Monday, March 02, 2009

A Few Questions

Our President has just proposed funding and building Community Health Centers as a way to extend primary care access to those without such access now. Cool. An aim of this would be to unburden Emergency Rooms from providing such care now (which we do, and for free). In theory this means I will make more money for less work and do more true Emergency Medicine. Thanks Mr. President and double cool!

I wonder though, since there's going to be a summit of deep thinkers (see last sentence of story), if the word 'industry' means 'physicians', because, call me crazy, but if we are going to discuss ways to solve our health care crisis it would seem to me a bit silly to form that solution without doctors and nurses at the table. See, we are actually the ones that do the patient care stuff (like mechanics work on your Benz). I have a hunch that 'industry' does not mean 'health care providers'... just a hunch.

A further hunch tells me that the administrators at these clinics will make more than the health care providers, and therefore, that they will be understaffed with providers, or, staffed with providers who can't get a job elsewhere. That's not so cool.

What will be cool though, is all the new forms and projects that can be created! Super cool, because my mom always told me that when I have a difficult project to do that I should start by making a list! Then I make a second list of important things from the first list and break it down using different colored ink! Change!


  1. 911
    Haven't you figured out yet, the patient's don't come to see you or the nurses like me, they come to see the clipboards. Otherwise, if they came to see the Doctors and Nurses, the clipboards wouldn't keep expecting us to see more and more patients with less and less staff.

  2. gregg,
    you are correct. thanks.

  3. So what are they gonna dispense at these Community Health Centers?? Tic Tacs? Will the "Providers" be exempt from Malpractice Suits in exchange for dealing with this shall we say, Litiginous Segement of society? Can't wait for the first patient sent home with a tummy ache that really has a leaking triple A... This is gonna be better than a Charlie Chan movie...

  4. So when will you start your private, private practice? I may not have much extra cash after I can't deduct my mortgage interest or the 10%+ I tithe each year, but I promise I won't sue you.

  5. I'm not sure I trust a government run health center. Thinking...thinking...thinking...nope, I'm certain of it. I definitely don't trust a government run anything. Knowing my luck, I'd get a doc named Apu with an accent thicker than my coffee whose training came from a four dollar scholarship in Bangladesh.

    Me sooo not happy with the way American is tilting.

  6. Since we already have 'community' health clinics in place in my hometown, I wonder why those folks don't go there in the first place? Rhetorical question I know, but they still over-burden our ER with some of the most stupid $#!+ to the cost of $7.02 million expansion... solely to make it more community friendly?! Guess who's paying for it? Not the folks that visit, but since they seem to think it's their right... There are 4 or 5 of the clinics scattered about town easily accessible by public transportation. The population is 250,000+ yet they choose the ER. So no insurance and a higher cost to go visit the ER versus a $1.00 bus ride to the free clinic. Go figure.

  7. Well, murse, maybe the free clinics are not the one stop shopping the public health our "less than paying" customers desire. If you go to the clinic, you actually might have to come back another day for a test. The local overburdened ER is a wait, but it's all done at once. At no cost, because you have the Medicaid Gold Card.. a.k.a. ClubMed Gold, or you are from Camp NoPayUs where you and your address is, and always will be, anonymous .All to the delight of the clipboard zombies that look at me and see patient throughput, utilization and Press-Gainey scores in the air conditioned boardroom with the soft chairs and the real oak table.

    And, the OBots are about to make it worse.

    "Government's view of the economy could be summed up in a few short phrases: If it moves, tax it. If it keeps moving, regulate it. And if it stops moving, subsidize it. "

    -Ronald Reagan

  8. Know whats great?

    Obama might end up killing the entire physician recruitment biz.

  9. igloo...

    Kim is feeling the pain as well, as I am sure 95% of all you ER docs and staff.

    murse c -

  10. Obama might end up killing the entire physician recruitment biz.

    I think they will start trucking in physicians from overseas. And lowering licensing standards, because they will have to.

  11. lynpricewrites,

    ....... on the bright side. if Apu treats you for malaria or leishmaniasis, he may do pretty well.

    Other than those, you're on your own.

  12. A buddy of mine worked for a short time as a dentist in one of these community clinics in South Carolina after retiring from the military. I guess my Albert Schweitzer days are over (of course he never heard of JCAHO),but after the horror stories he told, there is no way in hell I would ever work in one of those places unless they paid me a big pile of money. I don't know which stories were worse; the ones about the administrators or the ones about the patients.

    I think it will devolve into the care you are willing to pay for out of pocket. Some will opt for community care, those that can afford it will go for "concierage" care.

  13. There's something wrong here. MSNBC says you all approve of Obama's plans. You are looking forward to the booming business from all the new customers.

  14. who or what is msnbc? whoever they all they may gargle my nutsack.

    it is true that we doctors stand to benefit on the front end of an obama like plan because we will actually be paid to see every patient. we will make more for less work and probably less liability. in the end though, it will just make us fat and lazy and people will die. at least it's change though... change.

    keith olberman is an ass clown as is chris matthews and have about five neurons between them all tingly with obamagasms. if they aren't gay, they should be.

  15. Perhaps newcomers to the area do not know about available community healthcate -- I have no idea whether my town has such a thing and I've lived here for four years...

  16. "who or what is msnbc? whoever they all they may gargle my nutsack."

    spit on my screen with that one...