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Primary Care docs - a vanishing breed?

 
 
Miller
 
  1  
Reply Sat 30 Sep, 2006 10:33 am
CalamityJane wrote:
Walter Hinteler wrote:
I just looked it up - though there are only figures pre 2002 online:

general preactioners get as much as neurologists/psychiatrists; they are at the bottom of the table.
Internists acting as well as family doctors are in the middle field.


Walter, most GPs team up with HMOs (Health Maintenance Organizations)
whose health insurance plans dictate them to see certain GPs. This insures them a steady income through constant patient flow, however, once contracted with an HMO the GP agrees to capitation fees, and in order to pay for his overhead, it is not uncommon for a GP to see 40 patients per day. Quality is replaced by quantity.

Another aspect is the "laying all eggs in one basket" dilemma. Should
the HMO decide not to contract with a particular GP any longer, his practice is mostly bankrupt.

In order to avoid such pitfalls, GPs and other speciality physicians for
that matter, employ PAs (physician assistants) to see the HMO patients
while the GP or specialist will see patients with better insurance plans.


Many of these HMOs are also owned by the MDs who service the member patients. So, they're involved in setting fees as well as their own salaries.
0 Replies
 
CalamityJane
 
  1  
Reply Sat 30 Sep, 2006 12:52 pm
You're absolutely right, Miller, and those are the unstable HMOs.
I have seen such MD owned HMOs that prospered very nicely until
the officers started taking higher salaries, profit sharings, and and....
Then the corner-cutting started and in the end they folded.

Having an abundance of HMOs in southern California is like walking
on a mine field when choosing healthcare. Pathetic.
0 Replies
 
Miller
 
  1  
Reply Sun 1 Oct, 2006 09:51 am
Miller wrote:
Quote:
There's no opportunity to educate the patient/client about how to maintain and monitor their own health.


These duties are now being taken over, clinically by RNs and PharmD, as they should be.

Also, with the internet available to most, who have computers, MDs now would like to have patients
educate themselves, as incidentally may are doing on A2K.

Back to student loans, a woman recently graduated from Tufts Medical School in Boston , with an MD and a loan debt of about $184,000. She promised the US Army to serve in the Army following her education, if the Army would pay her way through Medical School. Well, the Army did pay her way through med school and recently called her up for duty in the military.

Guess what? The woman now has told the Army that she can not serve, because her religion
Christian Coptic?) prohibits her from doing so.


Twisted Evil


What many students forget about , when taking out student loans either from the Army or the Federal Gov, is the issue of compounding interest. The original loan was for $184,000, with compounding over a period of 8 years ( 4 yr med school, 1 yr internship, 2 yr residency, 1 yr fellowship ), the net amount now owed, since no payments have ever been made by the MD, has risen to about $271,851.

If you take out a loan, be sure to start paying on it ( interest only is a possibility ) even, while you're stil in school, to avoid giant balances in the end.
0 Replies
 
patiodog
 
  1  
Reply Sun 1 Oct, 2006 12:05 pm
Self-education in the medical arena is a double-edged sword: there are a lot of very dubious sources of information out there, and perfectly legitimate sources of information that are only really useful within the context of a broader body of knolwedge.
0 Replies
 
 

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