First and foremost physicians need to quit apologizing for the money they make. Of all the professions it may be the only one that blocks them from sharing in the revenue they generate with their customers (patients), their licenses (script) and their hared work.
Here they touched on a discussion of wealth and being rich, they are two very different things.
Being rich is in the moment and is based on your work effort. Wealth is generational and survives your working life and can be passed to the next generation.
The system allows doctors to be rich while blocking them from wealth.
We need to start by changing the narrative. Why is it when we discuss lower income earners (minimum wage) we discuss it in hourly wages yet with physicians we only want to discuss and show earned income?
When we discuss the insane salaries (and bonuses) of the CEOs of hospitals, insurance companies, pharmaceutical, medical device etc we immediately go to "well its a small percentage of the multi millions they mange. yet when we talk about physicians income we never include the number of patients they treat, the number of people they employ, the number of businesses they support with theirr scripts, the work they put into becoming a physician ............
We need to remember true leaders unite, those that wish to conquer divide. Those that profit rather than provide care thrive on the division of physicians and they created the complexity in order to justify their profits.
We need to understand that by cutting physicians pay each year leads to two outcomes. Physicians are either forced to become employed or they continue to increase their volume. both lead tenth same result, the more patients you see the harder you work the more scripts you write that admit patients to hospitals, order labs, CTs, MRIs, X-rays, pharmaceuticals, PT, OT ...... All the things that they profit from that you are blocked from.
We need to have the discussion as to why the American public believe they need to be protected from the doctors that trained and devoted themselves to our care form over utilizing, by those that trained in and are bonuses by physicians utilization.
This was a fantastic and vibrant conversation. The issues that were brought up regarding silencing by shaming are so very important. It took me at least a decade into the profession to fully realize the ways we are all being manipulated by everyone who is orbiting the profession. It is difficult to watch the way these tactics are employed on the newer and newly employed physicians, who are being emotionally strung out, quickly used up, and then blamed, sometimes by those who had a vastly different experience, for wanting something better.
The selfless physician of yore seems like a bit of a myth to me. Let's all admit that those physicians got something in return for their " selflessness": ownership, autonomy, sense of accomplishment, in addition to (sometimes out of proportion) compensation. You are allowed none of those as an employed physician. Absolutely correct that these conversations need to be had with our primary audience, the newer generation of physicians. All other parties are completely uninterested in talking about this in a constructive way, because all of them , including the general population, feel they benefit from cutting us out of the conversation and keeping us working for as little as they possibly can. It really is that simple. So, thanks for making all these great points.
However, that leads me to my one gripe about this video. It did not really deeply discuss whether physicians have become a "nuisance" in the medical arena. Indeed, we have. Not only, as you somewhat touched on, in the political and financial arenas, but to our patients as well. Patients no longer view us as a source of information, but as a conduit to obtain what they have been told elsewhere that they need or want. That could be a whole different topic.
As a plan manager we are willing to pay 200% of Medicare - not 500% of Medicare because we look at the cost reports that systems file showing that costs are 100% to 120% of Medicare. Now that over 50% of doctors are employed by health systems it is hard for us to break out the doctor's value out from the total bill. We are not able to separately reward the doctor with the system we have.
Great conversation, we need more of this.
First and foremost physicians need to quit apologizing for the money they make. Of all the professions it may be the only one that blocks them from sharing in the revenue they generate with their customers (patients), their licenses (script) and their hared work.
Here they touched on a discussion of wealth and being rich, they are two very different things.
Being rich is in the moment and is based on your work effort. Wealth is generational and survives your working life and can be passed to the next generation.
The system allows doctors to be rich while blocking them from wealth.
We need to start by changing the narrative. Why is it when we discuss lower income earners (minimum wage) we discuss it in hourly wages yet with physicians we only want to discuss and show earned income?
When we discuss the insane salaries (and bonuses) of the CEOs of hospitals, insurance companies, pharmaceutical, medical device etc we immediately go to "well its a small percentage of the multi millions they mange. yet when we talk about physicians income we never include the number of patients they treat, the number of people they employ, the number of businesses they support with theirr scripts, the work they put into becoming a physician ............
We need to remember true leaders unite, those that wish to conquer divide. Those that profit rather than provide care thrive on the division of physicians and they created the complexity in order to justify their profits.
We need to understand that by cutting physicians pay each year leads to two outcomes. Physicians are either forced to become employed or they continue to increase their volume. both lead tenth same result, the more patients you see the harder you work the more scripts you write that admit patients to hospitals, order labs, CTs, MRIs, X-rays, pharmaceuticals, PT, OT ...... All the things that they profit from that you are blocked from.
We need to have the discussion as to why the American public believe they need to be protected from the doctors that trained and devoted themselves to our care form over utilizing, by those that trained in and are bonuses by physicians utilization.
This was a fantastic and vibrant conversation. The issues that were brought up regarding silencing by shaming are so very important. It took me at least a decade into the profession to fully realize the ways we are all being manipulated by everyone who is orbiting the profession. It is difficult to watch the way these tactics are employed on the newer and newly employed physicians, who are being emotionally strung out, quickly used up, and then blamed, sometimes by those who had a vastly different experience, for wanting something better.
The selfless physician of yore seems like a bit of a myth to me. Let's all admit that those physicians got something in return for their " selflessness": ownership, autonomy, sense of accomplishment, in addition to (sometimes out of proportion) compensation. You are allowed none of those as an employed physician. Absolutely correct that these conversations need to be had with our primary audience, the newer generation of physicians. All other parties are completely uninterested in talking about this in a constructive way, because all of them , including the general population, feel they benefit from cutting us out of the conversation and keeping us working for as little as they possibly can. It really is that simple. So, thanks for making all these great points.
However, that leads me to my one gripe about this video. It did not really deeply discuss whether physicians have become a "nuisance" in the medical arena. Indeed, we have. Not only, as you somewhat touched on, in the political and financial arenas, but to our patients as well. Patients no longer view us as a source of information, but as a conduit to obtain what they have been told elsewhere that they need or want. That could be a whole different topic.
Regarding the “Set-up”.
https://open.substack.com/pub/raymondkordonowy/p/macra-is-not-smart-or-we-eat-our-own-dont-we-or-will-the-cannibals-please-rise?r=v5y0p&utm_medium=ios
As a plan manager we are willing to pay 200% of Medicare - not 500% of Medicare because we look at the cost reports that systems file showing that costs are 100% to 120% of Medicare. Now that over 50% of doctors are employed by health systems it is hard for us to break out the doctor's value out from the total bill. We are not able to separately reward the doctor with the system we have.