Devastating 13.7% Cut in Medicare Reimbursement

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Blah, blah, blah. Same shiit different day. For 20 years the ASA has been fighting with all their heart and soul to stop the lowering of reimbursement rates and for 20 years, they have been losing the battle. When the surgeons only accept cash, check or credit card, the money pot returns to anesthesia. ---Zippy
 
Why don't we finally all just sack it up, and walk out. We as physicians ultimately have those that set these rates by the balls, maybe it's finally time to stand up for ourselves and stop being pushed around. Take a day off, a week off, whatever it takes. ALL OF US PHYSICIANS. You want to cut our salaries now, suckas?
 
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Now you're talkin' blocks. Ain't goin' to happen though because most of the docs are piano-handed. Yeah, I like that. Only emergency surgs in big hospitals for 1 month. Let the citizens of the USA squeel like little pigs! Regards, ---Zippy
 
blocks said:
Why don't we finally all just sack it up, and walk out. We as physicians ultimately have those that set these rates by the balls, maybe it's finally time to stand up for ourselves and stop being pushed around. Take a day off, a week off, whatever it takes. ALL OF US PHYSICIANS. You want to cut our salaries now, suckas?
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They actually did that in France. Dont think it would work out that well here, probably backfire
 
zippy2u said:
Blah, blah, blah. Same shiit different day. For 20 years the ASA has been fighting with all their heart and soul to stop the lowering of reimbursement rates and for 20 years, they have been losing the battle. When the surgeons only accept cash, check or credit card, the money pot returns to anesthesia. ---Zippy
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Good attitude :rolleyes:
 
I'll admit that the ASA has been pretty useless here. I find it hard to send any money to them. :mad:
 
Like I've said before, send your money, turkey and xmas baskets to those docs that only accept cash, check or credit cards. That is the only way to place docs back in the driver's seat of the money bus. That little soccer mom will gladly pay the stone fabricator thousands of dollars with CASH for those granite countertops without a blink of an eye. Well, I need $800.00 in cash, check or credit card to put her chosen son to sleep so the ENT dude can take out the tonsils. It ain't rocket science... ---Regards, --Zip
 
that is how my horse vet does it....and he banks. he is an equine surgeon. one of his bread and butter cases is colic surgery which is basically a colon resection. there is no equine anesthesiologist, he does it. three lead ekg, etc. colic surgery usually runs around $10,000-12,000. if your horse shows up and needs colic surgery they require a deposit right then and there before they will even let him off the trailer.

here's the thing though... it will only work if all or most of us do it and there will always be some dumb schmucks who don't see the big picture.

and the public has come to believe that health care is a right not a priviledge. you know what i say to that: the number one thing that has improved life expectancy and quality of life in this country in the past 200 years was not penicillin (thats what most guess) it was sanitation -- indoor plumbing as we know it and someone to come and cart the garbage away. therefore i think that when my toliet breaks at 3 am someone should come fix it for free because my health is a right.;)

if anesthesiologists and surgeons could band together maybe it would work. also, looking further down the line what if anes is walmarted in a huge way. what if it was a national company like walmart that ran anes. do you think they would have the lobby power to change things? is there an upside to walmarting anes?
 
amyl said:
that is how my horse vet does it....and he banks. he is an equine surgeon. one of his bread and butter cases is colic surgery which is basically a colon resection. there is no equine anesthesiologist, he does it. three lead ekg, etc. colic surgery usually runs around $10,000-12,000. if your horse shows up and needs colic surgery they require a deposit right then and there before they will even let him off the trailer.

here's the thing though... it will only work if all or most of us do it and there will always be some dumb schmucks who don't see the big picture.

and the public has come to believe that health care is a right not a priviledge. you know what i say to that: the number one thing that has improved life expectancy and quality of life in this country in the past 200 years was not penicillin (thats what most guess) it was sanitation -- indoor plumbing as we know it and someone to come and cart the garbage away. therefore i think that when my toliet breaks at 3 am someone should come fix it for free because my health is a right.;)

if anesthesiologists and surgeons could band together maybe it would work. also, looking further down the line what if anes is walmarted in a huge way. what if it was a national company like walmart that ran anes. do you think they would have the lobby power to change things? is there an upside to walmarting anes?
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ding ding ding.....that's why many are not willing to pay for their healthcare....

The US government won't come up with a federally funded program to get granite tops for those who can't afford is the same reason why people are not willing to pay up front.

A lot of physicians won't "strike" because stopping work means no income for that time period....and many people are not budgeted to take that hit.
 
Yes, but how long would a REAL strike last before this gets corrected? One day? Not even. I am talking about ALL PHYSICIANS saying, look, you've got until Jan 1 2007 to correct this, then if this goes into effect, we all have a work stoppage. All of us...from the OR to the family docs office to your local ER. You think that battle would take a long time to win?

As far as lost income, compare a day or so with 5-14% of your income initially, then up to 40% or whatever it is in the future. This has to stop NOW. Imagine what kind of position we would be in if the physicians of the 1980's had the cajones to stand up and unite when the cuts begans to erode the golden age. We need to say to the politicians, we have the clout here, we undestand health care, this is our patients well being, this is our livelihood, and we're not going to stand for you eroding health care anymore. You have 8 weeks to fix this, get to work.
 
National physician "Day Off" day: January 1st.
 
It has to be a grass roots thing. Don't count on the ASA and AMA to supprt ya. They're tied in with the worthless-crats. Goin' to be hard gettin' those 3rd world born docs to get on board. $100.00 to provide anesthesia for an appy is like $3000.00 in the old country. So when we get started?... ---Zip
 
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Nah blocks, one day is for piano-handed prima-donnas. Go Rambo "shock and awe" style-- 1 month to start--- all elective cases cancelled and only emergency cases to be done. I can live off my saved coin for 1 month, no problem mon. ---Zippy
 
Are these cuts targeted only at Anesthesiologists or are they across the board (a previous article that was posted seemed to indicate that compensation was being slashed across the board)? Also, do people generally anticipate these cuts going through as proposed or will they be trimmed via some sort of negotiation? Thanks.
 
Across the board. But some get hit harder than others and some even get a raise. I think the hardest hit is psych, I can't remember for sure.

It will be hard to get those that are receiving raises to join in. Employees as well will not be able to strike as easily b/c they may lose their jobs. We would definitely need to cover emergences.

There would be some face saving needed after the strike as well. The crats won't lye down without a fight and it would get ugly just like every strike does. Remember the baseball strike in '94? It took MLB about 10 yrs to recover. Do we want to be viewed as lawyers are viewed, as money grubbing snakes? THis will most definitely be the twist thrown on the strike by the gov't/lawyers.
 
blocks said:
Why don't we finally all just sack it up, and walk out. We as physicians ultimately have those that set these rates by the balls, maybe it's finally time to stand up for ourselves and stop being pushed around. Take a day off, a week off, whatever it takes. ALL OF US PHYSICIANS. You want to cut our salaries now, suckas?
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Anyone notice that this very thing happened in Germany a few months back?
 
In case you guys haven't noticed, the avg american makes 40k a year while 8 out of the 10 top paying jobs are physcians (at least according to us news). Amercians aren't going to care about a bunch of high priced docs bitching to keep their salaries high. We aren't wal mart employees who make minimum wage and can't afford basic needs. Even the lowest earning docs make over 80k. Doctors will be seen as total villains fighting for an extra bmw and the gov't will come off looking like their trying to help the people. In most other countries, docs make much less than in the US. Most people believe healthcare is too expensive as it is so any cuts to physicians salaries will be ok as long as it lowers their taxes or insurance cost. You won't find many americans or politicians who will stand up for "health care only if you can afford it". Walking out will only polarize the people against docs and we will lose what little support we have.
 
It may be tough getting some foreign-borns on board, but has anyone discussed healthcare philosophy with most medical students lately?? Talk about liberal..... The AMSA is pushing hard for a national healthcare program. It's ridiculous how idealistic these folks can be sometimes. (by the way, i'm a med student....lol)
 
cfdavid said:
Anyone notice that this very thing happened in Germany a few months back?
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I used to practice in France and they do go on strike frequently there, you know why?
They have real unions for each specialty, and each union has full control and loyalty. In other words when the union says strike they all strike and real negotiations take place and the real issues are addressed.
This is why this will never happen or be effective in this country.
There is no such structure here because the fear of communism a few decades ago put major limits on any meaningful union activity.
 
This was tried in philadelphia a few years ago by surgeons; some ER's stopped accepting trauma's for a couple of weeks due to the lack of practicing neurosurgeons. The impetus there was the required paying into the "CAT" fund (catastrophic fund) by physicians; the state had required an astronomical pay-in that year due to one or two nine-figure verdicts against physicians that had been litigated in the city.

It worked locally, but I don't think it would go over well nationally.
 
plankton it's not that simple, and you can't just call it "xenophobia".

America is much more populous than France, and everything simply isn't unionized here. The fact that it's different doesn't make it wrong.


Single-payer or unionization does not necessarily translate into better. What works in France may not go over well in the US.
 
Vaderize said:
plankton it's not that simple, and you can't just call it "xenophobia".

America is much more populous than France, and everything simply isn't unionized here. The fact that it's different doesn't make it wrong.


Single-payer or unionization does not necessarily translate into better. What works in France may not go over well in the US.
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Exactly, there is no unions here that can lead an effective strike and the fear of "Foreign Borns" is not making us more united!
That's why it will never work to walk out!
 
Zip

Yer my new hero.
 
me454555 said:
In case you guys haven't noticed, the avg american makes 40k a year while 8 out of the 10 top paying jobs are physcians (at least according to us news). Amercians aren't going to care about a bunch of high priced docs bitching to keep their salaries high. We aren't wal mart employees who make minimum wage and can't afford basic needs. Even the lowest earning docs make over 80k. Doctors will be seen as total villains fighting for an extra bmw and the gov't will come off looking like their trying to help the people. In most other countries, docs make much less than in the US. Most people believe healthcare is too expensive as it is so any cuts to physicians salaries will be ok as long as it lowers their taxes or insurance cost. You won't find many americans or politicians who will stand up for "health care only if you can afford it". Walking out will only polarize the people against docs and we will lose what little support we have.
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Doctors have no support so what do we have to lose? People HAVE to come to the doctor when they are sick whether they like it or not. If they have to pay more than $5 they already don't like us and are grumbling about how rich doctors are. The "average american" doesn't go to school until they are 30. The "average american" doesn't pay 200K+ to go to school until they are 30. And the "average american" works 9-5 or less. So doctors are more educated and work harder than 90% of the population.. then why is it a sin to make more money than 90% of the population. It is the fear of people viewing us as moneygrubbers that allows the true moneygrubbers the ability to keep taking advantage of us. True moneygrubbers like insurance companies and lawyers just keep bringing in the $$$... building bigger buildings, new bmw's, millions of dollars in bonuses... but we should feel bad about wanting to get paid? If you want to work for free then volunteer. Medicine is a job. You try raising a family off of 80K/yr with 200K debt jack.
 
Noyac said:
Across the board. But some get hit harder than others and some even get a raise. I think the hardest hit is psych, I can't remember for sure.

It will be hard to get those that are receiving raises to join in. Employees as well will not be able to strike as easily b/c they may lose their jobs. We would definitely need to cover emergences.

There would be some face saving needed after the strike as well. The crats won't lye down without a fight and it would get ugly just like every strike does. Remember the baseball strike in '94? It took MLB about 10 yrs to recover. Do we want to be viewed as lawyers are viewed, as money grubbing snakes? THis will most definitely be the twist thrown on the strike by the gov't/lawyers.
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We should be able to put a positive spin on it if we can communicate that what we are doing is in response to pay cuts, not making outrageous demands. I mean the average person doesn't stand for a big pay cut without a fight, and neither should we. If it ends up that we are viewed negatively so be it, at least they would respect us. I personally don't view anyone positively who allows people to walk all over them. And the public needs to know that these cuts will do nothing to improve health care, in fact they will worsen matters.

It is possible to co-ordinate through the AMA or ASA, but you're right, given their ineffectiveness to this point, I'm not optimistic. One thing we can do as members is let them know how pissed we are. They need to get tough and block this, BEFORE it happens. There is no putting the genie back in the bottle once this starts. And if it does, and our professional organizations do nothing, I think it's time to pull our financial support. If they are not in favor of doing everything in our means to stop this, then what good are they.

We need to stand up and take control of this. This is OUR field, not the field of some idiot group of politicians. They have no idea what really is going on in health care, they just want to get re-elected ad free up some cash in their budget atour expense. If we don't take them by the balls now, they won't take us seriously, and this will pass. And then we are on the proverbial slippery slope. We need to stop asking them to do something about it, and start getting tough. It may be best to start getting tough with our own professional organizations, demanding that they do things beyond a letter writing campaign begging policians to stop this.
 
badgas said:
Doctors have no support so what do we have to lose? People HAVE to come to the doctor when they are sick whether they like it or not. If they have to pay more than $5 they already don't like us and are grumbling about how rich doctors are. The "average american" doesn't go to school until they are 30. The "average american" doesn't pay 200K+ to go to school until they are 30. And the "average american" works 9-5 or less. So doctors are more educated and work harder than 90% of the population.. then why is it a sin to make more money than 90% of the population. It is the fear of people viewing us as moneygrubbers that allows the true moneygrubbers the ability to keep taking advantage of us. True moneygrubbers like insurance companies and lawyers just keep bringing in the $$$... building bigger buildings, new bmw's, millions of dollars in bonuses... but we should feel bad about wanting to get paid? If you want to work for free then volunteer. Medicine is a job. You try raising a family off of 80K/yr with 200K debt jack.
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Exactly...if the general public is too self absorbed to understand the sacrifices we make, then I don't give a damn what they think. I know people who didn't even graduate from college making more money than I do as a resident right now. They have the lack of insight to complain about the price of health insurance, while they are driving nice cars, have a plasma TV, etc. I actually have one acquantance who refused to pay out of pocket for health insurance, and drove a Mercedes! Gotta love L.A.

I really don't care what people with an uninformed opinion think.
 
Unfortunately

Its that "uninformed public" that votes for lower taxes at the cost of good reimbursement. So if they are not on the side of stopping the cuts, the politicians dont give a crap what anyone says.
 
Conflicted said:
Unfortunately

Its that "uninformed public" that votes for lower taxes at the cost of good reimbursement. So if they are not on the side of stopping the cuts, the politicians dont give a crap what anyone says.
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True. But, if we threaten to walk out because the "do nothing congress" is cutting medicare, and is unable to fix the ongoing healthcare crisis, the people WILL take notice. And, no matter what the public will think of us, they have a far greater respect for physicians than they do lawyers and politicians. Our congress will do anything to manage the impending sh*tstorm of public outrage, and ultimately shift money towards medicare at even the hint of a walkout. They are elected by the public, we aren't.

We are the physicians here. We are the one's responsible, we are the experts in healthcare. The public believes that. Now we just need to stand up for ourselves and our patients and stop being pushed around by politicians, lawyers, and insurance companies.
 
badgas said:
Doctors have no support so what do we have to lose? People HAVE to come to the doctor when they are sick whether they like it or not. If they have to pay more than $5 they already don't like us and are grumbling about how rich doctors are. The "average american" doesn't go to school until they are 30. The "average american" doesn't pay 200K+ to go to school until they are 30. And the "average american" works 9-5 or less. So doctors are more educated and work harder than 90% of the population.. then why is it a sin to make more money than 90% of the population. It is the fear of people viewing us as moneygrubbers that allows the true moneygrubbers the ability to keep taking advantage of us. True moneygrubbers like insurance companies and lawyers just keep bringing in the $$$... building bigger buildings, new bmw's, millions of dollars in bonuses... but we should feel bad about wanting to get paid? If you want to work for free then volunteer. Medicine is a job. You try raising a family off of 80K/yr with 200K debt jack.
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i couldn't agree more...help i am a third year med student and i pay a lot of money to work harder than all the people i know. i think that docs earn every penny they are paid and then some....this isn't an easy road, in fact, for me it has been hard as hell to have no life, and i do mean no life for the past three years...and i have five more years of no life to look forward to.... don't even get me started on the debt that me and my classmates have put ourselves in.

hour for hour we probably make less than a lot of jobs that require less training, less education, and less intelligence. ok have to go, am making myself mad now...
 
amyl said:
i couldn't agree more...help i am a third year med student and i pay a lot of money to work harder than all the people i know. i think that docs earn every penny they are paid and then some....this isn't an easy road, in fact, for me it has been hard as hell to have no life, and i do mean no life for the past three years...and i have five more years of no life to look forward to.... don't even get me started on the debt that me and my classmates have put ourselves in.

hour for hour we probably make less than a lot of jobs that require less training, less education, and less intelligence. ok have to go, am making myself mad now...
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Do any of you have friends outside of the medical world? Trying talking to them about how hard we work or how much we have to pay. Their answer is always the same "you're going to make so much $$ when your out so don't bitch about it". None of my friends feel even the slightest bit bad for me putting in the long hours and going into debt. Most of them are actually envious that I'm doing what I love or getting into a good career.

These are the average americans. These are the people that vote and these are the people who the politicians need to please. Talk to the teachers out there making 40k/yr. They don't care that they only had to pay for schooling 1 year post bachelors or that they get summers off. All they know is that they make 40k/yr and are having a hard time affording health insurance. They want as much helath care as possible for as little $$ as possible. Do you think they would care if your salary was cut from 250k to 200k if it saved them $200/month in healthcare costs? NO......They make 40k and they think its completely unfair you make so much to begin with.

Doctors are a small minority of the people. I agree w/what everyone is saying b/c we earn every dollar we make w/our hard work during med school, residency, and beyond. We are some of the smartest, hard working people in the country and we should be paid accordingly. This is a perspective that most people won't understand b/c they haven't gone through anything this rigourous or sacrificed this much.

What we need to do is figure out ways to cut medicaid spending that takes money out of the pockets of the insurance companies and lawyers. Thats an idea that the american people and politicians can get behind.
 
me454555 said:
Do any of you have friends outside of the medical world? Trying talking to them about how hard we work or how much we have to pay. Their answer is always the same "you're going to make so much $$ when your out so don't bitch about it". None of my friends feel even the slightest bit bad for me putting in the long hours and going into debt. Most of them are actually envious that I'm doing what I love or getting into a good career.

These are the average americans. These are the people that vote and these are the people who the politicians need to please. Talk to the teachers out there making 40k/yr. They don't care that they only had to pay for schooling 1 year post bachelors or that they get summers off. All they know is that they make 40k/yr and are having a hard time affording health insurance. They want as much helath care as possible for as little $$ as possible. Do you think they would care if your salary was cut from 250k to 200k if it saved them $200/month in healthcare costs? NO......They make 40k and they think its completely unfair you make so much to begin with.

Doctors are a small minority of the people. I agree w/what everyone is saying b/c we earn every dollar we make w/our hard work during med school, residency, and beyond. We are some of the smartest, hard working people in the country and we should be paid accordingly. This is a perspective that most people won't understand b/c they haven't gone through anything this rigourous or sacrificed this much.

What we need to do is figure out ways to cut medicaid spending that takes money out of the pockets of the insurance companies and lawyers. Thats an idea that the american people and politicians can get behind.
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This thread is like a twilight zone episode where everyone is completely f'ing mad, and you are the only one who has any sanity, but everyone else thinks youre the one who is nuts.
 
amyl said:
hour for hour we probably make less than a lot of jobs that require less training, less education, and less intelligence. ok have to go, am making myself mad now...
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Not true, at least in the here-and-now anesthesiologist market.

In the right scenerio a clinician can make $250-280 bucks an hour.
 
blocks said:
Why don't we finally all just sack it up, and walk out. We as physicians ultimately have those that set these rates by the balls, maybe it's finally time to stand up for ourselves and stop being pushed around. Take a day off, a week off, whatever it takes. ALL OF US PHYSICIANS. You want to cut our salaries now, suckas?
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I still dont understand why this hasnt happened.

S h it, I'll take a YEAR off.

Supposedly against the law for physicians to do this.

But what if ALL physicians did it in protest?????

Whos gonna be the picket-line-crossers????
 
yes i do have friends outside of medical school. one lawyer, one in law school. one in the insurance business diversifiying risk. one owns their own business. one taking part in mom and dad's business. all but the one in law school make six figures. by the time i am done they will all probably be making 250k. the one starting his own business has worked hard, but not as hard as i have. the rest together haven't worked as hard as i have. there are many other reasons, at least for me, to be a doctor. but lets face it there are MUCH easier ways to make a buck. this profession used to be rewarded and respected and should be again.
 
Planktonmd said:
cfdavid said:
It may be tough getting some foreign-borns on board,

It's amazing how xenophobia is so deeply rooted in many people regardless of their education.
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I was responding to another posters comment on how foreign born doctors may not feel they're getting such a bad rap. After all, in many countries, medical schools are state sponsored. So, they may not have the debt concerns that many US grads have. Also, the perception may be that US wages, however falling they may be, are still far and above what they could have earned in their home countries. So, chill out, it had nothing to do with xenophobia.
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***
 
jetproppilot said:
I still dont understand why this hasnt happened.

S h it, I'll take a YEAR off.

Supposedly against the law for physicians to do this.

But what if ALL physicians did it in protest?????

Whos gonna be the picket-line-crossers????
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Word, Jet. I think it hasn't happened yet because we have been convinced that standing up for our profession is in opposition to good patient care. In reality, flexing our muscle is very much in our patients' interest as well. We know what good health care is because that is what we spend our lives doing, the politicians and lawyers and executives know jack about that.

Right now, we are just taking what they feed us. But ultimately, we hold the cards it's just a matter of if and when we play them. It is totally unacceptable to be pushed around and forced to eat a 14% reimbursement cut, with the promise of more cuts to come. This because the politicians don't respond to our begging them to change things. I think it's time to stress to our professional organizations to take action to make some real changes. The profiteering by the jokers in suits, the hands in physicians pockets taking our well earned income, and the cheapening of our patients quality of care is only going to stop if WE make it stop.:thumbup:
 
The idea of using tough measures to fight reimbursement cuts has merit, but I'd like to know how much of an incentive this move would be for midlevels, who'd see this as an opportunity to expand their power grab.

Let's remember that the best way to curtail a strike if by having other source of labors ready to do that job (not as good of a job), but a job nevertheless. When the american autoworkers bitch and complain, the automakers just move their plants to china and mexico and problem is solved.

In our case, having people who have been taught how to do our job could bite us in the ass if hospitals decide they have enough qualified monkeys to replace the absentee docs whether CRNAs, NPs, PAs, etc. The outcomes would likely be disastrous but the fact that some could be empowered to think they could fill our shoes, would not be good for us. If this idea were to fly, it would have to be UNannounced to the mainstream media/public so no one has time to prepare and get enough people ready to replace you.

Just remember the orthopods in Las Vegas who walked out without warning, shutting down the hospital they worked at overnight and forcing people to be flown to CA/AZ for care. Imagine that in a national scale.
 
toughlife said:
The idea of using tough measures to fight reimbursement cuts has merit, but I'd like to know how much of an incentive this move would be for midlevels, who'd see this as an opportunity to expand their power grab.

Let's remember that the best way to curtail a strike if by having other source of labors ready to do that job (not as good of a job), but a job nevertheless. When the american autoworkers bitch and complain, the automakers just move their plants to china and mexico and problem is solved.

In our case, having people who have been taught how to do our job could bite us in the ass if hospitals decide they have enough qualified monkeys to replace the absentee docs whether CRNAs, NPs, PAs, etc. The outcomes would likely be disastrous but the fact that some could be empowered to think they could fill our shoes, would not be good for us. If this idea were to fly, it would have to be UNannounced to the mainstream media/public so no one has time to prepare and get enough people ready to replace you.

Just remember the orthopods in Las Vegas who walked out without warning, shutting down the hospital they worked at overnight and forcing people to be flown to CA/AZ for care. Imagine that in a national scale.
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Well, if a walkout situation occurred and the hospital staff went to crnas, then they would have some unhappy surgeons. At every hospital I have been at there are a good number of surgeons who refuse to do cases with a crna in the room due to the great increase in liability over anesthesia complications. I doubt this is much different at most hospitals. Unhappy surgeons = unhappy ORs = unhappy hospital in my opinion. The whole system is gonna crash eventually... how it crashes is the mystery. And for those out there wanting their salaries to be cut because other people make less or it will save money for the patient, go do volunteer work. Cutting physician salaries will not save money for the patient... it will just give insurance companies the money to build an extra skyscraper downtown. If there is anything I can do to prevent people from making more money off of my hard work then I can assure you that I am going to do it.
 
cfdavid said:
Planktonmd said:
I was responding to another posters comment on how foreign born doctors may not feel they're getting such a bad rap. After all, in many countries, medical schools are state sponsored. So, they may not have the debt concerns that many US grads have. Also, the perception may be that US wages, however falling they may be, are still far and above what they could have earned in their home countries. So, chill out, it had nothing to do with xenophobia.
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I am chilling out trust me, and why shouldn't I?
I am a "foreign-born" Doctor who has no worries because I had a free education and what ever they pay me would be good, after all in my home country we work for peanuts. I just wish they would stop charging us taxes so I could put more money in my Swiss bank account and get that new yacht that would look nice next to my water front mansion.:)
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blocks said:
Word, Jet. I think it hasn't happened yet because we have been convinced that standing up for our profession is in opposition to good patient care. In reality, flexing our muscle is very much in our patients' interest as well. We know what good health care is because that is what we spend our lives doing, the politicians and lawyers and executives know jack about that.

Right now, we are just taking what they feed us. But ultimately, we hold the cards it's just a matter of if and when we play them. It is totally unacceptable to be pushed around and forced to eat a 14% reimbursement cut, with the promise of more cuts to come. This because the politicians don't respond to our begging them to change things. I think it's time to stress to our professional organizations to take action to make some real changes. The profiteering by the jokers in suits, the hands in physicians pockets taking our well earned income, and the cheapening of our patients quality of care is only going to stop if WE make it stop.:thumbup:
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How are cuts to our pay going to hurt the care of our patients? Why does it matter how much we paid to them? All they know is "I breath deep, I go to sleep, I wake up later, I pay my bill". Selling the idea that we're fighting medicare cuts in our pay for their benefit will be a tough sell, especially if it costs them less in taxes.
 
badgas said:
Well, if a walkout situation occurred and the hospital staff went to crnas, then they would have some unhappy surgeons. At every hospital I have been at there are a good number of surgeons who refuse to do cases with a crna in the room due to the great increase in liability over anesthesia complications. I doubt this is much different at most hospitals. Unhappy surgeons = unhappy ORs = unhappy hospital in my opinion. The whole system is gonna crash eventually... how it crashes is the mystery.
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Surgeons can get away with not working w/CRNAs b/c there is ample availability of anesthesiologists around to cover for them. If anesthesiologists walked out and surgeons had the choice of working w/a CRNA or losing a days worth of pay, how long do you think it would take them to say "Ok, I guess I'll have to work w/a CRNA today". This might not be fesible for some of the more complicated cases but I'll bet the B&B cases would still roll on.

And for those out there wanting their salaries to be cut because other people make less or it will save money for the patient, go do volunteer work. Cutting physician salaries will not save money for the patient... it will just give insurance companies the money to build an extra skyscraper downtown. If there is anything I can do to prevent people from making more money off of my hard work then I can assure you that I am going to do it.
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No one here is wants our salaries cut and I agree that cutting physcians salaries will not save much for the pt. You hit on the crux of the problem w/that last sentance. The cuts should be coming from insurance companies and others who are making a lot of money off of us, not the docs themselves.
 
me454555 said:
Surgeons can get away with not working w/CRNAs b/c there is ample availability of anesthesiologists around to cover for them. If anesthesiologists walked out and surgeons had the choice of working w/a CRNA or losing a days worth of pay, how long do you think it would take them to say "Ok, I guess I'll have to work w/a CRNA today". This might not be fesible for some of the more complicated cases but I'll bet the B&B cases would still roll on.
QUOTE]

To make this idea work all docs need to walk out. No way you can make it work by having only one group of specialists do it. As it's been said, it'd have to be a nationwide effort for this work.


I would not mind the idea of a union if it came down to that. Gotta have some collective bargaining power to have a voice.
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toughlife said:
me454555 said:
Surgeons can get away with not working w/CRNAs b/c there is ample availability of anesthesiologists around to cover for them. If anesthesiologists walked out and surgeons had the choice of working w/a CRNA or losing a days worth of pay, how long do you think it would take them to say "Ok, I guess I'll have to work w/a CRNA today". This might not be fesible for some of the more complicated cases but I'll bet the B&B cases would still roll on.
QUOTE]

To make this idea work all docs need to walk out. No way you can make it work by having only one group of specialists do it. As it's been said, it'd have to be a nationwide effort for this work.


I would not mind the idea of a union if it came down to that. Gotta have some collective bargaining power to have a voice.
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I'm not positive on this, but aren't unions for physicians illegal??
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me454555 said:
How are cuts to our pay going to hurt the care of our patients? Why does it matter how much we paid to them? All they know is "I breath deep, I go to sleep, I wake up later, I pay my bill". Selling the idea that we're fighting medicare cuts in our pay for their benefit will be a tough sell, especially if it costs them less in taxes.
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Do you really think that's going to save money in taxes? The cash from reimbursement cuts is already spent, a thousand times over. Cutting medicare directly hurts patients by first, docs seeing less medicare patients in direct response to the cuts, so it's an access issue for medicare patients. Then, as the reimbursement cuts ripple to private insurance it translates to doctors squeezing in more patients to their day, spending less time with each, and hiring more midlevels to see patients for them instead of seeing them themselves. Eventually, it means less med students going into those specialties that are hit the hardest by cuts, again, a patient access issue. As mentioned previously, these cuts never in any way get passed on to the healthcare consumer, they line the pockets of the insurance companies, administrators, executives, lawyers etc...basically the a*holes who think about how to skim money from the health care system all day while we are thinking about how we can best provide health care for patients. This is how health care has been eroded over the last 20 years, nobody, especially the average citizen likes it, and it continues on that theme, with a huge step down if this goes into effect.
 
You guys dont get it. Out of all specialties, gas docs have the lowest ability to enforce better salaries thru collective action.

Government has a huge double-headed trump card with you guys: its the federal government's "get out of jail free" CRNA/FMG card.

Gas docs strike and its a matter of days before the govt changes the regs essentially allowing CRNAs to run roughshod over your specialty.
 
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