|
|
 |
 |
 |
|
|
|||
|
||||
|
||||
Re: VBACFrom: jkulkin (jkulkin@mindspring.com)Sun Oct 29 19:01:27 2000
Very unfortunate and I share your frustration. I invite any of you to spend a day with me in a managed care setting. I invite you to review the medical records of 25 yo women with 2cm ovarian cyst scheduled for emergency laparotomy and oophorectomy. When I talked to the doctor about this case and suggested a laparoscopy he said, "Good idea". Should I have to do this. I see myself as a patient advocate. I invite you to review records of proposed diagnostic cardiac caths with a follow up angioplasty proposed for 3 days later if disease is found . For list members this is like doing a diagnostic laparoscopy on Monday and ablating the discovered endometriosis on Thursday. After 3 full years in this new arena I can safely say there is good and bad managed care as there are varying qulaities of any service or business. There are several companies with excellent programs in place and they are also working hard to improve. There are available data on the internet on hosptal profitability.....so understand that well managed hospitals today are in fact quite profitable. Some of these hospitals even have mobile cardiac cath labs (that's right...mobile) with no ability to do interventions. I am with a managed care company that actually includes community physicians in the development of HMO policy. These physicians also review cases against community developed guidelines. Georgia is one of 3 states in the country with a mandate that insurane companies must pay for chlamydia screening. Why is it then that only 25% of patients in the 16-26 yo age group have this screening. We are in the middle of a quality initiative to be certain this number increases substantially. And yes, we do pay for it to be done. Actually, I left practice after having a hysterectomy denied...18 week fibroids with a Hb of 7. The medical director wouldn't take our phone calls and the patient had an emergency hyst at a county hopital at 3 am on a Sunday. We are now in bad need of moving this health care transition to a sytem of care delivery that is more effective from both a quality and cost perspective. Patient satisfaction is very low. I have a personal friend who today is 2 days post total knee replacement and a PA made rounds on her. NO DOC. Explain that to me as I just don't get it? I could probably go on for hours expressing the passion I have for working on the system on behalf of the patients. I hope you'll all find a way to contribute to the change. I don't see a turnaround to medicine as practiced 20 years ago just as I don't see the present system prevailing. The final model is to be determined. Jay "art fougner, md" wrote:
> that was then - this is now - today hospitals are up against it, thanks
|
|
Return to
|
Mail a New Message to the Forum: ob-gyn-l@obgyn.net Forum Administrator: geffrey.klein@obgyn.net Report Technical Problems: webmaster@obgyn.net Last Updated: Mon Nov 2 04:46:08 2009 |
The American Medical Association is no longer designating CME hours for AMA Category II CME credit. However, physicians themselves may self designate learning activities as Category II CME credit hours if they feel it is of sufficient educational merit and meets the formal definitions of continuing medical education. OBGYN.net believes these interaction in this forum meets these criteria. For further information see the AMA web site.