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Doctors Appointments

Discussion in 'The Okie Corral' started by GeorgiaGlocker, Aug 15, 2012.

  1. GeorgiaGlocker

    GeorgiaGlocker Incirlik AB 73 - 75

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    Does your physician spend enough time with you during your office visit? I am hearing from friends that more and more physicians are acting like that have a plane to catch and can't leave the room quick enough.
     
  2. LEO/Dad

    LEO/Dad Navy Veteran

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    I now have a Physician Assistant. She actually spends more time with me, and seems more thorough. I think you will be seeing more PA's as Docs retire with this healthcare mess.
     

  3. JW1178

    JW1178

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    Wait until Obamacare kicks in if you think it's bad now.
     
  4. fx77

    fx77 CLM

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    It will only get worse
    And the new generation of doctors with the electroic health records EHR don't even look at yu..they are too busy entering data on the keyboard or touch screen so that the record can sustain the billing codes...what a joke...
     
  5. jpa

    jpa CLM

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    I'm not sure about IL law but in NV a PA-C is required to have a supervising physician. The biggest user of PA-C's is the VA and I agree that more offices will have 1 doc with 3-4 PA-C's working for them actually seeing patients. Here they can do everything their doc allows them to including prescribing narcotics. They make like $70-$90k. The doc makes over $200k. Not a hard choice.

    I usually just go to a doc in a box if I get sick. I use the same clinic and usually wind up with a different doc each time, but they have my records available and can see what I was there for before.

    I have noticed a trend with docs where they are seriously overbooking themselves on "clinic" days and then the rest of the week they're either teaching at a med school or traveling out of state to lecture at some seminar. On the clinic days they'll easily start the day with 20 patients waiting and go from there. My mom has to see her orthopedic surgeon for a healing ankle fracture. Her appointments are usually at 10 and we're lucky to be out of his office before noon. Most of the time we leave around 1.

    My mom is going to the burn care center for wound care. Appts are usually at 10, doc rolls in around 10:30 with his rolex and his tightly tailored suit. He takes 5 minutes to look at the wound, writes some notes on the charts and is off to the next patient. She usually doesn't get out of there before 11:30 or so.
     
  6. M2 Carbine

    M2 Carbine

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    My doctor spends about 5 minutes talking about my health problem, then about 30 minutes talking about guns.
    Because of him I recently got another CMP M1 Garand.
    :supergrin:


    Bad thing is he says that if obama care stands he's going to retire early.
    Other doctors in the area are saying the same thing.
     
    Last edited: Aug 15, 2012
  7. sputnik767

    sputnik767

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    There was an article recently in I believe American Family Physician (could be wrong about the journal) where some wingnut wrote that in order to better accommodate the pending influx of new patients once Obamacare kicks in, family docs should start work 2 hours earlier, finish work 2 hours later, remove all chatter from the patient-doctor interaction, and basically spend roughly 10 mins per patient. Needless to say, this person was probably not a doc. She also said that docs should start relying more on PAs. There are many problems with that which I am not going to get into, but as of today, if your family doc is not spending as much time with you as you would like, it is because he/she probably has to see 40-50 patients per day to stay afloat, especially if this doc accepts medicaid. Such is the nature of primary care right now, and it's probably going to get worse.
     
    Last edited: Aug 15, 2012
  8. LEO/Dad

    LEO/Dad Navy Veteran

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    I live in a city (50.000 population) with only one hospital. I don't believe there are any independent doctors left. They all now are employees of the hospital. The hospital seems to be well funded,and are expanding. They seem to be responsive to patient care. My wife and I are on Medicare with our supplements, and are satisfied with our care. I hope it continues. When my doctor had his own business, he told me he just had to spend too much time on administration duties, rather than healthcare. He just couldn't afford it anymore.
     
  9. Diesel_Bomber

    Diesel_Bomber

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    Yes, my doctor spends enough time with me. If she didn't she would not be my doctor.
     
  10. 9jeeps

    9jeeps

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    According to O-Care. If you are over 70. You are dead meat. By the time I'm gone you kids might have that age down to fifty. Yep! Elect that guy again and you may be an organ donor,
    like it or not!
     
  11. CitizenOfDreams

    CitizenOfDreams

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  12. gwalchmai

    gwalchmai Lucky Member

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  13. Restless28

    Restless28

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    That drives me nuts. My MD is a young guy and this is him.
     
  14. sputnik767

    sputnik767

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    Electronic medical records are a good thing. If your doc is not making eye contact with you when he is talking, the problem is 2-fold. One, he/she really has to get you out as soon as possible. It's not that he doesn't like you or care about you, but he does have a family to feed and a business to run. And the environment is such that your doc needs to see as many patients as possible in as short amount of time as possible. Two, if your doc is not making eye contact while typing, that's understandable, I can't look at you and write at the same time. But he/she should be looking at you when asking you questions. That's not the fault of electronic medical records, just poor bedside manner. I am only a student, but when I interview a patient, I always look at him or her. But if I do it this way, I have to make pauses to write, if it's a relatively complicated case. This way does take a bit longer to interview, but I prefer it.
     
  15. Restless28

    Restless28

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    Actually, I found myself talking to him while he typed away at times. I guess it's just the way it's gonnna be from now on for all of us.
     
  16. sputnik767

    sputnik767

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    Yep, unfortunately it seems to be headed in that direction. Docs just can't spend as much time with patients anymore. Still, they should do what they can to be as personable as possible. You can't build a solid patient-doctor relationship if you don't even bother to make eye contact, and this leads to problems with trust and therefore, patient compliance. It is very rare that I ask questions and write at the same time, but if it's a really complicated case and I know that I may have to do an EKG, urine dipstick, or pulmonary function test (or all 3 tests), and there are other patients waiting, some compromises have to be made. If it's a slow day however, my attending physician will chat with some of his patients for a half an hour.
     
  17. podwich

    podwich

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    If the doc has to see a patient every 15 minutes or less, has ever-increasing levels of paperwork (electronic medical records required clicks/entries), has results to follow-up on, has other office duties to attend to, well... The visit's going to be cut as short as possible (or the doc's going to run late).

    Primary care reimburses pitifully. In a practice that accepts a decent amount of low-income/Medicaid/write-offs, the reimbursement may not even be enough to cover costs (practices may be hospital-owned and run at a loss with ancillaries {labs, radiology, etc.} helping to make up for the loss). At the same time, the doc has to fit in as many patients as possible to help as well.

    Reimbursement for physician services is slanted heavily toward procedures (it's improved some, but it's still significant).

    I'm interested to see if very small, concierge medicine practice picks up significantly (i.e., pay a flat fee, have the doc on retainer and specific services covered). If it's a small practice, the cost of overhead is reduced significantly. Also, by going to a concierge practice, the doc doesn't need to bill insurance/worry about most collection/etc, further decreasing costs. A small practice could reasonably be run either by the doc himself or by him and an assistant. By reducing these costs, the doc can significantly reduce the number of patients he has to see to meet costs and thus can increase the visit time significantly. The downside is you drop the people who can't afford the annual fee.
     
  18. larry_minn

    larry_minn Silver Member Millennium Member

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    Some prep would help Dr.s see more pts a day. I had a specailist I had to set up appt months ahead. She came in. "Hi Larry, lets see you should have some X-rays so go down and get those" I told her "I have less then week old X-rays sent to you" "OH, Ok then we want to do a TB screen/ etc.etc" So I tell her "those have also all been done/ results sent/I have copy of my labs along" Finally she says "well I guess I need to review this info, see you in three weeks" Starts to walk out, then turns around "maybe I should listen to your lungs since you are here"
    Wonder why I am not in hurry to go back???? I wasted HRS of my time to tell her to review info she had?????
     
  19. Crypsis

    Crypsis

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    Doctors are only reimbursed for 10-15 minutes of their time. If they spend more time than that with you, they are losing money.

    Doctors are forced to use electronic medical records or face fines. This means they are forced to be typing in non-user friendly interfaces. They also have to type in a ton of mundane details to make the encounter complete in the records.

    Doctors must pump out the patients now to maintain their salary because each year their reimbursements for everything they do goes down. As if what they do is worth less today than it was yesterday.

    Doctors pay keeps getting cut all in the name of reducing health care costs, even though doctor salaries are a very small piece of the pie.

    All these aspects of your doctors visit are changes or penalties forced upon the doctor by people who don't like a doctors shiny car, shiny suit, shiny boat or whatever flavor of the month hate they have.

    When you cry about your doctor making too much and demanding lower prices, don't complain about lesser service you receive because of it.

    Also, don't take your hate out on the doctor for health care expenses. He is an easy target because he is in your face and you see him driving down the road. The bigger expenses and the ones more appropriate to cut back on are behind the scenes administration, insurance and other bloat. Think about that when you complain about your office visit.

    Also, think about how bad Obamacare is going to be for you come November.
     
  20. janice6

    janice6 Silver Member

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    Mine is pretty good. He doesn't rush me and asks if something is bothering me. Then he listens and acts on my concerns. It could be worse.