Teladoc, k health .... telemedicine

[BoardingDoc]

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They really need to have a strict timer for these telemedicine visits. Make it 5 minutes, so that it abruptly cuts off if the patient is streaming too much verbal diarrhea. Have an option so that the doctor can extend the session if needed at their discretion.

Unfortunately, that would lower pt satisfaction scores and Teladoc evidently has enough suckers willing to spend 45 minutes dealing with literal nonsense for 23 dollars.

 

[thegenius]

I got a text from VISTA staffing solutions for telemedicine position in NY.
- 6 hr shifts,
- min 48 hrs / month
- $280/hr rate
- 100% virtual services
- any active licenses accepted

that doens't sound too bad...can't you just recommend to "go to the closest ER" if there is anything in doubt and possibly an emergency?

 

[BoardingDoc]

I got a text from VISTA staffing solutions for telemedicine position in NY.
- 6 hr shifts,
- min 48 hrs / month
- $280/hr rate
- 100% virtual services
- any active licenses accepted

that doens't sound too bad...can't you just recommend to "go to the closest ER" if there is anything in doubt and possibly an emergency?

You can tell people to go to the ER. They don't like that answer, which in turn affects your pt satisfaction scores, which in turn modifies your chances of continued employment. Also, I would be curious if you follow through with these people get more details. My strong suspicion is that the comp is not actually what you think it is.

E.g. comp is "up to 280/hr" or somesuch.

 

[sloh]

The theme I’m getting from this thread is patient satisfaction ruins everything lol

 

[BoardingDoc]

The theme I’m getting from this thread is patient satisfaction ruins everything lol

The Cost of Satisfaction

Background Patient satisfaction is a widely used health care quality metric. However, the relationship between patient satisfaction and health care utilization, expenditures, and outcomes remains ill defined.Methods We conducted a prospective cohort study of adult respondents (N = 51 946) to the...

jamanetwork.com

Takeaway from the conclusion: "In a nationally representative sample, higher patient satisfaction was associated with less emergency department use but with greater inpatient use, higher overall health care and prescription drug expenditures, and increased mortality."

It should literally be illegal to base any clinical decision making on patient satisfaction scores. But it won't because, you know, money.

 

[thegenius]

You can tell people to go to the ER. They don't like that answer, which in turn affects your pt satisfaction scores, which in turn modifies your chances of continued employment. Also, I would be curious if you follow through with these people get more details. My strong suspicion is that the comp is not actually what you think it is.

E.g. comp is "up to 280/hr" or somesuch.

Yea I have no desire to do telemedicine at this time, so I haven't followed up with them. And right...just adding "Up To..." markedly changes the offer!

 

[thegenius]

The theme I’m getting from this thread is patient satisfaction ruins everything lol

It does! Patient satisfaction is great for economies where the product or service is not a "necessity" and paid for by the customer.
It's terrible when the customer feels entitled to the service and doesn't pay for it, or only pays a fraction of the cost. It's why our health care system is such a pile of S**T.

 

[swamprat]

This is true except the telemedicine platform I use amwell a lot of times people self pay. If I don’t write an antibiotic they r pissed. Honestly I used to explain explain explain why but wasn’t worth it. I give my one sentence blurb now write it and be done. Bad medicine but whatever I like the side gig. Only time I am serious is kids. I had a mom hang up on me when I told them her 15 year old son doesn’t need a Z pack for 2 days of nasal congestion

It does! Patient satisfaction is great for economies where the product or service is not a "necessity" and paid for by the customer.
It's terrible when the customer feels entitled to the service and doesn't pay for it, or only pays a fraction of the cost. It's why our health care system is such a pile of S

 

[thegenius]

This is true except the telemedicine platform I use amwell a lot of times people self pay. If I don’t write an antibiotic they r pissed. Honestly I used to explain explain explain why but wasn’t worth it. I give my one sentence blurb now write it and be done. Bad medicine but whatever I like the side gig. Only time I am serious is kids. I had a mom hang up on me when I told them her 15 year old son doesn’t need a Z pack for 2 days of nasal congestion

Yup makes sense.

 

[sylvanthus]

Hmm was debating doing k health. I work a week on week off and cant get any bloody ED hours now so was thinking of picking up some hours while chillin at home. Second guessing that now.

 

[swamprat]

Hmm was debating doing k health. I work a week on week off and cant get any bloody ED hours now so was thinking of picking up some hours while chillin at home. Second guessing that now.

Are they even hiring? I went through the hiring process, did the training and then was told sorry we over hired peace. Thats when I started doing amwell. Just like you I'm subspecialist so can't get that side ED hours due to covid and well the specialty going to sh-t

 

[sylvanthus]

What blows is the people in the ED are more my peeps, but I cant even get any shifts there. I dont really socialize or even get along well with typical IM/CCM people. So im relegated to coming here to be with my people. Thankfully we hired 3 EM/CCM people starting in august for a “swing” shift. EM trainees taking this place over.

 

[bravotwozero]

What blows is the people in the ED are more my peeps, but I cant even get any shifts there. I dont really socialize or even get along well with typical IM/CCM people. So im relegated to coming here to be with my people. Thankfully we hired 3 EM/CCM people starting in august for a “swing” shift. EM trainees taking this place over.

Hey man, just be glad you have an 'out' unlike most of us. You don't have to wonder if you'll still have a job in an ICU in 5 years time.

 

[sylvanthus]

Hey man, just be glad you have an 'out' unlike most of us. You don't have to wonder if you'll still have a job in an ICU in 5 years time.

Ahhh but I do, NPs are running alot of ICUs at night. Washington state has legislation in the works to reimburse NPs at same rate as docs. While they wont make more, it will incentivize hospitals to hire NPs instead of docs, collect the same amount of money, and pay less in salary.

Noones safe, how long till some number cruncher realizes they can save 200k by replacing me with a midlevel?

 

[emergentmd]

Hey man, just be glad you have an 'out' unlike most of us. You don't have to wonder if you'll still have a job in an ICU in 5 years time.

When will docs start to realize that APCs are taking jobs away from most specialties?

Look at all those surgeons who are hiring NPs instead of a new doc partner. Look at all of the office based specialists hiring NPs to see their patients instead of another doc.

Look up at all of the websites for office practices and you will see a list of NPs outnumbering MDs.

I can't remember the last time my wife or I saw the doc for our yearly visits.

 

[GeneralVeers]

When will docs start to realize that APCs are taking jobs away from most specialties?

Look at all those surgeons who are hiring NPs instead of a new doc partner. Look at all of the office based specialists hiring NPs to see their patients instead of another doc.

Look up at all of the websites for office practices and you will see a list of NPs outnumbering MDs.

I can't remember the last time my wife or I saw the doc for our yearly visits.

Why would you waste your time seeing someone with less medical knowledge than you for an annual visit? As a physician you should demand to see another physician. Jenny certainly isn't qualified to give me an opinion on anything.

 

[Socrates25]

I did this last year when I had the whole day off or did it at work. They gave bonuses b/c it was busy so ended up being 35-40/pt. I was able to see/chart 7 pts/hr so not bad making 225+/hr handing out zpaks all day.

But it seems to have slowed down and I am not not doing it for 23/pt and sitting to snipe the next patient.

Oh so you're the guy I have to warn patients about -- maybe you never learned this in medical school but zpacks don't work for viruses.

Instead of scripting them, why dont you just tell them to order zpacks from an online pharmacy in Mexico. Delivered straight to your door, no doctor visit required.

Or I have another idea. Take only URI complaints and use this as your protocol:

Patient: I have had a runny nose for 2 days
Doctor: I've heard enough. Sounds like you have a sinus infection, here's your zpack

I could easily do 25-30 patients an hour using this approach. You need to up your game!

 

[Birdstrike]

Oh so you're the guy I have to warn patients about -- maybe you never learned this in medical school but zpacks don't work for viruses.

No one else on this forum has ever written a z-pak for someone they knew had a virus, just so you know.

 

[Birdstrike]

Why would you waste your time seeing someone with less medical knowledge than you for an annual visit? As a physician you should demand to see another physician. Jenny certainly isn't qualified to give me an opinion on anything.

Jenny is very good at Rx'ing meds and ordering labs as requested, and therefore the perfect provider for doctors who want to self-treat.

 

[Socrates25]

No one else on this forum has ever written a z-pak for someone they knew had a virus, just so you know.

If you're going to sell out your profession and do bad patient care, then you might as well get rich at it.

If you get paid $25 per visit I could easily make a million per year on telemed

Dont even let the patient talk, just look at the chief complaint on the computer and as soon as they connect you say "I see you have congestion, I will send in a zpack immediately. Have a nice day!"

I could easily see 30 patients an hour using such an approach.

30 patients/hour x 8 hours x 5 days x 50 weeks x $25 = $1.5 million

 

[emergentmd]

Oh so you're the guy I have to warn patients about -- maybe you never learned this in medical school but zpacks don't work for viruses.

Instead of scripting them, why dont you just tell them to order zpacks from an online pharmacy in Mexico. Delivered straight to your door, no doctor visit required.

Or I have another idea. Take only URI complaints and use this as your protocol:

Patient: I have had a runny nose for 2 days
Doctor: I've heard enough. Sounds like you have a sinus infection, here's your zpack

I could easily do 25-30 patients an hour using this approach. You need to up your game!

Shocking news to me b/c my American Trained medical school and Trauma center residency never taught me this.

Seems really odd that when I give a viral infection a Zpak they leave happy and they get better in a few dys. But when I do not, they go to their PCP feeling worse a few dys later who tells them that I screwed up, gave them a ZPAK, get better and I get a complaint.

Let me go back to reading about antibiotics and viruses. Maybe I will stopping giving out ZPAKs until I get a definitive bacterial diagnosis so I get constant complaints that I have no clue what I was doing b/c their PCP miraculously saved them with a ZPAK 2 dys later b/c they were feeling worse. Because you know, PCPs would never throw EM docs under the bus b/c they want to take the glory of making their pts feel better with a zpak.

But of course PCPs always practice great clinical medicine when they are sending their new asymptomatic pts with SBPs over 170 telling them to go immediately to the ER or they will stroke out. Oh wait. How about that pt with a DVT who obviously needs to go to the ER to get a script for xarelto.

 

[sloh]

In 2021, the customer is always right. It’s not longer the practice of medicine. It’s customer service. And the patients like it that way

 

[Socrates25]

Shocking news to me b/c my American Trained medical school and Trauma center residency never taught me this.

Seems really odd that when I give a viral infection a Zpak they leave happy and they get better in a few dys. But when I do not, they go to their PCP feeling worse a few dys later who tells them that I screwed up, gave them a ZPAK, get better and I get a complaint.

Let me go back to reading about antibiotics and viruses. Maybe I will stopping giving out ZPAKs until I get a definitive bacterial diagnosis so I get constant complaints that I have no clue what I was doing b/c their PCP miraculously saved them with a ZPAK 2 dys later b/c they were feeling worse. Because you know, PCPs would never throw EM docs under the bus b/c they want to take the glory of making their pts feel better with a zpak.

But of course PCPs always practice great clinical medicine when they are sending their new asymptomatic pts with SBPs over 170 telling them to go immediately to the ER or they will stroke out. Oh wait. How about that pt with a DVT who obviously needs to go to the ER to get a script for xarelto.

I'm not gonna pretend that PCPs dont overscript abx too. But its worse for doctors who dont really know their patients well (i.e. ER, urgent care, telemed)

If you actually talk to patients instead of trying to get them out of your exam room in 5 mins, I think you'd find that many of them are more reasonable then you think.

Talk to them about the patients who get cdiff colitis from antibiotics and have to have a bowel resection.

I have patients that seek me out because I don't hand out antibiotics like candy.

 

[Birdstrike]

Shocking news to me b/c my American Trained medical school and Trauma center residency never taught me this.

Seems really odd that when I give a viral infection a Zpak they leave happy and they get better in a few dys. But when I do not, they go to their PCP feeling worse a few dys later who tells them that I screwed up, gave them a ZPAK, get better and I get a complaint.

Let me go back to reading about antibiotics and viruses. Maybe I will stopping giving out ZPAKs until I get a definitive bacterial diagnosis so I get constant complaints that I have no clue what I was doing b/c their PCP miraculously saved them with a ZPAK 2 dys later b/c they were feeling worse. Because you know, PCPs would never throw EM docs under the bus b/c they want to take the glory of making their pts feel better with a zpak.

But of course PCPs always practice great clinical medicine when they are sending their new asymptomatic pts with SBPs over 170 telling them to go immediately to the ER or they will stroke out. Oh wait. How about that pt with a DVT who obviously needs to go to the ER to get a script for xarelto.

Reality

 

[Birdstrike]

If you're going to sell out your profession and do bad patient care, then you might as well get rich at it.

If you get paid $25 per visit I could easily make a million per year on telemed

Dont even let the patient talk, just look at the chief complaint on the computer and as soon as they connect you say "I see you have congestion, I will send in a zpack immediately. Have a nice day!"

I could easily see 30 patients an hour using such an approach.

30 patients/hour x 8 hours x 5 days x 50 weeks x $25 = $1.5 million

I haven't prescribed a z-pak for years, but go on...

 

[Birdstrike]

In 2021, the customer is always right. It’s not longer the practice of medicine. It’s customer service. And the patients like it that way

True. We didn't make it that way. Administrators did. And now we suffer the consequences of the decision to turn Medicine over to them and the politicians. But there's little to be gained by spending too much time frustrated by it, more to be gained by adapting to it, or simply accepting it. It sucks, but it is what is is.

 

[Apollyon]

If you actually talk to patients instead of trying to get them out of your exam room in 5 mins, I think you'd find that many of them are more reasonable then you think.

First, thank for the insult. Second, have you ever been in a community ED, especially after office hours? Most are not reasonable. As I've said many a time, "the only time we see normal people in the ED is when they have an accident - ranging from a cut finger to rolling over their car - or have crushing chest pain".

To "actually talk to patients" reveals that many aren't even too literate, or REALLY aren't the most sociable creatures on the planet. Yet, still, we try.

You're peds, and, what's the worst thing about peds? The parents.

 

[MechEDoc]

If you're going to sell out your profession and do bad patient care, then you might as well get rich at it.

If you get paid $25 per visit I could easily make a million per year on telemed

Dont even let the patient talk, just look at the chief complaint on the computer and as soon as they connect you say "I see you have congestion, I will send in a zpack immediately. Have a nice day!"

I could easily see 30 patients an hour using such an approach.

30 patients/hour x 8 hours x 5 days x 50 weeks x $25 = $1.5 million

Don't aim so low. I'll write a computer script with "IDIOCRACY" flag set to TRUE, it'll crank out these visits at essentially infinite speed...

 

[MechEDoc]

I have patients that seek me out because I don't hand out antibiotics like candy.

Really? Word must of got out at the section 8 housing...

Oh wait, that's after hours weekend ED patient that will never have to pay these bills and "knows their body".

I remember clearly some simpleton mother who's kid almost certainly didn't need a head CT, I went through PECARN, radiation risks, everything. I couldn't talk her out of it. Since the kid didn't have a 100% slam dunk no head CT history, they got a head CT.

Me > your kid's head CT was fine, I'm sending you home.

Mom > really? I didn't show anything?

Me > yes, that's right, it didn't show anything.

She never got the slight and left happy and no smarter than when she came in. Since the CT head likely had 2 mSv of radiation and this might have upped her fatal CA risk by 1/10,000, changing her lifetime fatal CA risk from 0.2 to 0.2001, I can't see losing much sleep about it. No complaint, patient happy. Sure, it was bad medicine, but I needed a job and there wouldn't be anyone to back me up. Hospital wants a happy patient, ED group wants a happy hospital.

 

[Birdstrike]

If you actually talk to patients instead of trying to get them out of your exam room in 5 mins, I think you'd find that many of them are more reasonable then you think.

I'm not saying you're doing anything wrong. In fact, I think how you approach things, is right. But something tells me you either haven't been doing this very long, or you have a job that doesn't care about production. I could be wrong.

 

[robellis]

I'm not saying you're doing anything wrong. In fact, I think how you approach things, is right. But something tells me you either haven't been doing this very long, or you have a job that doesn't care about production. I could be wrong.

Or he could shockingly put patients before profit

 

[Apollyon]

Or he could shockingly put patients before profit

In the world of unicorns and rainbows, it's that easy. However, there is still a charge for keeping the lights on, and paying staff.

This same guy posted this thread. Even if you, whomever you are, don't believe it, it's true.

 

[Birdstrike]

Or he could shockingly put patients before profit

I'm sure his/her administrators would find that quite shocking.

 

[Birdstrike]

This same guy posted this thread.

He/she comes to the EM forum presenting as an anti-consumer-medicine warrior of altruism. Then simultaneously starts a
"Hey yo, let's maximize profits" thread?

That's priceless.

 

[VA Hopeful Dr]

Or he could shockingly put patients before profit

That's the kind of talk that gets your contract not renewed.

 

[Socrates25]

First, thank for the insult. Second, have you ever been in a community ED, especially after office hours? Most are not reasonable. As I've said many a time, "the only time we see normal people in the ED is when they have an accident - ranging from a cut finger to rolling over their car - or have crushing chest pain".

To "actually talk to patients" reveals that many aren't even too literate, or REALLY aren't the most sociable creatures on the planet. Yet, still, we try.

You're peds, and, what's the worst thing about peds? The parents.

I'd still rather deal with parents and the antibiotic stuff than deal with adult patients who all want oxycontin and yell at you for being a horrible doctor for ignoring their pain.

Even on the rare occassion when parents get upset that I wont give them an antibiotic I don't have to deal with the nastiness of chronic pain med seekers.

 

[Socrates25]

I'm not saying you're doing anything wrong. In fact, I think how you approach things, is right. But something tells me you either haven't been doing this very long, or you have a job that doesn't care about production. I could be wrong.

I plead guilty on the second charge.

I own my clinic. My only boss is the patient. If people don't like me, they walk. And I have lost a very few number of patients who saw me one time and didn't like the fact that I didnt give them an antibiotic and they never came back. And I've had anti-vax people who I refuse to treat and they left too.

However, those numbers only account for 1-2% of my patients. 98% of them will come back despite the fact that there's a free clinic down the street that will treat their kids at zero cost to them and give them whatever antibiotic they want with no questions asked.

I'm not perfect. Every few months there's a kid who comes in who has been having severe nasal congestion/coughing for 2 weeks straight, mom has already tried OTC remedies appropriately, mom is at risk of getting fired for missing too much work, and in those cases I'll give them an antibiotic.

I schedule 20 patients per day, MAX

I'm fine making 250k which I know you guys scoff at, but it's good enough for me.

If I wanted to I could schedule 40-50 patients per day and make 500k, but it's not worth it.

 

[MechEDoc]

/

 

[MechEDoc]

I plead guilty on the second charge.

I own my clinic. My only boss is the patient. If people don't like me, they walk. And I have lost a very few number of patients who saw me one time and didn't like the fact that I didnt give them an antibiotic and they never came back. And I've had anti-vax people who I refuse to treat and they left too.

However, those numbers only account for 1-2% of my patients. 98% of them will come back despite the fact that there's a free clinic down the street that will treat their kids at zero cost to them and give them whatever antibiotic they want with no questions asked.

I'm not perfect. Every few months there's a kid who comes in who has been having severe nasal congestion/coughing for 2 weeks straight, mom has already tried OTC remedies appropriately, mom is at risk of getting fired for missing too much work, and in those cases I'll give them an antibiotic.

I schedule 20 patients per day, MAX

I'm fine making 250k which I know you guys scoff at, but it's good enough for me.

If I wanted to I could schedule 40-50 patients per day and make 500k, but it's not worth it.

I respect that.

 

[GeneralVeers]

I plead guilty on the second charge.

I own my clinic. My only boss is the patient. If people don't like me, they walk. And I have lost a very few number of patients who saw me one time and didn't like the fact that I didnt give them an antibiotic and they never came back. And I've had anti-vax people who I refuse to treat and they left too.

However, those numbers only account for 1-2% of my patients. 98% of them will come back despite the fact that there's a free clinic down the street that will treat their kids at zero cost to them and give them whatever antibiotic they want with no questions asked.

I'm not perfect. Every few months there's a kid who comes in who has been having severe nasal congestion/coughing for 2 weeks straight, mom has already tried OTC remedies appropriately, mom is at risk of getting fired for missing too much work, and in those cases I'll give them an antibiotic.

I schedule 20 patients per day, MAX

I'm fine making 250k which I know you guys scoff at, but it's good enough for me.

If I wanted to I could schedule 40-50 patients per day and make 500k, but it's not worth it.

I think you really don't understand where we are coming from. We don't "scoff" at 250K. You are your own boss, setting your own schedule, your own practice, and making great money. I wouldn't criticize any of that.

I would scoff at the sucker working for a CMG, busting their ass, and making that same money.

 

[dratif12]

I did this last year when I had the whole day off or did it at work. They gave bonuses b/c it was busy so ended up being 35-40/pt. I was able to see/chart 7 pts/hr so not bad making 225+/hr handing out zpaks all day.

But it seems to have slowed down and I am not not doing it for 23/pt and sitting to snipe the next patient.

hi,
I am interested in doing Telemedicine Job. I am wondering if they allow you to work from overseas or are there any restrictions to stay within USA? Pls reply.

Thanks

 

[dratif12]

I got a text from VISTA staffing solutions for telemedicine position in NY.
- 6 hr shifts,
- min 48 hrs / month
- $280/hr rate
- 100% virtual services
- any active licenses accepted

that doens't sound too bad...can't you just recommend to "go to the closest ER" if there is anything in doubt and possibly an emergency?

hi,
I am planning to do Telemedicine primary care Job. I am a FM trained Physician and have 5 years of inpatient and outpatient experience. I am wondering if they allows Physician to work from overseas or are there any restrictions for Physician to work within US.
Pls let me know. Thanks.

 

[Socrates25]

That's the kind of talk that gets your contract not renewed.

I don't have a contract.

 

[Socrates25]

Ahhh but I do, NPs are running alot of ICUs at night. Washington state has legislation in the works to reimburse NPs at same rate as docs. While they wont make more, it will incentivize hospitals to hire NPs instead of docs, collect the same amount of money, and pay less in salary.

Noones safe, how long till some number cruncher realizes they can save 200k by replacing me with a midlevel?

When NPs first started barging into the field, I was told that primary care was dead.

Here we are 20 years later, and ironically enough primary care is actually one of the BEST fields to counter the NPs.

I run a private peds clinic. When I set up shop 5 years ago there were 5 other clinics that were completely run by NPs. Now there are 3.

Within 3 months of establishing a practice I had stolen at least 500 patients from those NP clinics. And I didn't steal them by throwing antibiotics at every patient who walked in the door either.

Here's what you guys don't understand.

When you work for the patient and not an intermediary like a hospital, NPs don't affect your business unless you're a piker.

Primary care is about relationships. Primary care doctors (and NPs) who are pikers don't build relationships. Pikers walk at the bell. Pikers brush off the parents of a newborn who don't understand why they are crying a lot at night. Pikers interrupt the mom of a 2 year old talking about a cough to say that they are going to send in antibiotics and then walk out the door without listening to a single word the mom said.

I'm part of an online collaborative group of private practice pediatricians. Many of those groups hire NPs, but that's ONLY because they've put in ads at the AAP and got zero responses from pediatricians for new job postings. They hire NPs out of necessity, not because they want to put doctors out of business.

Every time a neighoring peds clinic hires an NP it's music to my ears. You can bet bottom dollar I'm going to be stealing a few more of their patients.

At this point, I don't want anymore patients. I stopped taking new patinets once and a bunch of people in teh community got pissed off at me so I decided to start a waiting list, so I take one new patient a month. I have people on my waiting list for 6 months that could easily disappear and go to one of the NP clinics but when my staff calls them to tell them that I have an open slot, they always want to take it. Out of the last 100 wait list positions, only 2 said they didn't need the spot anymore.

 

[VA Hopeful Dr]

I don't have a contract.

 

[sylvanthus]

When NPs first started barging into the field, I was told that primary care was dead.

Here we are 20 years later, and ironically enough primary care is actually one of the BEST fields to counter the NPs.

I run a private peds clinic. When I set up shop 5 years ago there were 5 other clinics that were completely run by NPs. Now there are 3.

Within 3 months of establishing a practice I had stolen at least 500 patients from those NP clinics. And I didn't steal them by throwing antibiotics at every patient who walked in the door either.

Here's what you guys don't understand.

When you work for the patient and not an intermediary like a hospital, NPs don't affect your business unless you're a piker.

Primary care is about relationships. Primary care doctors (and NPs) who are pikers don't build relationships. Pikers walk at the bell. Pikers brush off the parents of a newborn who don't understand why they are crying a lot at night. Pikers interrupt the mom of a 2 year old talking about a cough to say that they are going to send in antibiotics and then walk out the door without listening to a single word the mom said.

I'm part of an online collaborative group of private practice pediatricians. Many of those groups hire NPs, but that's ONLY because they've put in ads at the AAP and got zero responses from pediatricians for new job postings. They hire NPs out of necessity, not because they want to put doctors out of business.

Every time a neighoring peds clinic hires an NP it's music to my ears. You can bet bottom dollar I'm going to be stealing a few more of their patients.

At this point, I don't want anymore patients. I stopped taking new patinets once and a bunch of people in teh community got pissed off at me so I decided to start a waiting list, so I take one new patient a month. I have people on my waiting list for 6 months that could easily disappear and go to one of the NP clinics but when my staff calls them to tell them that I have an open slot, they always want to take it. Out of the last 100 wait list positions, only 2 said they didn't need the spot anymore.

The point you seem to be ignoring is that as a pcp you have your own patients. My point is that working inside a hospital we dont have our own patients, we get what is given to us and therefore have zero power. The docs who stand to have some control over their futures and some degree of safety from midlevels, are those who have their own patients. My point still stands.

 

[Fox800]

hi,
I am planning to do Telemedicine primary care Job. I am a FM trained Physician and have 5 years of inpatient and outpatient experience. I am wondering if they allows Physician to work from overseas or are there any restrictions for Physician to work within US.
Pls let me know. Thanks.

It depends on the group. Some insurance payers stipulate that you have to be located in the US. However, you could always have a "home base" in the US, a virtual mailbox service that receives/opens/scans mail for you, use a VPN to remote in from elsewhere...there is no way they would know.

 

[Apollyon]

It depends on the group. Some insurance payers stipulate that you have to be located in the US. However, you could always have a "home base" in the US, a virtual mailbox service that receives/opens/scans mail for you, use a VPN to remote in from elsewhere...there is no way they would know.

In the same vein as remote radiologists, I would posit that one would need a license in the state.

I recall the rads guy at my last job, and him with what appeared to be a literal ream of paper of all the applications for privileges from the entire company. There had to be 20 docs worth of paper. It reminded me of that movie, "Caligula". Although execrable in writing, and, essentially, porn, there is a scene with Cal doing the admin busy work, where he stamps a document, and says, "For the Senate and people of Rome" (SPQR - "Senatus Populusque Romanus"), time after time, after time, and it's drudgery.

 

[southerndoc]

In the same vein as remote radiologists, I would posit that one would need a license in the state.

I recall the rads guy at my last job, and him with what appeared to be a literal ream of paper of all the applications for privileges from the entire company. There had to be 20 docs worth of paper. It reminded me of that movie, "Caligula". Although execrable in writing, and, essentially, porn, there is a scene with Cal doing the admin busy work, where he stamps a document, and says, "For the Senate and people of Rome" (SPQR - "Senatus Populusque Romanus"), time after time, after time, and it's drudgery.

Hopefully he has someone that can fill out most of the paperwork for him.

 

[Apollyon]

Hopefully he has someone that can fill out most of the paperwork for him.

No, the apps were all filled out when he got them. However, yes, although I don't know, it's likely the office staff from the company filled out the lion's share.