Asymptomatic HTN

[Mount Asclepius]

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We also haven’t won the battle in what society will pay for us to rule out badness in the worried well. We are forced to see them, but society won’t pay us what they pay for a joint replacement in a 90 year old. Ortho wrote reimbursement and we just clean up the distal radius reduction scraps in between chest pain rule outs and negative abdominal CTs. I agree that we don’t add much value to treating the worried well, but it’s the elephant in the room that eventually is going to need to be addressed. Otherwise we will crank up the pph volume of these patients in order to reach high income physician pay, where as those not in control of their billing will be forced to be high-burnout cogs in the CMG/PE machine.

 

[Porfirio]

We also haven’t won the battle in what society will pay for us to rule out badness in the worried well. We are forced to see them, but society won’t pay us what they pay for a joint replacement in a 90 year old. Ortho wrote reimbursement and we just clean up the distal radius reduction scraps in between chest pain rule outs and negative abdominal CTs. I agree that we don’t add much value to treating the worried well, but it’s the elephant in the room that eventually is going to need to be addressed. Otherwise we will crank up the pph volume of these patients in order to reach high income physician pay, where as those not in control of their billing will be forced to be high-burnout cogs in the CMG/PE machine.

I don’t think society has control of this.

Hospital Admin, Insurance Admin, and CMGs have this control. If you want to add Governmental agencies, them too.

The control we have is only to walk with our feet. The job culture now is to reward those who job hop or are PRN. There is no reason to stay other than the $$$/hr. You have to be willing to walk away.

 

[Mount Asclepius]

I don’t think society has control of this.

Hospital Admin, Insurance Admin, and CMGs have this control. If you want to add Governmental agencies, them too.

The control we have is only to walk with our feet. The job culture now is to reward those who job hop or are PRN. There is no reason to stay other than the $$$/hr. You have to be willing to walk away.

I used the term society loosely, really meaning those in control as you noted.