Doctor Ma’am

Moms in the wild - a mother's day thread 🧵 1. "Look Mom, I'm scaring them!"

All of the US right now

They shoulda just done hot ones and whoever lived can have it

This post has been getting quite the attention. Want to know why your office visit doesn't run on time? Take a seat... this may take a while... Healthcare consolidation means doctors are no longer owner/operators of their own small business, able to cater to their patients' needs. They can't even set the prices they want. With the physician fee schedule being imposed on us by CMS, we are beholden to the price assigned to our CPT codes. For your beloved pediatrician, those E&M CPT codes reimburse very very poorly. Sure, some clinics can negotiate better rates with insurance companies, but for the most part it's a fraction of what is needed to run a small business. Econ 101 tells us that price caps cause shortages. Here it is in action. The price cap set on E&M codes means that doctors can no longer generate enough revenue off of professional fees to run their E&M-based practice. Additionally, they have more and more regulatory burdens that increase the price of running a practice (mandated EHR uptake, quality metrics, etc) while reimbursement declines. That's not all. The large hospital conglomerates have rules written in their favor, giving a competitive advantage. They get to charge more for those E&M visits due to "facility fees." They get to be tax-exempt entities. They get massive discounts on drug purchases that they can resell for profit. They get "economies of scale" in operating EHR & quality metrics. They can absorb the cost of a financially underperforming clinic by ensuring they capture downstream revenue from referrals, imaging and labs. It doesn't take a policy expert to see that the small, independent practice has no chance of surviving. So they sell out. The physicians become employees of a system which tells them how many patients they must see. They say they can't see patients in that small of a time frame, but the corporation doesn't care. It plans on replacing them with NPs or PAs soon anyway. The other option is they open a concierge clinic. They stop taking government funds and get away from the price caps. They charge what they feel is needed to give the patients the attention they deserve. So, what can you, healthcare policy expert and consumer of healthcare goods, do for the situation? Take your business to a practice which runs on time. If you have to pay for it, pay for it. That's the beauty of the free market. You're free to take your business to a concierge practice or cash-pay clinic. Nobody is forcing you to go to the practice which is chronically late. And if your answer is: "but healthcare is a RIGHT! It should be free!!" Just remember, you'll get what you pay for. @anish_koka @DrBrian4Health @cscla @DutchRojas @LighthouseDPC

i asked for your list of medications but you said they're in the computer med rec - rupi kaur

I can’t express to you how terrible American Airlines @AmericanAir is and how wonderful @SouthwestAir has been and always will be. My ride or die, truly

happy international woman's day!

me signing my contract vs me doing my job

Meanwhile I still have a few patients on warfarin 🫠💀

Gondor has no king. Gondor needs no king.

jesus is back baby

Teachers buy school supplies out of their own pockets.

*drops below 80°* Midwesterners:

I would simply feed this man concentrated chicken soup on his ice cream and cherry pie filling on his spaghetti until he no longer had the strength to believe in god

Can confirm as someone whose commute went from 70 minutes to 5

This is why primary care physicians need more than fifteen minutes with their patients. Having time to take a good history and do the right thing matters.

Why do we live here?

I’m 3 weeks into my first real attending job (primary care IM/geriatrics) and I wish I could go back to sad intern me and tell her how great it will be one day