Describe Ideal Dynamics for IPM MD-MidLevel Team...

[drpainfree]

That's great, and you're operating in an ideal situation that you've spent yrs building.

...but the math problem still exists friend.

when you talk like a MBA, focus on all "math problem", you already lost respect from a fellow pain PHYSICIAN. I have a boutique pain practice with less than a handful patients on 2 tabs of Norco 5 (they've been with me for at least 3-5 years at minimum, no one has asked for escalation, stable). the rest of my patients have acute or subacute on chronic TRUE pain problem. I make sure new patients wait no more than 2 weeks, mostly 7 days to see me.

I've been practicing close to 10 years now, and haven't changed and don't plan to change, despite it's been getting harder to fighting the trend.

I refuse to hire a PA/NP even though most if not everyone has done so in my area.

Why? Simple! treat others like how you'd like to be treated.

If I have PA and I'm too busy to see new consults, and if you as a pain physician come to see me, how would you feel I let you see my PA?

Also, don't use the "math" to justify your problem of maximizing profit or sacrificing quality. It makes you sound like an administrator, not a physician.

the SINGLE BIGGEST problem with this country's healthcare is too many smart people getting into MBA then messing around in healthcare, instead of engineering, high-tech, manufacturing, infrastructure and too many MBA-wannabe, including physicians who caused this problem to begin with long ago.

The tragedy is coming, when you actually need top-quality healthcare, and all you can find is, PA/NA tell you how's going to treat you despite you have more education, experience and knowledge than they do.

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[drpainfree]

the issue with APPs is that there really is no such thing as "algorithm" medicine. every patient is different and nuanced. APPs (and roger chou, for that matter) love little flow charts and algorithms. but they dont exist in real world medicine. there is always a little tangent that doesnt follow that straight line on a chart.

that being said, i do sometimes use APPs for patients that A. take up way too much of my time, B. have a language barrier that necessitates a translator , C. I don't like D. i have no patience for E. smell really bad, F. are likely to no-show or G. are middle eastern

as far as G, is concerned, that is sort of a joke. sort of. im middle eastern myself, and i find those patients to be some of the neediest

if you take that group of patients as a whole, most of them end up being medicaid.

i do realize that I am talking out of both sides of my mouth here. i accept that APP care is suboptimal, but i also accept mitch's premise about the math.

So the two-tiered system, where quality of healthcare is separated by qualification, education, experience of providers, in the name of solving "math" problem.

All animals are equal, but some are more equal than others.

 

[MitchLevi]

when you talk like a MBA, focus on all "math problem", you already lost respect from a fellow pain PHYSICIAN. I have a boutique pain practice with less than a handful patients on 2 tabs of Norco 5 (they've been with me for at least 3-5 years at minimum, no one has asked for escalation, stable). the rest of my patients have acute or subacute on chronic TRUE pain problem. I make sure new patients wait no more than 2 weeks, mostly 7 days to see me.

I've been practicing close to 10 years now, and haven't changed and don't plan to change, despite it's been getting harder to fighting the trend.

I refuse to hire a PA/NP even though most if not everyone has done so in my area.

Why? Simple! treat others like how you'd like to be treated.

If I have PA and I'm too busy to see new consults, and if you as a pain physician come to see me, how would you feel I let you see my PA?

Also, don't use the "math" to justify your problem of maximizing profit or sacrificing quality. It makes you sound like an administrator, not a physician.

the SINGLE BIGGEST problem with this country's healthcare is too many smart people getting into MBA then messing around in healthcare, instead of engineering, high-tech, manufacturing, infrastructure and too many MBA-wannabe, including physicians who caused this problem to begin with long ago.

The tragedy is coming, when you actually need top-quality healthcare, and all you can find is, PA/NA tell you how's going to treat you despite you have more education, experience and knowledge than they do.

Cool story bro.

 

[ateria radicularis magna]

when you talk like a MBA, focus on all "math problem", you already lost respect from a fellow pain PHYSICIAN. I have a boutique pain practice with less than a handful patients on 2 tabs of Norco 5 (they've been with me for at least 3-5 years at minimum, no one has asked for escalation, stable). the rest of my patients have acute or subacute on chronic TRUE pain problem. I make sure new patients wait no more than 2 weeks, mostly 7 days to see me.

I've been practicing close to 10 years now, and haven't changed and don't plan to change, despite it's been getting harder to fighting the trend.

I refuse to hire a PA/NP even though most if not everyone has done so in my area.

Why? Simple! treat others like how you'd like to be treated.

If I have PA and I'm too busy to see new consults, and if you as a pain physician come to see me, how would you feel I let you see my PA?

Also, don't use the "math" to justify your problem of maximizing profit or sacrificing quality. It makes you sound like an administrator, not a physician.

the SINGLE BIGGEST problem with this country's healthcare is too many smart people getting into MBA then messing around in healthcare, instead of engineering, high-tech, manufacturing, infrastructure and too many MBA-wannabe, including physicians who caused this problem to begin with long ago.

The tragedy is coming, when you actually need top-quality healthcare, and all you can find is, PA/NA tell you how's going to treat you despite you have more education, experience and knowledge than they do.

I am not familiar with the idea of a “boutique pain practice.” What does that mean, if you don’t mind explaining it? Thanks!

 

[drpainfree]

Opposite problem by me. There are plenty of pain docs. Every local pain doc still seems to need a mid level even if they are still doing gas on the side to make ends meet…

I am not familiar with the idea of a “boutique pain practice.” What does that mean, if you don’t mind explaining it? Thanks!

sure, I ACTIVELY limit my patient panel size. I reject and quickly discharge about 50% or more of new consults because I know they will not be a good fit for my practice, medically or psychologically.

I treat patients who really need my expertise, experience and education and who appreciate my being their pain physician.

you can say I'm in early retirement and can afford how I practice because financial pressure is not too high. actually, it's not quite true, I just mentally force myself not to lose my sight from why I became a physician 20 years ago.

 

[buddababa]

sure, I ACTIVELY limit my patient panel size. I reject and quickly discharge about 50% or more of new consults because I know they will not be a good fit for my practice, medically or psychologically.

I treat patients who really need my expertise, experience and education and who appreciate my being their pain physician.

you can say I'm in early retirement and can afford how I practice because financial pressure is not too high. actually, it's not quite true, I just mentally force myself not to lose my sight from why I became a physician 20 years ago.

Respect.

What's your panel size?