The article below raises serious questions. Questions related to expectations of patients of their physicians and hospitals and the health system as a whole. Questions about the expectations of physicians about their economic status, both in terms of finances but also legal exposure for care. Questions about the disparities in payments for services between one carrier and another. Questions about the true costs of medical services. Finally, questions about how we are going to create incentives that reward physicians for quality care, while reducing their legal risks and maintaining legitimate expectations about economic success.
These are tough questions. For while many Americans feel doctors are overpaid, few want to go to a doctor who is perceived as not financially successful. For while many Americans may resent a large home or car owned by their physician, they wonder about the physician who lives modestly – is he/she really any good? For while many Americans feel doctors are very wealthy, in point of fact, most physicians live well, but are NOT wealthy. There is a world of difference. One requires major cash reserves, the other major cash flow. Most physicians can qualify to some degree on the cash flow, but most do not qualify on the cash reserve side of the equation. Why? Because most physicians do not actually begin practice until they are in their early to mid 30’s. Also, most leave medical school and residency in major debt, often well over $200,000 or more in debt. So they open their working career with a house note but no house, so to speak.
In the end, we must find a way to remove excessive risk from the practice of medicine allowing doctors to again use judgment. Otherwise, the natural tendency for a multiplicity of reasons will be to reach for the most expensive of all medical instruments: the physicians pen. The doctor’s pen wields more economic power than any other tool. With it medications, tests, imaging studies, procedures of all types and surgery can be unleashed from the medical / surgical armamentarium. Wise use of this instrument is not only necessary for good patient health and outcomes, but it turns out, may be one of the major keys to reduce spiraling health care costs. In the end doctors are human, and they respond to the same incentives that any human would. Common sense can solve much of this, that is if there is enough of it left in our political leaders . . . jomaxx
The Cost Conundrum – What a Texas town can teach us about health care.
McAllen is in Hidalgo County, which has the lowest household income in the country, but it’s a border town, and a thriving foreign-trade zone has kept the unemployment rate below ten per cent. McAllen calls itself the Square Dance Capital of the World. “Lonesome Dove” was set around here. McAllen has another distinction, too: it is one of the most expensive health-care markets in the country. Only Miami—which has much higher labor and living costs—spends more per person on health care. In 2006, Medicare spent fifteen thousand dollars per enrollee here, almost twice the national average. The income per capita is twelve thousand dollars. In other words, Medicare spends three thousand dollars more per person here than the average person earns.
http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande?yrail
www.blogburst.com
www.condron.us
http://en.wikipedia.org/wiki/Medical_malpractice
http://www.mayoclinic.com/health/aboutthissite/aboutmayoclinic
http://www.dhr-rgv.com/whoweare.htm