Wintery Knight

…integrating Christian faith and knowledge in the public square

How do doctors feel about the federal government’s regulation of their profession?

In the Wall Street Journal, a doctor speaks out about government control of health care.

Excerpt:

In my 23 years as a practicing physician, I’ve learned that the only thing that matters is the doctor-patient relationship. How we interact and treat our patients is the practice of medicine. I acknowledge that there is a problem with the rising cost of health care, but there is also a problem when the individual physician in the trenches does not have a voice in the debate and is being told what to do and how to do it.

[...]The Centers for Medicare and Medicaid Services dictates that we must use an electronic health record (EHR) or be penalized with lower reimbursements in the future. There are “meaningful use” criteria whereby the Centers for Medicare and Medicaid Services tells us as physicians what we need to include in the electronic health record or we will not be subsidized the cost of converting to the electronic system and we will be penalized by lower reimbursements. Across the country, doctors waste precious time filling in unnecessary electronic-record fields just to satisfy a regulatory measure. I personally spend two hours a day dictating and documenting electronic health records just so I can be paid and not face a government audit. Is that the best use of time for a highly trained surgical specialist?

This is not a unique complaint. A study commissioned by the American Medical Association last year and conducted by the RAND Corp. found that “Poor EHR usability, time-consuming data entry, interference with face-to-face patient care, inefficient and less fulfilling work content, inability to exchange health information between EHR products, and degradation of clinical documentation were prominent sources of professional dissatisfaction.”

In addition to the burden of mandated electronic-record entry, doctors also face board recertification in the various medical specialties that has become time-consuming, expensive, imposing and a convenient method for our specialty societies and boards to make money.

Meanwhile, our Medicare and Medicaid reimbursements have significantly declined, let alone kept up with inflation. In orthopedic surgery, for example, Medicare reimbursement for a total knee replacement decreased by about 68% between 1992 and 2010, based on the value of 1992 dollars. How can this be? Don’t doctors have control over what they charge for their services? For the most part, no. Our medical documentation is pored over and insurers and government then determine the appropriate level of reimbursement.

I don’t know about other physicians but I am tired—tired of the mandates, tired of outside interference, tired of anything that unnecessarily interferes with the way I practice medicine. No other profession would put up with this kind of scrutiny and coercion from outside forces. The legal profession would not. The labor unions would not. We as physicians continue to plod along and take care of our patients while those on the outside continue to intrude and interfere with the practice of medicine.

We could change the paradigm. We could as a group elect not to take any insurance, not to accept Medicare—many doctors are already taking these steps—and not to roll over time and time again. We have let nearly everyone trespass on the practice of medicine. Are we better for it? Has it improved quality? Do we have more of a voice at the table or less? Are we as physicians happier or more disgruntled then two years ago? Five years ago? Ten years ago?

Doctors certainly provide a lot more value to me than unions, lawyers and government workers of all sorts. I wish we had more doctors, and fewer unions, lawyers and government workers. Anything that doctors can do to push back against their tormentors would be welcome in my opinion.

 

Filed under: News, , ,

Obama administration report: 65% of small firms face Obamacare premium hikes

From Investors Business Daily.

Excerpt:

Released into a news black hole last Friday, an official Obama administration report finds that ObamaCare will push premiums up for two-thirds of small businesses. Cross off another ObamaCare promise.

The report came from the actuary for the Centers for Medicare and Medicaid Services — which means it’s from the administration’s official ObamaCare number cruncher.

What it found was that 65% of small businesses that offer insurance will likely see their premiums rise thanks to ObamaCare. That translates into higher insurance costs for 11 million workers.

The reason? These companies generally employ younger, healthier workers and so had been paying lower-than-average rates.

But since ObamaCare bans insurance companies from considering health when setting premiums, these companies will get hit with higher costs.

“We are estimating that 65% of small firms are expected to experience increases in their premium rates,” the report said, “while the remaining 35% are anticipated to have rate reductions.”

The report doesn’t say how big these hikes will be, but we have good reason to believe the extra costs will be significant.

One study, for example, found that 63% of small employers in Wisconsin will see premiums jump 15% because of ObamaCare. A separate study found that 89% of small companies in Maine would see rate hikes of 12% on average.

Another, by consulting firm Oliver Wyman, concluded that ObamaCare would push up small group premiums nationwide 20%.

Is this how the bill was sold to us by the Obama administration and their supporters in the mainstream media?

No:

In 2009, Obama promised small businesses that his plan would “make the coverage that you’re currently providing more affordable.” Later he said it would drive small-business premiums down by 4% in its first year, and as much as 25% by 2016.

As recently as last summer, Pelosi was proclaiming that “if you’re a small business … it lowers costs,” while Waxman said the law would make “high-quality healthy insurance more affordable and more widely available for small businesses.”

Notice that nowhere — either before or after ObamaCare passed — did any Democrat say anything about two-thirds of small businesses paying more for health coverage so the lucky one-third could get rate cuts.

Next time you hear a big government liberal promising you goodies at no cost, keep in mind their record. They are making policy from emotions, not from mathematics. They believe that they are lying to you for your own good. Their goal is not to tell the truth at all. And don’t rely on the left-wing journalism crowd to hold them accountable, they flunked math too.

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New study: NHS patients are 45 percent more likely to die than US health care patients

Wes sent me this article from the UK Telegraph.

Excerpt:

Patients are 45% more likely to die in NHS hospitals than in US ones, according to figures revealing how badly England’s health service compares with those of other countries.

Previously unpublished data collated by Professor Sir Brian Jarman over more than 10 years found NHS mortality rates were among the worst of those in seven developed countries.

A patient in England was five times as likely to die of pneumonia and twice as likely to die of septicaemia compared to similar patients in the US, the leading country in the study, the data suggested.

The elderly were found to be particularly at risk in English hospitals compared with those in the other countries.

The figures showed that the situation had improved since 2004, when the death rate in English hospitals was 58% higher than that in the best performing country.

But NHS institutions still lagged behind in the most recent data, from 2012, despite reforms of the health service and increased funding.

Of the other six countries studied, only the US was named because of the sensitivity of the data.

Prof Sir Brian, who adjusted the data to take account of differences in the countries’ health services, did not initially release his figures because he was so shocked by them he at first assumed there must be a flaw in his methodology.

There was, however, “no means of denying the results,” he said.

“I expected us to do well and was very surprised when we didn’t,” the Imperial College London medic told Channel 4 News.

“If you go to the States, doctors can talk about problems, nurses can raise problems and listen to patient complaints.

“We have a system whereby for written hospital complaints only one in 375 is actually formally investigated. That is absolutely appalling.”

Previously, I had posted a summary of a book by Scott Atlas, a medical doctor at the Hoover Institute at Stanford University. In that article, he laid out the reasons why the U.S. healthcare system was the best in the world.

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New report exposes NHS socialized medicine as an unmitigated disaster

The UK Telegraph reports on the sorry state of socialist Britain. (H/T Dina)

Excerpt:

Eleven NHS trusts were put into “special measures” after an investigation found thousands of patients died needlessly because of poor care.

The report blamed poor staffing levels and lack of oversight, and said that staff did not address the needs of patients. It concluded the hospitals investigated were “trapped in mediocrity”.

[...]The review, ordered by the Prime Minister, began in February following the public inquiry into the scandal at Mid Staffordshire Hospital Foundation Trust, where up to 1,200 people died amid “appalling” failings in care.

Inspectors visited 21 hospitals, run by 14 NHS trusts, which had the highest recent mortality rates in England. They found that some of the risks to patients were so severe that they were forced to step in immediately.

[...]At Buckinghamshire Healthcare NHS Trust, junior doctors described a “frightening” workload which left them responsible for up to 250 patients at weekends. Elderly patients were left on the lavatory with the door open, while others were left on trolleys for hours on end. At one of the trust’s community hospitals, nurses were forced to call 999 because there were not enough doctors.

At Blackpool Teaching Hospitals Foundation Trust, patients’ families had to feed other patients because nurses were busy while other vulnerable elderly people were left in soiled conditions. At Northern Lincolnshire and Goole NHS Foundation Trust, relatives said they were not only washing and dressing patients but turning them to prevent bed sores. Receptionists were left to take decisions about how quickly patients were seen in A&E, as happened in Mid Staffs.

Sir Bruce said: “For me this is in many ways a difficult day for the NHS — because we are laying bare some truths. On the other hand, the transparency with which this review has been conducted, I hope will be a turning point for the NHS.”

Dirt and dust was found to be “ingrained” on the wards at North Cumbria University Hospitals NHS Trust and two operating theatres were shut immediately due to poor hygiene.

Figures showed up to 13,000 excess deaths since 2005 at the 14 trusts investigated, advisers to the review said.

“No statistics are perfect but mortality rates suggest that since 2005 thousands more people may have died that would normally be expected at the 14 trusts reviewed,” Mr Hunt told the Commons.

At Basildon and Thurrock University Hospitals NHS Foundation Trust, up to 1,600 people more than expected may have died during the period. Inspectors found patients stayed up to two weeks in temporary areas without shower facilities. Others were left in ambulances “stacked” outside A&E departments, or waiting hours on trolleys.

At East Lancashire Hospitals NHS Trust, high numbers of stillbirths at the maternity unit — eight in March — were never investigated, nor reported to the trust’s board. An elderly woman was discharged at 3am and told she had “no choice”, inspectors found.

Patients at George Eliot Hospital waited up to 10 days to see a senior doctor. Nurses were not trained to treat bedsores, leaving patients in crippling pain. At Sherwood Forest Hospital NHS Foundation Trust, inspectors found significant backlogs of scans and X-rays which had never been examined, and complaints which dated back three years.

At Tameside Hospital NHS Foundation Trust, whose chief executive and medical director resigned this month, wards had no doctors in charge at nights, while patients were shifted from ward to ward.

At United Lincolnshire Hospitals NHS Trust there were 12 “never events” — incidents so serious, such as operations on the wrong part of the body, or surgical instruments left inside a patient, that they should never occur — in three years. Patients felt too frightened to complain in case it led to worse care, the report found.

What happened? How is it that UK citizens and businesses pay over half their incomes to the government, and yet the government cannot even provide basic health care for customers?

The missing factor

Let Dr. Walter Williams, professor of economics at George Mason University, explain why the NHS has failed to please their customers:

The NHS is what happens when people repeatedly elect governments that are ignorant of basic economics.

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New study: belief in God can significantly improve mental health outcomes

From Psych Central. (H/T Rob P.)

Excerpt:

A new study suggests belief in God may significantly improve the outcome of those receiving short-term treatment for psychiatric illness.

Researchers followed patients receiving care from a hospital-based behavioral health program to investigate the relationship between patients’ level of belief in God, expectations for treatment and actual treatment outcomes.

In the study, published in the current issue of Journal of Affective Disorders, researchers comment that people with a moderate to high level of belief in a higher power do significantly better in short-term psychiatric treatment than those without.

“Belief was associated with not only improved psychological well-being, but decreases in depression and intention to self-harm,” says David H. Rosmarin, Ph.D., an instructor in the Department of Psychiatry at Harvard Medical School.

The study looked at 159 patients, recruited over a one-year period. Each participant was asked to gauge their belief in God as well as their expectations for treatment outcome and emotion regulation, each on a five-point scale.

Levels of depression, well-being, and self-harm were assessed at the beginning and end of their treatment program.

Obviously, the issue of God’s existence is a matter to be decide based on what is true and false, but this kind of story might help us to get motivated for persuasion.

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