I think for my sanity I may have to stop reading the New York Times. Ok, so I know sticking my head in the sand isn't the answer, but an article I read this morning has my blood pressure up again. A few weeks ago I wrote an angry response to Dr. Karen Sibert's op-ed on women doctors. I have since read many other responses, some calmer and more thought out than mine. It is nice to know I am not alone in my belief that women can work part-time and still be good doctors.
This morning there was an article in the Times about government "mystery shoppers" who will be calling primary care physicians (pediatricians and ob/gyns included) to see if they are accepting new patients, if so how long it will take to get an appointment and if there are different answers depending on the type of insurance (private or medicare/medicaid) the patient has. If you would like to read the article you can find it here.
http://www.nytimes.com/2011/06/27/health/policy/27docs.html?nl=todaysheadlines&emc=tha24
I object to this on many levels.
The stated purpose of this survey is to see if there is a doctor shortage. Really? I'm pretty sure this is already known. It seems to me we can compare the number of doctors trained with the number of people in the US and figure this one out. It has nothing to do with how long it takes to get an appointment and if a doctor takes medicare.
They also say that all of the information will be kept confidential. Again, really? I don't trust the government to do this, do you? There will be leaks and some doctors will be penalized for not being able to book a patient in the window that some bureaucrat set.
What really bothers me though is the need the government feels to spy on doctors. Do they think that if we get a call from a new patient vs a call from someone who identifies themselves as a government survey taker we will change our answers?
I am tired of being maligned by my own government. Clearly, they think I will lie if asked directly so they feel a need to lie to me. They also think that I only order diagnostic tests for the money (even when I get none) and that I am quick to order or perform procedures, again for the money.
Most doctors in this country get paid based on the number of patients we see. It doesn't matter if we spend 10 minutes or 10 hours with that patient, we get the same amount of money. Because of this it is to our benefit to squeeze in as many patients as possible. I'll be surprised if any doctors on this production model have long waits. Salaried doctors may be another story, but...
Most doctors in this country and beyond went into medicine because they are genuinely caring people who want to serve their communities. Because of this, I'll be surprised if the patient mentioned in the above article who complains of coughing up blood and trouble breathing will be made to wait anywhere.
Doctors are not the problem in this system. Our rates are set by private insurance companies who take their cues from Medicare. We work hard to provide the best care we can within the limits we are given. We are not allowed to unionize or strike. When I contacted my government representatives and offered to help craft the new healthcare initiative I was given a thank you and a request for money.
I have many patients that I see who cannot afford to pay me and I see them anyway, because they need me. I am in a sub-specialty where it takes a long time to see a patient. It can take an hour or more for me to do a new patient consultation. And yet the government decided last year that I shouldn't get paid any more for that than I get for a ten minute patient exam.
I have three children and a mortgage. Somehow I need to earn a living.
There are bad apples in every profession. I am tired of my profession being vilified because of them and the misinformation that is out there. This attitude will keep people from going into medicine and drive others out. Surveys like this will only exacerbate the doctor shortage that it is supposedly trying to find.
No one goes into medicine for the money. It makes no sense. You spend the first four years paying or going into debt for medical school. You spend the next 3-7 or more years earning miminal salaries and working non-stop as residents. You then make it to attending status and have to see as many patients as possible to try and make enough money to pay your overhead, live, and eventually retire someday.
Doctors may make higher salaries than some professions, but we don't make as much as some others.
Since when did earning a salary become a crime?
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