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Please carefully read the following:
Im currently an intern in Philadelphia and Ive been following recent governmental policy healthcare changes. There are a lot of myths and misinformation contained in articles and blogs regarding the Affordable Care Act, however Ive taken the time to painstakingly review the FTCs documents regarding the Affordable Care Act as well as portions of the actual Affordable Care Act.
I will clearly state that the main objective of presenting this issue is NOT to ignite a political discussion nor endorse a particular candidate for the upcoming elections.
More so I am attempting to gauge the national and local interests in a medical student and resident strike to attempt to give physicians as a whole a voice in national health care policy, raise awareness regarding physician responsibilities, costs of training, tort reform and most importantly patient care and maintenance of the patient doctor relationship.
Should there be regional and widespread interest in the matter, I present that we form a democratic organization insofar that our mission is to define goals that we would organize and strike for that align with the following themes: our primary goal is not for higher salaries or better reimbursements but our primary initiative is to provide better high quality patient care.
We would object to the following items held within the Affordable Care Act:
1. The statute in affect already that penalizes hospitals by 1% for readmissions.
2. The creation of a model which reimburses or pays for outcomes rather than activity. (I.e. reimbursements ONLY for a patient having a HbA1C < 8.0% in a DM patient, how are noncompliant patients dealt with?)
3. Disproportionate costs of Medical/Undergraduate Education in parallel to resident and physician salaries.
4. Profit sharing from other specialties to primary care. Under new medicare laws radiology and radiation oncology will be allocating 4% and 15% respectively to IM and geriatricians.
Goals:
1. Include some level of tort reform or discussion of malpractice in the affordable care act.
2. Present a model that allows for lower interest loan repayment for medical students and/or lowering the cost of education overall.
3. Present the key idea that individual social irresponsibility regarding ones health and lifestyle choices should not result in penalizing physicians and that physicians cannot account for non-compliance, that every human has the right to being alive, but feeling well is a privilege and we should have a system that enforces this theme.
EDITORIAL PORTION:
Sure, we have the AMA but theyve done a poor job representing physicians and they only represent a small percentage of physicians. Not to mention allegations that they have a constant revenue stream from medicare for their coding model. Unfortunately, corporate anti-trust laws prevent physicians from unionizing. Unfortunately, a resident strike on a large scale could lead to a serious social collapse and do the very thing we as physicians have taken an oath to and morally/ethically wish to prevent which are patient deaths or poor outcomes. Thus Im posting for ideas for enacting social change before resorting to a full blown strike.
Based on statistics we are approaching a physician shortage of ~ 100K doctors by 2020. Couple this to 20 million new medicare patients out of 47 million new patients being pushed into the health system and a campaign to make hospitals more transparent, with a model that pays medicare providers (doctors) and hospitals based on outcomes rather than activity will lead to higher volumes of patients (more work) without an increase in pay. I predict that the volume will be dealt with by employing more nurse practitioners and PAs, unfortunately this will lead to less interaction between the supervising physicians and the patients ultimately leading to a decrease in the quality of care. By increasing transparency in the medical system we will further stratify patients based on socioeconomic status. For example, if hospital A has a higher mortality rate/complication rate regarding MI and sepsis in relation to hospital B, patients with higher socioeconomic statuses and educational statuses will ultimately choose hospital B leaving lowering income patients with tougher socioeconomic dispositions to hospital A. This example also applies to surgeons who would ultimately choose to operate on patients with less co-morbities because it would show better outcomes.
Im currently an intern in Philadelphia and Ive been following recent governmental policy healthcare changes. There are a lot of myths and misinformation contained in articles and blogs regarding the Affordable Care Act, however Ive taken the time to painstakingly review the FTCs documents regarding the Affordable Care Act as well as portions of the actual Affordable Care Act.
I will clearly state that the main objective of presenting this issue is NOT to ignite a political discussion nor endorse a particular candidate for the upcoming elections.
More so I am attempting to gauge the national and local interests in a medical student and resident strike to attempt to give physicians as a whole a voice in national health care policy, raise awareness regarding physician responsibilities, costs of training, tort reform and most importantly patient care and maintenance of the patient doctor relationship.
Should there be regional and widespread interest in the matter, I present that we form a democratic organization insofar that our mission is to define goals that we would organize and strike for that align with the following themes: our primary goal is not for higher salaries or better reimbursements but our primary initiative is to provide better high quality patient care.
We would object to the following items held within the Affordable Care Act:
1. The statute in affect already that penalizes hospitals by 1% for readmissions.
2. The creation of a model which reimburses or pays for outcomes rather than activity. (I.e. reimbursements ONLY for a patient having a HbA1C < 8.0% in a DM patient, how are noncompliant patients dealt with?)
3. Disproportionate costs of Medical/Undergraduate Education in parallel to resident and physician salaries.
4. Profit sharing from other specialties to primary care. Under new medicare laws radiology and radiation oncology will be allocating 4% and 15% respectively to IM and geriatricians.
Goals:
1. Include some level of tort reform or discussion of malpractice in the affordable care act.
2. Present a model that allows for lower interest loan repayment for medical students and/or lowering the cost of education overall.
3. Present the key idea that individual social irresponsibility regarding ones health and lifestyle choices should not result in penalizing physicians and that physicians cannot account for non-compliance, that every human has the right to being alive, but feeling well is a privilege and we should have a system that enforces this theme.
EDITORIAL PORTION:
Sure, we have the AMA but theyve done a poor job representing physicians and they only represent a small percentage of physicians. Not to mention allegations that they have a constant revenue stream from medicare for their coding model. Unfortunately, corporate anti-trust laws prevent physicians from unionizing. Unfortunately, a resident strike on a large scale could lead to a serious social collapse and do the very thing we as physicians have taken an oath to and morally/ethically wish to prevent which are patient deaths or poor outcomes. Thus Im posting for ideas for enacting social change before resorting to a full blown strike.
Based on statistics we are approaching a physician shortage of ~ 100K doctors by 2020. Couple this to 20 million new medicare patients out of 47 million new patients being pushed into the health system and a campaign to make hospitals more transparent, with a model that pays medicare providers (doctors) and hospitals based on outcomes rather than activity will lead to higher volumes of patients (more work) without an increase in pay. I predict that the volume will be dealt with by employing more nurse practitioners and PAs, unfortunately this will lead to less interaction between the supervising physicians and the patients ultimately leading to a decrease in the quality of care. By increasing transparency in the medical system we will further stratify patients based on socioeconomic status. For example, if hospital A has a higher mortality rate/complication rate regarding MI and sepsis in relation to hospital B, patients with higher socioeconomic statuses and educational statuses will ultimately choose hospital B leaving lowering income patients with tougher socioeconomic dispositions to hospital A. This example also applies to surgeons who would ultimately choose to operate on patients with less co-morbities because it would show better outcomes.
