Comments on: Comments on P4P from the SGIM national meeting http://www.medrants.com/archives/3279 Internal medicine, American health care, and especially medical education Sat, 11 Feb 2012 15:15:48 +0000 hourly 1 http://wordpress.org/?v=3.3.1 By: john http://www.medrants.com/archives/3279/comment-page-1#comment-495569 john Thu, 19 Jul 2007 01:54:02 +0000 http://medrants.com/index.php/archives/3279#comment-495569 PFP started voluntarily for surgeons July 1. I have chosen to ignore it entirely, if only because I've become so frustrated with CMS and reimbursement in general that I consider the 1.5% "bonus" an insult that does not merit response. After watching 50-100% decreases in reimbursement for surgery over the past 14 years, I will not waste my time nor my 7 full time office personells' time compiling more BS government forms to document what we've been doing all along. The bonus for an appendectomy ($400 for coming in at 11 pm, getting the patient out in less than 12 hours after a 30 minute laparoscopic procedure, and NINETY days of free follow-up wound care, phone calls, any complications, and liability ) is six bucks. Thanks, but no thanks. I will spend the extra 20 minutes on a jog, daydreaming about what second careers are available to an angry surgeon. When I was a medical student a common saying was "It's not about the money." I naively believed that , until they stopped paying us. PFP started voluntarily for surgeons July 1. I have chosen to ignore it entirely, if only because I’ve become so frustrated with CMS and reimbursement in general that I consider the 1.5% “bonus” an insult that does not merit response. After watching 50-100% decreases in reimbursement for surgery over the past 14 years, I will not waste my time nor my 7 full time office personells’ time compiling more BS government forms to document what we’ve been doing all along.
The bonus for an appendectomy ($400 for coming in at 11 pm, getting the patient out in less than 12 hours after a 30 minute laparoscopic procedure, and NINETY days of free follow-up wound care, phone calls, any complications, and liability ) is six bucks. Thanks, but no thanks. I will spend the extra 20 minutes on a jog, daydreaming about what second careers are available to an angry surgeon.
When I was a medical student a common saying was “It’s not about the money.” I naively believed that , until they stopped paying us.

]]> By: Matt http://www.medrants.com/archives/3279/comment-page-1#comment-494040 Matt Mon, 09 Jul 2007 13:13:10 +0000 http://medrants.com/index.php/archives/3279#comment-494040 "“You can’t have simplistic measures and think you are measuring quality,” Dr. Hayward said. “The measures don’t reflect the reality that you have to tailor treatments to individual patients.”" Exhibit "A" on why you will never have national standards of care. It's not the lawyers, it's the doctors. ““You can’t have simplistic measures and think you are measuring quality,” Dr. Hayward said. “The measures don’t reflect the reality that you have to tailor treatments to individual patients.””

Exhibit “A” on why you will never have national standards of care. It’s not the lawyers, it’s the doctors.

]]> By: Steve Lucas http://www.medrants.com/archives/3279/comment-page-1#comment-493750 Steve Lucas Sat, 07 Jul 2007 11:12:57 +0000 http://medrants.com/index.php/archives/3279#comment-493750 You may want to check out the WSJ Health Blog : More Is Less: Lessons From a Life in Health Research concerning the retirement of Jack Wennberg. He showed, through years of research, that outcomes and cost are not necessarily related. What is striking is that after 30 years we still are not looking at health care in a realistic manner concerning cost vs benefits. While P4P may be looked upon as a solution the unintended consequences of check box medicine will over ride any benefit. Steve Lucas You may want to check out the WSJ Health Blog : More Is Less: Lessons From a Life in Health Research concerning the retirement of Jack Wennberg. He showed, through years of research, that outcomes and cost are not necessarily related. What is striking is that after 30 years we still are not looking at health care in a realistic manner concerning cost vs benefits.

While P4P may be looked upon as a solution the unintended consequences of check box medicine will over ride any benefit.
Steve Lucas

]]>