New CPT codes, integrative care

[toothless rufus]

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New CPT codes: designed to be a boon, benign, or malignant? What was the reasoning behind the new CPT codes?

1. To increase reimbursement

2. No real reason. Just some schmuck coming up with something to keep their job, and will neither increase nor decrease reimbursement.

3. Nefarious. To actively prevent one from sustaining or even with the intent of decreasing reimbursement by making it more difficult to be reimbursed as the patietn needs to have a certain number of "hoops" to qualify.

I have my guesses. Furthermore, who says we wanted this change anyway? Did they (whoever they are) consult or poll physicians to see if we thought it was a good or necessary idea? Why don't we have the final word in how we bill for OUR services? What gives them the right? They didn't go to medical school, residency, and sacrifice time. nor will they bear the responsibility.

Considering the duration of training and the high level of responsibility, being a physician should come with a hefty compensation reflecting these things.

Integrative care: Is this just some blah blah blah talk, an optional way to manage care only if you find it to be something you would CHOOSE to participate in it, or is it going to be mandated on us as a means of forcibly driving down costs?

I am greatly angered, and sick to death of whomever is trying to ruin the future of medicine in general to be a lucrative field as well as dictating the way physicians practice, and the quality of care that patients receive.

How can they be stopped once and for all? Because it really needs to happen. Physicians should rule their own roosts.

 

[kugel]

IMHO, physicians "abdicated" their role in deciding how they are reimbursed in the 60's and 70's when charges skyrocketed and physicians refused to become involved in efforts to control costs and instead bought labs to which they could refer all their patients.

If you want a role now, you will have to show how maintaining (or growing) salaries benefits society. In doing that, you will probably also have to show how physicians are policing their ranks - which we generally do Not do.

 

[splik]

Physicians should rule their own roosts.

The problem with this is you end up doing what's best for you and not what's best for your patient, which is rampant in healthcare in the US. Ordering unnecessary investigation, scheduling more frequent visits, prescribing unnecessary medications, and even performing unnecessary procedures happens day in, day out. When it was profitable to keep patients in hospital longer, they were, and when it became more profitable to discharge them quickly, this has become more frequent. It is the reason we see patients on adderall, xanax, klonopin, methadone, and medical marijuana time and again.

Now targeting physician earnings is a fairly ineffective way at reducing healthcare costs as we account for only 7% of the overall cost. But it is easy, and it is certainly the case that a lot of fat can be cut, and patients will better off for it. Reducing medicaid reimbursements in general is a bad idea, but the fact that the reimbursement system needs a complete overhaul to reward preventive care and not procedures, to reimburse psychological therapy for chronic pain instead of pointless procedures that don't work.

It always amuses me how the free market nutjobs are the ones who hypocritically decry the rise of nurse quacktitioners and other mid level providers etc the most. The AMA deliberately made it impossible for people to get into medical school for many years to artificially inflate earnings. This led to the back routes into medicine, e.g. DOs, NPs etc and thus earnings have and will continue to fall. There will always be plenty of people willing to go to medical school to be doctors. Some have cashed in on this expanding medical school places, opening up new schools, putting shiny price tags on education. But hey it's a 'free' market!

The golden era of medicine (which was never golden for patients) is long gone. The good news is you're not going to be out of a job and you will still be among the top 5% of earners in the country and top 0.001% in the world. And if you work hard, do a good job, have a good reputation, you can make even more than that. Or you can just open up an adult ADD clinic, a methadone mill, or some other shady venture should you wish to line your pockets more...

 

[vistaril]

New CPT codes: designed to be a boon, benign, or malignant? What was the reasoning behind the new CPT codes?

1. To increase reimbursement

2. No real reason. Just some schmuck coming up with something to keep their job, and will neither increase nor decrease reimbursement.

3. Nefarious. To actively prevent one from sustaining or even with the intent of decreasing reimbursement by making it more difficult to be reimbursed as the patietn needs to have a certain number of "hoops" to qualify.

I have my guesses. Furthermore, who says we wanted this change anyway? Did they (whoever they are) consult or poll physicians to see if we thought it was a good or necessary idea? Why don't we have the final word in how we bill for OUR services? What gives them the right? They didn't go to medical school, residency, and sacrifice time. nor will they bear the responsibility.

Considering the duration of training and the high level of responsibility, being a physician should come with a hefty compensation reflecting these things.

Integrative care: Is this just some blah blah blah talk, an optional way to manage care only if you find it to be something you would CHOOSE to participate in it, or is it going to be mandated on us as a means of forcibly driving down costs?

I am greatly angered, and sick to death of whomever is trying to ruin the future of medicine in general to be a lucrative field as well as dictating the way physicians practice, and the quality of care that patients receive.

How can they be stopped once and for all? Because it really needs to happen. Physicians should rule their own roosts.

ummmm....who is preventing you from doing that now? You have the right to charge whatever the heck you want if there is someone willing to pay it......

as for patients in various care networks, you have the right to contract with them(or not) as you see fit......

it seems to me like you are banging your hand on a desk saying "I demand that I see your patients and I demand to be paid this for seeing them".....that's ridiculous. It's always a two way street. It would be just as ridiculous if blue cross demanded you see their patients when you didn't want to at that rate.