[frankthetank]

If people took some responsibility and started eating healthier foods, started exercising, and slowed down a little, there wouldn't be such a need for doctors. Hopefully a depression will cut the workload of these physicians.

$this->bbcode_second_pass_quote('', 'W')ASHINGTON (Reuters) - Primary care doctors in the United States feel overworked and nearly half plan to either cut back on how many patients they see or quit medicine entirely, according to a survey released on Tuesday.

And 60 percent of 12,000 general practice physicians found they would not recommend medicine as a career.

[mattduke]

Hasn't anyone told them that we all have a right to their services?

[galacticsurfer]

Endless bureaucracy, red tape, legal worries make their lives a bitch. Go back to simple transactions of health care for goods, cash and a long-term relationship with a self-employed doctor serving his community.

[IgnoranceIsBliss]

Some doctors in my local area are transitioning to what is now being called 'boutique' medicine.

They limit their practice to only "rich" patients who will pay a large yearly fee (like a retainer given to a lawyer) and in return these patients will receive personalized treatment. Doctors don't want to mess with the hassle of insurance anymore and this new arrangement lets them spend a lot more time with each patient.

This issue is something to think about when we consider any plans for universal healthcare. We have a shortage of primary care doctors now which is only going to get a lot worse in the future, given the trends. If we add millions of currently uninsured patients to the rolls, what doctors are going to be available to serve them?
Also, a lot of doctors don't want to accept Medicare and Medicaid because of the low reimbursement rates. Are we going to eventually try to 'force' them to do so? Then we'll see a flight of doctors across our borders for sure!

[smallpoxgirl]

I think that you have to understand that the problems in primary care medicine are almost exclusively a government creation. Medicare assigns payment based on something called RVUs - Relative Value Units. For anything that a doctor can do, medicare has assigned it a value in RVUs. Medicare then sets a reimbursement rate per RVU which varies on a yearly basis. The RVU calculations are wildly biased towards procedures. If I take a mole off someone's back, that's the same number of RVUs as seeing 5 - 10 medical patients. Insurance companies pay more per RVU than medicare, but they use the same calculation. This is why our healthcare system is the way it is. Surgeons and anesthesiologists make big bank. Primary care docs get screwed. Even as a primary care doc, coming up with procedures to do is key to your economic survival. Sitting down to talk to patients doesn't pay the rent. Fixing it would be a very simple matter of congress telling Medicare to calculate RVUs in a way that's more even.

[frankthetank]

A doctor should be like a plumber. Just has a set rate, and you pay him that. No insurance necessary.

[AlexdeLarge]

$this->bbcode_second_pass_quote('mattduke', 'H')asn't anyone told them that we all have a right to their services?

[pedalling_faster]

$this->bbcode_second_pass_quote('frankthetank', 'A') doctor should be like a plumber. Just has a set rate, and you pay him that. No insurance necessary.

[smallpoxgirl]

$this->bbcode_second_pass_quote('frankthetank', 'A') doctor should be like a plumber. Just has a set rate, and you pay him that. No insurance necessary.

[EnergyUnlimited]

$this->bbcode_second_pass_quote('smallpoxgirl', 'P')rimary care docs get screwed. Even as a primary care doc, coming up with procedures to do is key to your economic survival. Sitting down to talk to patients doesn't pay the rent. Fixing it would be a very simple matter of congress telling Medicare to calculate RVUs in a way that's more even.

[vision-master]

$this->bbcode_second_pass_quote('smallpoxgirl', 'I') think that you have to understand that the problems in primary care medicine are almost exclusively a government creation. Medicare assigns payment based on something called RVUs - Relative Value Units. For anything that a doctor can do, medicare has assigned it a value in RVUs. Medicare then sets a reimbursement rate per RVU which varies on a yearly basis. The RVU calculations are wildly biased towards procedures. If I take a mole off someone's back, that's the same number of RVUs as seeing 5 - 10 medical patients. Insurance companies pay more per RVU than medicare, but they use the same calculation. This is why our healthcare system is the way it is. Surgeons and anesthesiologists make big bank. Primary care docs get screwed. Even as a primary care doc, coming up with procedures to do is key to your economic survival. Sitting down to talk to patients doesn't pay the rent. Fixing it would be a very simple matter of congress telling Medicare to calculate RVUs in a way that's more even.

[smallpoxgirl]

$this->bbcode_second_pass_quote('EnergyUnlimited', 'A')nd sending women to a doctor for monthly prescription of contraceptives is utter nonsense, unless there is an underlying problem requiring frequent checkups.

[vision-master]

Sumthing is fooken wrong!

I got's me a receipt right here in my grubby little paws from when I fooked up my elbow when a kid.

Itasca Clinic

August 3, 1964

Elbow Xray = $8
Office Vist = $5
Sling = $.25

Total fooken bill was $13.25

X'plain pleaze.

[EnergyUnlimited]

$this->bbcode_second_pass_quote('smallpoxgirl', '
')I can't begin to tell you how happy that would make me. Having to deal with insurance companies is a nightmare. Dealing with Medicare and medicaid is worse than a nightmare. It's hell on earth. Honestly, if the US ever gets single payer healthcare, I will probably either quit medicine or move out of the US. It would be like going to the DMV all day every day for the rest of your life. Screw that.

[EnergyUnlimited]

$this->bbcode_second_pass_quote('smallpoxgirl', '')$this->bbcode_second_pass_quote('EnergyUnlimited', 'A')nd sending women to a doctor for monthly prescription of contraceptives is utter nonsense, unless there is an underlying problem requiring frequent checkups.

[mattduke]

$this->bbcode_second_pass_quote('vision-master', 'S')umthing is fooken wrong!

I got's me a receipt right here in my grubby little paws from when I fooked up my elbow when a kid.

Itasca Clinic

August 3, 1964

Elbow Xray = $8
Office Vist = $5
Sling = $.25

Total fooken bill was $13.25

X'plain pleaze.

[Tyler_JC]

EU, I couldn't agree more about the prescriptions.

My dad is forced to pay $25 a month in co-pays (plus gas, wasted time, etc.) in order to go to his doctor to get his prescriptions renewed.

He's been on Lescol for the last decade.

Why can't he just buy a year's supply of the drugs at a time? Alternatively, why can't he just buy this stuff straight from a pharmacist?

I understand putting a barrier between consumers and Oxycontin. But who gives a damn about cholesterol medicine? Why is this something that primary care doctors need to be involved with on a monthly basis?

Once the doctor has decided that you should be on a drug, you shouldn't need monthly checkups to get it renewed. Your cholesterol level doesn't drop off a cliff after one month of using the medication. Acid reflux disease is a chronic condition. It's not going to suddenly disappear one day.

And if your condition changes, you can go to your doctor. But wasting the doctor's time with writing prescriptions does a huge disservice to society.

[Dreamtwister]

Let them quit. They'll be trading their services for chickens soon enough.

[EnergyUnlimited]

$this->bbcode_second_pass_quote('Tyler_JC', '
')And if your condition changes, you can go to your doctor. But wasting the doctor's time with writing prescriptions does a huge disservice to society.

[coyote]

$this->bbcode_second_pass_quote('Dreamtwister', 'T')hey'll be trading their services for chickens soon enough.