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(Buzzfeed)   Doctor in Kentucky needs to close his small medical practice due to the crushing requirements imposed by the brutal dictatorship known as Obamacare. That crushing requirement: Using computers   (buzzfeed.com) divider line 192
    More: Asinine, obamacare, Kentucky, electronic records, electronic health records, incentive programs, Reinvestment Act, medical practices, Centers for Medicare  
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2816 clicks; posted to Politics » on 10 Dec 2013 at 4:06 PM (32 weeks ago)   |  Favorite    |   share:  Share on Twitter share via Email Share on Facebook   more»



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2013-12-10 04:28:40 PM

xxcorydxx: machoprogrammer: There is a reason they are forcing small doctors offices to either close or to retire...

In 2009, the HITECH act was passed as part of the stimulus. Part of that is using an electronic medical record (EMR) in a "meaningful way", called "Meaningful Use". If the physician/hospital chooses not to partake, they do not get extra free money from taxpayers right now... In a few years, those tax payer dollar incentives turn into no medicare reimbursement penalties.

The problem is that EMRs are very, very expensive and the cheaper, smaller ones do not handle Meaningful Use very well. The nice ones are for bigger healthcare organizations and are tens of millions of dollars to just install (not counting support from the vendor, which is also in the millions).

The reason? Well let's just say EMR vendor CEOs know who to donate money to

It was NOT the ACA, but the HITECH Act that is causing it.

Bolded the part that I'm replying to.

I work for a cheaper, smaller EMR company, and we're one of the leaders in our state (ny) / region (northeast) when it comes to meaningful use.

We cater to small practices. we do not deal with hospitals. I've been here for 10 years, and in that time, we've grown from 100 employees to nearly 300, mostly due to the ARRA and Meaningful Use.

The other thing that I want to clarify for the threadshiatters that will be here shortly because the title of the thread has "Obamacare" in it, the ARRA and the ACA (0bummercare) have nothing to do with each other.

/making money right now to be on fark, thanks a lot, Obama!


Sorry, I should've said "in general". And agreed on both of the last two parts ;)
 
2013-12-10 04:30:29 PM
Eras end, old country doctor. And sometimes those eras get a little help ending.
 
2013-12-10 04:31:38 PM

Doc Lee: Interesting opinions on the doc...   http://www.topix.com/forum/city/somerset-ky/TBFFTRU5EKATF3NA5


Nice
 
2013-12-10 04:33:11 PM

Doc Lee: Interesting opinions on the doc...   http://www.topix.com/forum/city/somerset-ky/TBFFTRU5EKATF3NA5


That was interesting.
 
2013-12-10 04:33:53 PM

Serious Black: urbangirl: Serious Black:

How the hell is every single person in his office computer illiterate in 2013?


Somerset, KY

Yes, yes, it's a small backwoods town, but still, nobody in their office is even remotely computer literate? And there HAVE to be technically literate people in the area given that there are huge centers for SAIC and Blackboard nearby.


I've worked in various jobs in electrical supply, project management, and manufacturing for the last 6 years in Seattle.  You'd be amazed at the level of illiteracy even here.  Many times it felt like I was the only one in the room who knew "what these damn things do."
 
2013-12-10 04:34:02 PM

Arcanra: Serious Black: Kiteck said he is approaching retirement age, and that he and his office are "computer illiterate," adding that he would need special training to add electronic records. He said it would be a financial burden and take "thousands of man hours or woman hours to get the records on the computer."

How the hell is every single person in his office computer illiterate in 2013? Do they use abacuses to calculate people's bills?

Cool Story time. I work for a Medical Practice as the IT Manager, and we're a very computer savvy and literate bunch, from top to bottom, and use technology in every facet of our practice. We just bought a practice that has no computers period, and for the last thirty years has done everything with paper and pen. The transition for their staff to our way of doing things has been very, very difficult. They had prided themselves on being grognards and staying away from technology, but that strategy seems to have backfired since their boss, i.e. the managing partner of their practice, decided to sell to us so that when he retires in a year or so his patients have someone good to care for them. I expect that it's going to be a very, very painful transition for his staff. He of course, gets a pass as he is a physician and will be retiriing. His staff, not so much, and they are none too happy with the situation.


Yeah, well, tough shiat to them. We should not be in the business of maintaining obsolete technologies and methods just because people are afraid of change or too incompetent to change.
 
2013-12-10 04:34:44 PM

Doc Lee: Interesting opinions on the doc...   http://www.topix.com/forum/city/somerset-ky/TBFFTRU5EKATF3NA5


he tried to milk a cat!
 
2013-12-10 04:34:54 PM

mrshowrules: EatHam: mrshowrules: In other words, he has no reason to close now and very little reason to close later.  Article already indicates that he was close to retirement.  So Obama is now responsible for doctors retiring.

He has every reason to close now.  If he was going to retire soon anyway, why invest in keeping his practice open?  Sounds like more of an excuse for early retirement than anything else.

His rent will go up more than this token penalty will cost him.


Not if he just shuts it down, unless I'm missing something.
 
2013-12-10 04:36:04 PM

machoprogrammer: xxcorydxx: machoprogrammer: There is a reason they are forcing small doctors offices to either close or to retire...

In 2009, the HITECH act was passed as part of the stimulus. Part of that is using an electronic medical record (EMR) in a "meaningful way", called "Meaningful Use". If the physician/hospital chooses not to partake, they do not get extra free money from taxpayers right now... In a few years, those tax payer dollar incentives turn into no medicare reimbursement penalties.

The problem is that EMRs are very, very expensive and the cheaper, smaller ones do not handle Meaningful Use very well. The nice ones are for bigger healthcare organizations and are tens of millions of dollars to just install (not counting support from the vendor, which is also in the millions).

The reason? Well let's just say EMR vendor CEOs know who to donate money to

It was NOT the ACA, but the HITECH Act that is causing it.

Bolded the part that I'm replying to.

I work for a cheaper, smaller EMR company, and we're one of the leaders in our state (ny) / region (northeast) when it comes to meaningful use.

We cater to small practices. we do not deal with hospitals. I've been here for 10 years, and in that time, we've grown from 100 employees to nearly 300, mostly due to the ARRA and Meaningful Use.

The other thing that I want to clarify for the threadshiatters that will be here shortly because the title of the thread has "Obamacare" in it, the ARRA and the ACA (0bummercare) have nothing to do with each other.

/making money right now to be on fark, thanks a lot, Obama!

Sorry, I should've said "in general". And agreed on both of the last two parts ;)


Also, another major driving force (and lets be realistic here, THE driving force) behind the push for EMR is coming from a company called Surescripts. Surescripts is the monopoly that controls all communication for electronic prescribing, all formulary information collection (as in what your insurance says that it will cover, yes, doctors can see that now) and they've just started a new product that acts as a secured email between EMR offices. That's where the lobbyist money is coming from, not the peons like the company I work for.
 
2013-12-10 04:36:47 PM
So Obama has a time machine AND a computer now?
 
2013-12-10 04:36:54 PM

Serious Black: natazha: I was speaking to a doctor last Sunday, who said the ACA was going to destroy her practice for exactly that reason. She doesn't use computers and her overhead is almost 70% of her gross. She's going to go to a cash practice, but that won't last very long. If most people have insurance, who's going to pay cash?

Jesus titty-farking Christ. That's a ton of money.


It's actually not. Doctors have a ton of fixed costs, and few marginal costs per patient. That's why a single doctor in private practice is so rare these days.
 
2013-12-10 04:37:37 PM

Doc Lee: Interesting opinions on the doc...   http://www.topix.com/forum/city/somerset-ky/TBFFTRU5EKATF3NA5


My favorite.

He is a good doc, but he does like to grab ass and play with breasts. People who work at LCRH all know that. I personally like him. And it's hard to prove a dr touched you sexually, unless there is a witness.
 
2013-12-10 04:38:53 PM

GoodyearPimp: So Obama has a time machine AND a computer now?


I am guessing you didn't read the comments of this thread.
 
2013-12-10 04:39:12 PM

mrshowrules: From wiki: "Doctors who fail to use EMRs by 2015, Medicare reimbursements will be reduced by 1%. The deduction rate increases in subsequent years by 2% in 2016, 3% in 2017, 4% in 2018 "

In other words, he has no reason to close now and very little reason to close later.  Article already indicates that he was close to retirement.  So Obama is now responsible for doctors retiring.


You missed the part where if he had went to EMRs earlier he would have received bonuses for several years, the government would have literally paid for his transition to Electronic health care records.
 
2013-12-10 04:40:06 PM

A Dark Evil Omen: I had to shut down my chirurgical practice because of Obamacare, too. They won't let me offer paregoric to my youngest patients and the law demands that I abandon humorism and phrenology. Thanks, Obama.


Of course you'd say that, you've got the brain pan of a stage coach tilter!
 
2013-12-10 04:40:48 PM

spongeboob: mrshowrules: From wiki: "Doctors who fail to use EMRs by 2015, Medicare reimbursements will be reduced by 1%. The deduction rate increases in subsequent years by 2% in 2016, 3% in 2017, 4% in 2018 "

In other words, he has no reason to close now and very little reason to close later.  Article already indicates that he was close to retirement.  So Obama is now responsible for doctors retiring.

You missed the part where if he had went to EMRs earlier he would have received bonuses for several years, the government would have literally paid for his transition to Electronic health care records.


Yup- has treated those of us in the industry  very well. This is just another example of backwoods boneheads shooting themselves in the foot so that they can shout "LOOK WHAT YOU MADE ME DO TO MYSELF!"
 
2013-12-10 04:42:16 PM

Doc Lee: Interesting opinions on the doc...   http://www.topix.com/forum/city/somerset-ky/TBFFTRU5EKATF3NA5


I guess it's pretty tough to trade pain meds for sexual favors when you're tied up to the internet machine.
 
2013-12-10 04:42:24 PM
CSB: My allergist's office has had signs up for two years saying that wait times will be increased due to their transition to a computer system and how they need to get used to it.  The staff have pretty much coped, but the docs still fumble around with things and talk about how things were so much better without their tablets and ability to send prescriptions in  electronically. heh.
 
2013-12-10 04:46:55 PM

BMFPitt: Serious Black: natazha: I was speaking to a doctor last Sunday, who said the ACA was going to destroy her practice for exactly that reason. She doesn't use computers and her overhead is almost 70% of her gross. She's going to go to a cash practice, but that won't last very long. If most people have insurance, who's going to pay cash?

Jesus titty-farking Christ. That's a ton of money.

It's actually not. Doctors have a ton of fixed costs, and few marginal costs per patient. That's why a single doctor in private practice is so rare these days.


So adapt and stop being a single doctor in private practice! I can't imagine he is the only doctor in that town; surely a few of them could band together and defray the fixed costs a chunk.
 
2013-12-10 04:47:52 PM

redqueenmeg: CSB: My allergist's office has had signs up for two years saying that wait times will be increased due to their transition to a computer system and how they need to get used to it.  The staff have pretty much coped, but the docs still fumble around with things and talk about how things were so much better without their tablets and ability to send prescriptions in  electronically. heh.


a few of my customers have that on their outbound hold message, as someone that teaches them how to use their EMR, it's pretty infuriating, especially when these are the same offices that are combative and difficult for our training and support staff. If your doctor's office is using their computers as an excuse for providing you shiatty service, I'd suggest finding another doctor's office.
 
2013-12-10 04:48:40 PM

Serious Black: BMFPitt: Serious Black: natazha: I was speaking to a doctor last Sunday, who said the ACA was going to destroy her practice for exactly that reason. She doesn't use computers and her overhead is almost 70% of her gross. She's going to go to a cash practice, but that won't last very long. If most people have insurance, who's going to pay cash?

Jesus titty-farking Christ. That's a ton of money.

It's actually not. Doctors have a ton of fixed costs, and few marginal costs per patient. That's why a single doctor in private practice is so rare these days.

So adapt and stop being a single doctor in private practice! I can't imagine he is the only doctor in that town; surely a few of them could band together and defray the fixed costs a chunk.


Ummm, they did... That's why they are so rare now, as I stated.
 
2013-12-10 04:50:17 PM
Actually, many private practices are being scooped up by hospitals so they have a captive audience for referrals.

EMR (and related) software is super expensive.  A hospital near me has a 9 figure deal to have EPIC installed. Smaller hospitals can pay $40 million plus.
 
2013-12-10 04:50:55 PM
Too bad he doesn't know how to use the internet. He could go open source, it seems:
 
2013-12-10 04:51:26 PM
Practice Fusion  and  eClinical Works

nuff said
 
2013-12-10 04:51:50 PM

xxcorydxx: redqueenmeg: CSB: My allergist's office has had signs up for two years saying that wait times will be increased due to their transition to a computer system and how they need to get used to it.  The staff have pretty much coped, but the docs still fumble around with things and talk about how things were so much better without their tablets and ability to send prescriptions in  electronically. heh.

a few of my customers have that on their outbound hold message, as someone that teaches them how to use their EMR, it's pretty infuriating, especially when these are the same offices that are combative and difficult for our training and support staff. If your doctor's office is using their computers as an excuse for providing you shiatty service, I'd suggest finding another doctor's office.


Thanks for the suggestion. There are two allergists in town and the other office wrote a letter to me six years ago firing me as a patient for suggesting they submit a charge to my insurance company (they'd erroneously denied it originally).
 
2013-12-10 04:53:01 PM
Kentucky Redneck doctor needs computer??    proof that Republicans truly do feel theatened by Change.
 
2013-12-10 04:53:50 PM

QueenMamaBee: Serious Black: urbangirl: Serious Black:

How the hell is every single person in his office computer illiterate in 2013?


Somerset, KY

Yes, yes, it's a small backwoods town, but still, nobody in their office is even remotely computer literate? And there HAVE to be technically literate people in the area given that there are huge centers for SAIC and Blackboard nearby.

The whole town is 11 square miles, set in the middle of Pulaski County. I dare say that the SAIC and Blackboard people were imported or else the few technically literate people already have jobs and the rest of the town would remind me of my grandmother trying to figure out how to "download the emails."


Working at an institution that used Somerset to host Blackbaord, I would have to say from experience that I don't think the people working in the center are conventionally literate, much less computer literate.

/"we're taking the site down for the day to do an upgrade" was inevitably followed by "The site will be down indefinitely because we may have set something on fire - twice".
//Also, no one available from noon Friday to noon Monday - not even a emergency number to call.  Everything craters on the Friday before grades are due?  You just have to sit there with your thumb up your ass.
///An Amazonian rainforest dweller with advanced Parkinson's and a lobotomy running Blackboard off a Tandy and a tape deck would have been more competent
 
2013-12-10 04:53:51 PM

natazha: I was speaking to a doctor last Sunday, who said the ACA was going to destroy her practice for exactly that reason. She doesn't use computers and her overhead is almost 70% of her gross. She's going to go to a cash practice, but that won't last very long. If most people have insurance, who's going to pay cash?


She definitely should close her practice. There's no way you can run a business when overhead is 70% of your gross.

If capitalism is an expression of Drwinism as many believe, then thing of her as being thinned from the herd.
 
2013-12-10 04:53:56 PM

BMFPitt: Serious Black: BMFPitt: Serious Black: natazha: I was speaking to a doctor last Sunday, who said the ACA was going to destroy her practice for exactly that reason. She doesn't use computers and her overhead is almost 70% of her gross. She's going to go to a cash practice, but that won't last very long. If most people have insurance, who's going to pay cash?

Jesus titty-farking Christ. That's a ton of money.

It's actually not. Doctors have a ton of fixed costs, and few marginal costs per patient. That's why a single doctor in private practice is so rare these days.

So adapt and stop being a single doctor in private practice! I can't imagine he is the only doctor in that town; surely a few of them could band together and defray the fixed costs a chunk.

Ummm, they did... That's why they are so rare now, as I stated.


Peachy. But still, 70%? That's far beyond the admin costs of doctor's offices in just about any other country on the planet.
 
2013-12-10 04:58:50 PM

redqueenmeg: xxcorydxx: redqueenmeg: CSB: My allergist's office has had signs up for two years saying that wait times will be increased due to their transition to a computer system and how they need to get used to it.  The staff have pretty much coped, but the docs still fumble around with things and talk about how things were so much better without their tablets and ability to send prescriptions in  electronically. heh.

a few of my customers have that on their outbound hold message, as someone that teaches them how to use their EMR, it's pretty infuriating, especially when these are the same offices that are combative and difficult for our training and support staff. If your doctor's office is using their computers as an excuse for providing you shiatty service, I'd suggest finding another doctor's office.

Thanks for the suggestion. There are two allergists in town and the other office wrote a letter to me six years ago firing me as a patient for suggesting they submit a charge to my insurance company (they'd erroneously denied it originally).


unfortunately you aren't in our region, or I'd be more than happy to find you someone decent. When you view a doctor's office from a non patient side it gives you a completely different perspective of the way that offices run.

As someone that deals with doctors on a daily basis on the phone, I can tell you that the best ones are not the aloof petulant children with a porsche in the drive and a massive luxurious office. The best (in any specialty) are usually normal hard working people that go by their first name and treat their patients and business contacts as equals instead of inferior beings. They're also the ones that are embracing the modernization of American medicine, and will ultimately be the most successful over time.
 
2013-12-10 05:00:11 PM

redqueenmeg: xxcorydxx: redqueenmeg: CSB: My allergist's office has had signs up for two years saying that wait times will be increased due to their transition to a computer system and how they need to get used to it.  The staff have pretty much coped, but the docs still fumble around with things and talk about how things were so much better without their tablets and ability to send prescriptions in  electronically. heh.

a few of my customers have that on their outbound hold message, as someone that teaches them how to use their EMR, it's pretty infuriating, especially when these are the same offices that are combative and difficult for our training and support staff. If your doctor's office is using their computers as an excuse for providing you shiatty service, I'd suggest finding another doctor's office.

Thanks for the suggestion. There are two allergists in town and the other office wrote a letter to me six years ago firing me as a patient for suggesting they submit a charge to my insurance company (they'd erroneously denied it originally).


oh, and, by the way, a lot of primary care offices do allergy shots once you're diagnosed, which might save you a shiatload of money on copays.
 
2013-12-10 05:00:13 PM

Serious Black: BMFPitt: Serious Black: BMFPitt: Serious Black: natazha: I was speaking to a doctor last Sunday, who said the ACA was going to destroy her practice for exactly that reason. She doesn't use computers and her overhead is almost 70% of her gross. She's going to go to a cash practice, but that won't last very long. If most people have insurance, who's going to pay cash?

Jesus titty-farking Christ. That's a ton of money.

It's actually not. Doctors have a ton of fixed costs, and few marginal costs per patient. That's why a single doctor in private practice is so rare these days.

So adapt and stop being a single doctor in private practice! I can't imagine he is the only doctor in that town; surely a few of them could band together and defray the fixed costs a chunk.

Ummm, they did... That's why they are so rare now, as I stated.

Peachy. But still, 70%? That's far beyond the admin costs of doctor's offices in just about any other country on the planet.


Well make up your mind. Is it overhead or admin?

Overhead includes office space and durable equipment.
 
2013-12-10 05:00:14 PM

Doc Lee: Interesting opinions on the doc...   http://www.topix.com/forum/city/somerset-ky/TBFFTRU5EKATF3NA5


From the page:

He is a good doc, but he does like to grab ass and play with breasts. People who work at LCRH all know that. I personally like him. And it's hard to prove a dr touched you sexually, unless there is a witness.

What in the fark.
 
2013-12-10 05:00:17 PM

TheGreatGazoo: Actually, many private practices are being scooped up by hospitals so they have a captive audience for referrals.

EMR (and related) software is super expensive. A hospital near me has a 9 figure deal to have EPIC installed. Smaller hospitals can pay $40 million plus.


That's what big east coast hospitals have done for years.  But they should have been constantly building and updating their systems.  With the doctor I see (he works for PennHealth here in Philly), I can make appoints online, access my medical records, etc.  I even found out recently that he actually checks his email at the end of the day, every working day, which is probably a requirement.

I haven't been outside their network for medical care for 25 years, as I've had no need to.

/If we'd been allowed to set up a national medical database, everyone in the country would have the options I have.
 
2013-12-10 05:00:50 PM
Though Kiteck's ad blames Obamacare, the electronic health care incentive programs were part of the American Recovery and Reinvestment Act in 2009 - the federal stimulus act - and not part of the Affordable Care Act, according to the Centers for Medicare and Medicaid Services.


And I'm sure the good doctor will print a retraction and clear that up.
 
2013-12-10 05:01:22 PM

Dwight_Yeast: TheGreatGazoo: Actually, many private practices are being scooped up by hospitals so they have a captive audience for referrals.

EMR (and related) software is super expensive. A hospital near me has a 9 figure deal to have EPIC installed. Smaller hospitals can pay $40 million plus.

That's what big east coast hospitals have done for years.  But they should have been constantly building and updating their systems.  With the doctor I see (he works for PennHealth here in Philly), I can make appoints online, access my medical records, etc.  I even found out recently that he actually checks his email at the end of the day, every working day, which is probably a requirement.

I haven't been outside their network for medical care for 25 years, as I've had no need to.

/If we'd been allowed to set up a national medical database, everyone in the country would have the options I have.


we're working on it. be patient. Asshats like the guy in TFA are the main roadblock.
 
2013-12-10 05:01:28 PM
If this guy resisted learning about computers, which have been pretty ubiquitous business practice for the past 20 years, imagine what other technological advancements he has resisted learning about regarding the practice of medicine.
 
2013-12-10 05:01:31 PM
I am so okay with this it if not even funny.

I want EHRs. You know why I want them? I'm have a drug allergy. Luckily its not a serious allergy, but it could develop into one if I'm given the drug regularly.

If I end up in the ER due to a car accident, and I'm unconscious/delirious/etc, I want the doctors to be able to pull up my medical history by contacting my insurance company/my doctor and getting all my records. I want e-prescribing, where the system screams bloody murder if they try to prescribe me the medication I'm allergic to.
No human is perfect. No machine is perfect either, but its much better at this stuff than the average human. And before you say that this kind of stuff doesn't happen- I was in the hospital to get my appendix out, wearing a bright orange medical bracelet saying I'm allergic, its in all my records, and when they went to discharge me the doctor wrote a prescription for it, and the nurse handed it to us. Luckily my parents were with me and caught it before we left, but jeez.

EHRs are an important upgrade to our medical system, and any doctor not willing to see the benefits should be done practicing medicine.
 
2013-12-10 05:02:18 PM

BMFPitt: Serious Black: BMFPitt: Serious Black: BMFPitt: Serious Black: natazha: I was speaking to a doctor last Sunday, who said the ACA was going to destroy her practice for exactly that reason. She doesn't use computers and her overhead is almost 70% of her gross. She's going to go to a cash practice, but that won't last very long. If most people have insurance, who's going to pay cash?

Jesus titty-farking Christ. That's a ton of money.

It's actually not. Doctors have a ton of fixed costs, and few marginal costs per patient. That's why a single doctor in private practice is so rare these days.

So adapt and stop being a single doctor in private practice! I can't imagine he is the only doctor in that town; surely a few of them could band together and defray the fixed costs a chunk.

Ummm, they did... That's why they are so rare now, as I stated.

Peachy. But still, 70%? That's far beyond the admin costs of doctor's offices in just about any other country on the planet.

Well make up your mind. Is it overhead or admin?

Overhead includes office space and durable equipment.


Where would it fall in here?

newshour.s3.amazonaws.com
 
2013-12-10 05:03:39 PM
What the doc may look like:

www.mannbeisstfilm.de

/obscure?
 
2013-12-10 05:04:15 PM

A Dark Evil Omen: I had to shut down my chirurgical practice because of Obamacare, too. They won't let me offer paregoric to my youngest patients and the law demands that I abandon humorism and phrenology. Thanks, Obama.


I abandoned my practice when I found out leeches weren't covered.
 
2013-12-10 05:05:44 PM

Serious Black: urbangirl: Serious Black:

How the hell is every single person in his office computer illiterate in 2013?


Somerset, KY

Yes, yes, it's a small backwoods town, but still, nobody in their office is even remotely computer literate? And there HAVE to be technically literate people in the area given that there are huge centers for SAIC and Blackboard nearby.


Let's see, single-doctor practice in a small town, and the doctor's near retirement - odds are his only employee is his wife, who's also probably in her 60's.  He's not looking to hire anyone new, never mind buying new equipment and learning new software.
 
2013-12-10 05:06:01 PM
My vet has even gone electronic, I mean really what are you waiting for?  I guess this guy just wants to retire but anyone else I mean really, electronic records are so much better and offer so many more ways to look at a patients history to spot trends that may indicate trouble that I don't know why you won't want to use them.  I think every doctor that I have seen since 2000 has been at least partially electronic, and I have stuck with those who have good electronic records since I know they can catch things that might otherwise be missed.
 
2013-12-10 05:07:22 PM

BMFPitt: Overhead includes office space and durable equipment.


Right, which is one reason a rural primary care doctor's overhead would ever be that high; they're either already established in practice or have taken over a practice (building, patients, etc) from another doctor.

There's also the issue of division of labor: I'd bet a rural doctor would have no trouble turning a profit if he or she was willing to handle insurance and billing in partnership with their receptionist; but some of these old established doctors are used to paying someone else to do all the paperwork while they work 30 hours or less a week.

My doctor has at least six (shared) support people, who handle all the secondary stuff (everything from checking you in to drawing blood) but he works a solid eight hours a day; once he's done with one patient, the next one is already ready and waiting.
 
2013-12-10 05:08:49 PM

Serious Black: BMFPitt: Serious Black: BMFPitt: Serious Black: BMFPitt: Serious Black: natazha: I was speaking to a doctor last Sunday, who said the ACA was going to destroy her practice for exactly that reason. She doesn't use computers and her overhead is almost 70% of her gross. She's going to go to a cash practice, but that won't last very long. If most people have insurance, who's going to pay cash?

Jesus titty-farking Christ. That's a ton of money.

It's actually not. Doctors have a ton of fixed costs, and few marginal costs per patient. That's why a single doctor in private practice is so rare these days.

So adapt and stop being a single doctor in private practice! I can't imagine he is the only doctor in that town; surely a few of them could band together and defray the fixed costs a chunk.

Ummm, they did... That's why they are so rare now, as I stated.

Peachy. But still, 70%? That's far beyond the admin costs of doctor's offices in just about any other country on the planet.

Well make up your mind. Is it overhead or admin?

Overhead includes office space and durable equipment.

Where would it fall in here?


So it seems you are talking about the absurd cost of insurance coding, on top of the inherent inflationary affect of third party payment, which is baked into the green, red, and blue bars on that graph.

That is different from what you were quoting in the post I originally responded to.
 
2013-12-10 05:11:45 PM

xxcorydxx: we're working on it. be patient. Asshats like the guy in TFA are the main roadblock.


Well, that and the "barcodes are the Mark of the Beast" loons who also oppose a national ID on religious grounds.
 
2013-12-10 05:12:12 PM

BMFPitt: Serious Black: BMFPitt: Serious Black: BMFPitt: Serious Black: BMFPitt: Serious Black: natazha: I was speaking to a doctor last Sunday, who said the ACA was going to destroy her practice for exactly that reason. She doesn't use computers and her overhead is almost 70% of her gross. She's going to go to a cash practice, but that won't last very long. If most people have insurance, who's going to pay cash?

Jesus titty-farking Christ. That's a ton of money.

It's actually not. Doctors have a ton of fixed costs, and few marginal costs per patient. That's why a single doctor in private practice is so rare these days.

So adapt and stop being a single doctor in private practice! I can't imagine he is the only doctor in that town; surely a few of them could band together and defray the fixed costs a chunk.

Ummm, they did... That's why they are so rare now, as I stated.

Peachy. But still, 70%? That's far beyond the admin costs of doctor's offices in just about any other country on the planet.

Well make up your mind. Is it overhead or admin?

Overhead includes office space and durable equipment.

Where would it fall in here?

So it seems you are talking about the absurd cost of insurance coding, on top of the inherent inflationary affect of third party payment, which is baked into the green, red, and blue bars on that graph.

That is different from what you were quoting in the post I originally responded to.


Sure, it seems like they are different things. But it's got to be accounted for somewhere, and I've never seen an accounting of how much money in health care goes to paying the rent and maintaining equipment.
 
2013-12-10 05:12:44 PM

Doc Lee: Interesting opinions on the doc...   http://www.topix.com/forum/city/somerset-ky/TBFFTRU5EKATF3NA5


Translation:  "I ain't a gettin' one of those newfangled commie-puters!  They might be watchin' me while I'm-a doin' a exam!"
 
2013-12-10 05:15:39 PM

mrshowrules: From wiki: "Doctors who fail to use EMRs by 2015, Medicare reimbursements will be reduced by 1%. The deduction rate increases in subsequent years by 2% in 2016, 3% in 2017, 4% in 2018 "

In other words, he has no reason to close now and very little reason to close later.  Article already indicates that he was close to retirement.  So Obama is now responsible for doctors retiring.


Obama said I could keep my doctor. Now my doctor wants to be a dancer and I need a new doctor now. Thanks Obama.
 
2013-12-10 05:18:15 PM

Serious Black: Sure, it seems like they are different things. But it's got to be accounted for somewhere, and I've never seen an accounting of how much money in health care goes to paying the rent and maintaining equipment.


Not much.  The basic reason healthcare is so expensive in this country are the layers and layers of middlemen, at level and in every detail.  Every middle man gets paid, and things become insanely expensive.

It's the reason Columbus and others went looking for another way to India: spices came overland, through the hands of dozens of merchants, who each jacked up the price a little.  By the time you got to England or Spain, they'd come 2/3rd of the way around the globe.

So why not send your own ships out and find a quicker route?  Come back with the goods and you could still charge the same retail price but keep all the profits.
 
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