Re: Menpause Question-long
From: art fougner, md (evsono@pipeline.com)
Wed May 9 10:46:35 2001
well there's the rub - good advice is not reimbursable, therefore seldom
given. since most advice is not worth more that what you pay for ...
Funny, we are the only group of professionals who are NOT paid for
advice, especially telephonic advice. and Jay, i quite agree, the
system is broke, literally, figuratively, and soon monetarily.
and el - those club memberships were taken over by HMO CEO's long ago.
art
At Tue, 08 May 2001, jkulkin wrote:
>
>Ah, to get on the soapbox.....
>
>This is part of the problem. Docs might love to "shoot the breeze" about
>menopause but the consumers and payors see this as anything but "shooting
>the breeze". This is valuable educational time and resources dedicated to
>wellness, which is what medicine is supposed to be about. Docs can't be
>expected to spend an hour talking about HRT at office visit
>reimbursements. Why do docs feel like they have to do it all themselves?
>What happened to delegating to responsible ancillary personell. Docs can
>however, provide accurate up to date information to their patients for home
>consumption. Patients with special needs can then arrange for additional
>paid for consultation. The information doesn't mean a pharma produced
>pamphlet that says HRT prevents Alzheimers. It should be as evidenced
>based as we can get. Technology makes this avaialble from a variety of
>sources (MEDEM?)
>
>The story running on Tom Brokaws news this week suggesting the entire
>delivery system is broke is really on target. Docs can't be expected to
>do "everything" anymore than a gourmet chef can be expected to do
>everyithing from the shopping, to table preparation, serving food and
>cooking as well. In health care delivery docs in control of the system are
>so afraid to change the delivery process. In my MBA training the analogy
>was used that Starbucks didn't change coffee, they changed the way we drink
>it. We need to do the same in health care. Comprehensive Women's clinics
>providing the staff to provide all ancillary services is becoming popular.
>The days of the cottage industry practice as we knew it as kids is
>history. In addition, remember when it comes to menopause we are talking
>about catering to a baby boomer generation that has driven presidents from
>office and made self empowering businesses like Home Depot a success.
>
>Tonight my mom rests comfortably in a hospital with an abnormal EKG after a
>near syncopal episode. Strss thallium and echo are abnormal necessitating
>cath tomorrow. Her doc, who I know for years, is a well trained
>cardiologist who does cath's in a facility that can't do angioplasty. So
>if a lesion requiring angioplasty is found tomorrw she must then be
>transferred to a facility for a second cath and angioplasty. This is
>doubly expensive, doubly anxiety producing and doubly risky. Wrong...we
>transferred her before the cath so that all can be done at once. Why do we
>allow our system to treat people this way??? The system is broke!
>
>Enough said.........
>
>Jay
>
>Garry Siegel wrote:
>
>> >
>> >And people pay cash w/o complaint for their visits to the alternative
>> >medicine crowds and pay big dollars at the GNC shysters, but they BMC
>> >(that's bitch/moan/complain for you non-yanks) about a $10 copay at
>> >the doc's office.
>>
>> Paul hit the nail on the head; I just hadn't gotten around to posting
>> it.
>>
>> The doctor in me would love to spend more time with patients, shooting
>> the breeze about menopause, hormones, etc.
>>
>> The businessman in me has to comply with the realities and economics of
>> an office practice.
>>
>> If they paid cash at the rate that I charge, I could lower my overhead
>> and spend more time. Since they don't, I can't.
>>
>> So, that is why woman may flock to those who espouse alternatives, and
>> pay them--they get someone's time for a reasonable cost, regardless of
>> the quality of information.
>>
>> I would love to get $200/hour (two patients per hour at $100) for 8
>> hours a day, and not have billing staff, significant malpractice
>> insurance (office based practice only)!
>>
>> Garry
>>
>> --
>> Garry E. Siegel, M.D., F.A.C.O.G.
>> Roswell, GA
>> Private Practice
--
art fougner, md
A series of 1000 cases begins with but a single anecdote.
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