Monday, March 21, 2016


What Happens When You Hold Doctors’ Feet to Fire
To maintain personal, social, political , legal pressure on someone in order to induce him or her to comply with one’s desire, to hold someone accountable for his or her act or promise.
Wiktionary, definition of  “To hold one’s feet to fire”
Primary care doctors are under personal, social, political, and legal pressures to see as many patients without mistakes as possible even though the doctors to not have the time or resources to do so. 
Result?  As documented in a Kaiser Health News report,  “Burnt-out Primary Care Doctor Are Voting with Their Feet.” 
With their burnt feet,  they are seeking shelter and refuge from the reform storm” because they feel they  are unable to do what is being asked from them. 
They are jumping off the burning deck of health reform,  which is sinking under waves of new patients enrolling or qualifying for Medicare, Medicaid,  and ObamaCare health exchanges.
Doctors are under pressure, and many of them are saying  they can’t take it anymore.
Rather than expounding on this overheated subject,  I refer you to the  1753 word Kaiser Health News story and to these quotes in that story which explain what is happening.
·         “Tired of working longer and harder because of discounted insurance payments and frustrated by stagnating pay and increasing oversight, many are going to work for large groups or hospitals, curtailing their practices and in some cases, abandoning primary care or retiring early.” 

·         “Stressed doctors, meanwhile, often mean anxious, dissatisfied patients. Many consumers report feeling shortchanged after waiting weeks or even months for an appointment, only to get a quick once-over and be told there isn’t time to address all their complaints in one visit.” 

·         “A 2012 Urban Institute study of 500 primary-care doctors found that 30 percent of those aged 35 to 49 planned to leave their practices within five years. The rate jumped to 52 percent for those over 50.”

·         “A RAND study for the American Medical Association last year found that nearly half of surveyed physicians called their jobs “extremely stressful” and more than one-quarter said they were either “burning out,” experiencing burnout symptoms “that won’t go away,” or “completely burned out” and wondering if they “can go on.”  

·         “Richard J. Baron, president of the American Board of Internal Medicine, set out to document how much time a doctor spends managing care and discovered that on a typical day, he or she handles 18.5 phone calls; reads 16.8 e-mails; processes a dozen prescription refills (not counting those written during a visit); interprets 19.5 lab reports; reviews 11 imaging reports; and reads and follows up on 13.9 reports from specialists.”

·         Perhaps the single greatest source of frustration for many physicians is a tool that was supposed to make their lives easier: electronic medical records. Many do not merely dislike electronic health records – they despise them. “We were surprised by the intensity of their reports,” said Mark Friedberg, a physician and co-author of last year’s RAND study.”

·         “To ease the burden, some physicians have started using scribes – laptop-carrying assistants who follow them in and out of the exam room. Scribing is one of several proposals to provide greater support to physicians by giving more responsibility to nurses, health coaches and health educators. But adding personnel involves additional costs, which worries physicians trying to limit their overhead.” 

·         “The trend line, meanwhile, is troubling. The Association of American Medical Colleges estimates the United States will be short 45,000 primary-care doctors in 2020, when 268,000 are projected to be practicing. That compares to a shortfall of 9,000 in 2010, with 254,800 practicing.”

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