Diplopia and Decoupling from 3rd Party Payers**
have one eye on the patient and one eye on the clock.
J. Rothman, who studies history of Medicine at Columbia University of
Physicians and Surgeons
Four articles caught
my eye today.
Leslie Kane, Carol Peckham, Medscape
Physician Compensation Report, April
Greg Freeman, “Medicare Op-Outs a Viable Physician
Strategy , “ Health Leaders Media, April
Coryn Rabin, “ 15 Minute Visits Take a Toll on on the Doctor-Patient
Relationships, “ Kaiser Health News,
April 21, 2014
Fellows, “Reform Puts Vice Grip
on Physician Groups , “Health Leaders
Media, April 20, 2014
The first article from Medscape was particularly
startling. It contains the news of a
survey of 24,000 physicians in 25 specialties by the American Academy of Private Physicians. The news is that 27,000 doctors are now in
direct independent/concierge practices and 81,000 are participating in
cash-only practices. The usual figure
reported is 5000 in concierge practices with no mention of cash-only practices.
This would indicate a mass exodus from 3rd party
This, in turn, as
reflected in the other 3 articles, may
cause these new realities.·
- Doctors are opting out of Medicare and Medicaid
in significant numbers.
- Many doctors cannot afford to accept new ObamaCare health exchange plan
patients which carry with them low
- Physician groups are caught in the ICD-10 , regulatory, reform vise.
doctors or patients like the “hamster
wheel” environment in which patients must be seen at the rate of 15 minutes or
less for doctors to meet their bottom-line,
pay their overhead, pay their staff, and keep their doors open.
Hence, the doctor diplopia phenomena in which doctors must
keep one eye on the patient and one eye on the patient. It may even require a third eye, with the other eye on the computer
screen, and a third hand (the first two are
needed for examining the patient) on the computer keyboard.
on doctors to see more patients at less pay
are causing a physician exodus from 3rd party practice to direct independent cash-only practices.
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