Fed up with frustrations, more doctors change course

[DixieBelle]

“It will take real structural change in the work environment for physician satisfaction to improve,” Dr. Mark Linzer, an internist at the University of Wisconsin who has done extensive research on physician unhappiness, told me. “Fortunately, the data show that physicians are willing to put up with a lot before giving up.”

Not long ago, fed up with what he perceived as a loss of professional autonomy, Dr. Bhupinder Singh, 42, a general internist in New York, sold his practice and went to work part time at a hospital in Queens.

“I’d write a prescription,” he told me, “and then insurance companies would put restrictions on almost every medication. I’d get a call: ‘Drug not covered. Write a different prescription or get preauthorization.’ If I ordered an M.R.I., I’d have to explain to a clerk why I wanted to do the test. I felt handcuffed. It was a big, big headache.”

When he decided to work in a hospital, he figured that there would be more freedom to practice his specialty.

“But managed care is like a magnet attached to you,” he said.

He continues to be frustrated by payment denials. “Thirty percent of my hospital admissions are being denied. There’s a 45-day limit on the appeal. You don’t bill in time, you lose everything. You’re discussing this with a managed-care rep on the phone and you think: ‘You’re sitting there, I’m sitting here. How do you know anything about this patient?’ ”

Recently, he confessed, he has been thinking about quitting medicine altogether and opening a convenience store. “Ninety percent of doctors I know are fed up with medicine,” he said.

And it is not just managed care. Stories of patients armed with medical knowledge gleaned from the Internet demanding antibiotics for viral illnesses or M.R.I. scans for routine symptoms are rife in doctors’ lounges. Malpractice worries also remain at the forefront of many physicians’ minds, compounded by increasing liability premiums that have forced many into early retirement.

In surveys, increasing numbers of doctors attest to diminishing enthusiasm for medicine and say they would discourage a friend or family member from going into the profession.

The dissatisfaction would probably not have reached such a fever pitch if reimbursement had kept pace with doctors’ expectations. But it has not.

SNIPPED


http://www.nytimes.com/2008/06/17/health/views/17essa.html?ex=1371528000&en=68fc7d81aa444219&ei=5124&partner=permalink&exprod=permalink

can you imagine what will happen if we get socialized medicine?

[Bondai]

The problems we are having now can be traced directly to Medicare and Medicade...the government meddling in the free market is a disaster every time. The health care industry represents 7-8% of the economy. The Dems are planning the takeover of a huge chunk of money and WE will be the ones who pay the price. No good can come from it.

[Wretched Excess]

since it was in the NYT, I knew there had to be a different point to this than the apparent one.  sure enough, in the penultimate paragraph:

A 10.6 percent cut in Medicare payments to physicians is scheduled to take effect on July 1. Further cuts are planned in coming years. Many doctors have told lawmakers that if the cuts go through, they will stop seeing Medicare patients.

well, the problem is that we don't have enough socialized medicine, obviously.  what we need is real universal health care, of course.   and these budget cuts are all george bush's fault, anyway.

[DixieBelle]

^you caught that too?

[Wretched Excess]

^you caught that too?

it couldn't be completely sensible, could it?  it's the times, for heaven's sake.    I nearly started reading the thing over from the beginning as I got close to the end;  "No way it's buried this far down.  it's here, and I just missed it".

it would have destroyed my utter lack of faith in the NYT if there hadn't been a hidden bomb somewhere in that story.