of healthcare facilities by the physicians who practice there to prevent the temptation to provide superfluous and unnecessary tests for the sake of extra billing money.
This opened to door to corporate ownership, and doctors gave up too much of their autonomy and control, becoming “mere” corporate employees like the rest of us. The corporations deliberately understaff and just push more and more and more patients onto doctors, nurses, respiratory therapists, everyone all across the board are being expected to take on more and more. Which of course degrades the quality of care.
It’s the corporations keeping the excess profit generated, not the physicians. Physicians have finally started seeing what’s going on and unionizing (at least up here in Massachusetts - University of Massachusetts and Mass General Brigham are both major hospital systems where resident doctors have unionized.) And it’s the resident (“junior”) doctors who are currently on strike in the UK.
Honestly, we need to get hospital ownership out of corporate hands and back into the hands of the providers who are motivated to take care of patients. We need to figure out better mechanisms for regulating fraud
A friend who is a recently new medical Dr. also told me about an unintended (well—lobbyist intended) consequence of Obamacare (USA specific ofc). Basically the bill included a clause requiring providers to use electronic healthcare records. This was supposed to be partially so that the hospitals could coordinate patient information better but that bit didn’t work because everyone implemented their own system and the systems largely don’t talk to eachother. But who now gets a tidy copy of all the patients’ charts? Their insurance companies ofc! Insurance companies are using the more detailed info to reject reimbursements if the chart doesn’t include extremely specific language the insurance company can say “that wasn’t documented to standards” and just not pay for it. If providers (doctors as well as hospitals) want reimbursements they have to keep up with all this language specified by the insurance companies and make sure they train everyone on the updates about once every six months. Obviously this puts more strain in smaller systems (and economically disadvantaged ones) that don’t have the money to basically hire lawyers to keep up with the documentation required in order to receive reimbursement. It’s absurd to me our doctors are having to put so much time into paperwork (and apparently having to wait 15 seconds between every click in the EHR databases but that’s almost a separate issue).
This is what I come here for, strong facts based analysis. Thank you for your service.
I’m fully aware of why, but it doesn’t change the fact, that I as the end user, get FAR less care than I did 5 years ago. AND I keep paying more and more and more every year for even less care.
I mean yes, I’m not contesting that. But laying responsibility for that at the feet of doctors is not going to fix the problem when corporations are the problem
More accurately, a for profit system is the real problem.
So accurate