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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 95
    More: Asinine, obamacare, Kentucky, electronic records, electronic health records, incentive programs, Reinvestment Act, medical practices, Centers for Medicare  
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2818 clicks; posted to Politics » on 10 Dec 2013 at 4:06 PM (1 year ago)   |  Favorite    |   share:  Share on Twitter share via Email Share on Facebook   more»



Voting Results (Smartest)
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2013-12-10 04:09:58 PM  
10 votes:
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.
2013-12-10 05:27:07 PM  
8 votes:
Firstly, this is a legitimate reason to retire.  If professional standards have changed in such a way that you cannot keep up with the standards of your profession, it's sensible and entirely honorable to bow out since you can no longer serve the people your profession serves at the minimum level of competence.  Medicine, especially, has always been a field where acceptable competence is a moving target, that's why continuing education and training is  required to renew your medical license.  If you don't feel up to keeping up, then don't, that's a perfectly valid decision that doesn't make you a bad human being.

That said:

1. This isn't about "the policies of Obamacare".  It's about you and your staff deciding that you'd rather stop practicing than do the required continuing education for your profession (and as noted above, continuing education has  always been a requirement).

2. The law doesn't "require" you to use computers.  The law allows the federal agencies to charge you a couple percent of the payout as a processing fee if you force  them to waste the man-hours to convert your paper records for you.  Essentially, they're offering a new paid service for doing your work for you, which you're free to pay for if you don't want to do it yourself.

3. That ad is in a custom computer-generated font, dipshiat.  You clearly have access to  someone who could be typing shiat into an electronic form for you, and the money to pay them.
2013-12-10 04:39:12 PM  
6 votes:

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 04:16:11 PM  
6 votes:
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.
2013-12-10 04:08:47 PM  
5 votes:
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?
2013-12-10 06:34:30 PM  
4 votes:

skullkrusher: I don't care if my doctor receives his journals in print format under the bottles left by the milkman. Knowing how to use an automated records system has absolutely farkall to do with being a doctor.


Intellectual curiousity has a lot to do with being a doctor.  If you can't learn how to use a computer after 20 year of them being common place in your profession, you're lacking in it.   We have no problem requiring other professional stay in the 20th Century. You just got your panties in a wad because you have some ridiculous romantic Hollywood quaint archetype about rural docs.
2013-12-10 05:01:31 PM  
4 votes:
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 04:27:18 PM  
4 votes:

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!
2013-12-10 04:26:07 PM  
4 votes:
If his office has no computers, how does he accept insurance? Do insurance companies allow everything to be done via snail mail?

/double-plus fun that the requirement had nothing to do with the ACA
2013-12-10 04:20:05 PM  
4 votes:

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.
2013-12-10 04:12:19 PM  
4 votes:
Kiteck said he is approaching retirement age, and that he and his office livery stable are "computer automobile illiterate," adding that he would need special training to add electronic records horseless carriages. He said it would be a financial burden and take "thousands of man hours or woman hours to get the records on the computer figure out where to hit the cars with the buggy-whip."
2013-12-10 03:59:31 PM  
4 votes:
Nearly 72,000 people had enrolled in new health coverage as of last Thursday, including Medicaid and private insurance.

Link

Have fun running on the repeal of that progress, Mitch.
2013-12-10 08:06:28 PM  
3 votes:

Gyrfalcon: This guy is just being a dick.



This.

These chodes love this bullshiat where they get to claim "Immagonna __________ cuz of Obamacare!!!"

A doctor I work with (and who I actually do like) switched to a concierge practice and was running radio spots like three years ago saying "Are you tired of the crazy waiting times caused by Obamacare?!?!"

He was a client, so I kept my mouth shut about it. But, it was really hard not to be like "fark you. Have you no decency, sir?"

I mean how can someone bring themselves to knowingly just flat-out farking lie like that? and so publicly? I mean, if your position is actually a good one... shouldn't you be able to sway people WITHOUT resorting to manipulative bullshiat? Shouldn't there be plenty of legitimate criticisms to rely on?

If you've got to pull shiat like that, it might be time to reevaluate where you stand.
2013-12-10 05:18:15 PM  
3 votes:

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.
2013-12-10 05:01:28 PM  
3 votes:
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 04:58:50 PM  
3 votes:

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 04:53:56 PM  
3 votes:

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 04:36:04 PM  
3 votes:

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 04:15:54 PM  
3 votes:

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?


They're not, but doctors live in this world where they just do whatever they want, whenever they want, and everyone around them is expected to adapt.
2013-12-10 04:11:17 PM  
3 votes:
So not policies of ACA.

I can see his point though. He is retiring soon and does not want to invest in expensive new technology and training.
2013-12-10 06:16:20 PM  
2 votes:

skullkrusher: InmanRoshi: ox45tallboy: 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.


This.

One can romanticize the archetype of  the folksy rural doctor, but there's probably a reason why many of them plant themselves to a captive pool of patients who don't have many accessible alternatives (and far, far away from the nearest malpractice lawyer).

Because they like living in rural areas just as many people in other professions do would be the logical first guess. I suppose you'd be happier if rural people were left without a licensed physician to care for them and forced to see a veterinarian for their health care needs but most people aren't assholes like that.


Nope.  We want them to have decent doctors - that is why non-rural people tend to be quite happy to subsidize doctors who will work in rural areas.  But, there is a certain segment of rural doctors who are there precisely because they have no competition.  Either they are inept hacks who know they have a captive audience; or, they become inept hacks because no competition means they can slide by, and they atrophy.  I've met some perfectly fine rural doctors - but I have met far more that would actually make me suggest that their patients visit the vet.  The vet doea have competition, and so is on top of his game, and he probably has a better understanding of medicine than Doc Peckerwood.
2013-12-10 06:02:07 PM  
2 votes:

skullkrusher: InmanRoshi: ox45tallboy: 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.


This.

One can romanticize the archetype of  the folksy rural doctor, but there's probably a reason why many of them plant themselves to a captive pool of patients who don't have many accessible alternatives (and far, far away from the nearest malpractice lawyer).

Because they like living in rural areas just as many people in other professions do would be the logical first guess. I suppose you'd be happier if rural people were left without a licensed physician to care for them and forced to see a veterinarian for their health care needs but most people aren't assholes like that.


Actually, I'd like standards to ensure that the doctors in rural areas were the kind you described, rather than the kinds who stay out in the sticks because they know they couldn't cut the mustard in a market where people had alternatives.   Weeding out doctors who haven't figured how to use a computer or  log onto the internet after 20 years seems like a good place to start.   I think a licensed medical professional should display the same intellectual curiosity and  technical competence in his craft as the guy changing my oil at Jiffy Lube, but that's just me.
2013-12-10 05:45:19 PM  
2 votes:

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.



If only there were some way to reduce her overhead costs.  Perhaps some kind of computing machine that could manage her medical records in electronic form?  If only such a thing existed...
2013-12-10 05:06:01 PM  
2 votes:
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 05:02:18 PM  
2 votes:

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 05:00:17 PM  
2 votes:

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 04:51:26 PM  
2 votes:
Practice Fusion  and  eClinical Works

nuff said
2013-12-10 04:50:55 PM  
2 votes:
Too bad he doesn't know how to use the internet. He could go open source, it seems:
2013-12-10 04:50:17 PM  
2 votes:
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 04:47:52 PM  
2 votes:

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 04:42:24 PM  
2 votes:
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 04:40:48 PM  
2 votes:

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 04:34:02 PM  
2 votes:

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 04:33:53 PM  
2 votes:

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 04:19:18 PM  
2 votes:

TrollingForColumbine: So not policies of ACA.

I can see his point though. He is retiring soon and does not want to invest in expensive new technology and training.


If only was some kind of business that offered these services.
2013-12-10 04:15:43 PM  
2 votes:

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.
2013-12-10 04:13:50 PM  
2 votes:

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.
2013-12-10 04:12:42 PM  
2 votes:
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.
2013-12-11 09:10:24 AM  
1 votes:

Close2TheEdge: HAHAHA.  I knew it had to be somewhere down around Somerset before I even clicked on the link.  This is the county that has racked up thousands of dollars in legal fees fighting the ACLU over the right to post the 10 Commandments in all the courthouses.  It's a freaky religious area.  There are honest-to-God snake handling Christian churches in that shiathole of an area.


My wife has some extended family in that town. When we were visiting a couple years ago, her father in law and I were making jokes about finding and going to a snake handling church since we were in the area.

...decided against it. Don't *really* want to be surrounded by psychos with venomous things.
2013-12-11 08:41:43 AM  
1 votes:

if_i_really_have_to: My god, you can't get doctors in New Zealand off a computer.  They get downright angry when they have to go back through written records to find notes you need (assuming they haven't already scanned them).

Optometrists and dentists, though.  No.  They will continue to handwrite their notes on A5 cards until Armageddon comes.

/Also physios, chiropractors and osteopaths
//Computers not new age and holistic enough for you bastards?


Admittedly I haven't been to a dentist in a while, and now that I have dental insurance I need to suck it up and go, but I've got shiate vision, and go to the optometrist pretty regularly, and they are ALL ABOUT the computers in there. Laptops and tablets just flying around, leaving gross photos of my eyes on the screen while I'm waiting for the doc to come back. *shudders* I've got this thing about eyes, and I have panic attacks at the eye doctor pretty regularly. Especially the glaucoma test. Still haven't managed to take one. Though I've heard they have a new digital way of testing that doesn't require the air puff or touching my eyeball. Most practices charge a bit extra for it, and most insurances won't cover it, BUT I DON'T CARE. GO TECHNOLOGY! (There's a history of glaucoma in my family... not being able to get the test without panic attacks is a big deal to me.)
2013-12-11 01:39:20 AM  
1 votes:
One of my younger brothers is an MD who just opened a practice. Electronic records systems aren't that expensive. They even have SaaS options now (what my brother did).
2013-12-11 01:05:41 AM  
1 votes:

glassa: Hey dumbass submitter!  It's not the computer that's the problem.  The problem is the systems that you have to buy.  They're incredibly expensive and private doctors are being forced out of business because they can't afford them.

Or as my boss is currently saying about our new system going online this weekend...it's only millions of dollars.  Doctors should not be expected to operate at a financial loss.


Sure, a one-doc practice isn't going to buy Epic or Cerner, but athenaHealth or Practice Fusion are options. Hell, Practice Fusion is free.  There's not even any hardware requirements apart from an average Windows PC as they host as well.  athenaHealth is something like $3k per year I believe, including hosting, which is within reason for a small provider.

Nobody in the small practices is going to buy any of the multimillion dollar packages, nor should they - they would be packed with a massive amount of features the practice won't use.  A single provider practice has vastly different IT needs than a multistate health network with thousands of inpatient beds, hundreds of clinics, a full suite of specialties and ancillaries, etc.  There are good options at pretty much any point on the spectrum.
2013-12-10 10:53:37 PM  
1 votes:

Hagbardr: 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 used Blackboard in college. I'm pretty sure the people who designed it were computer illiterate.


Holy crap, isn't that the truth.  Putting articles up on that monstrosity was such a PIA.  Of course, it was one of the first very early on in the online classroom experience.
2013-12-10 10:16:32 PM  
1 votes:

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 used Blackboard in college. I'm pretty sure the people who designed it were computer illiterate.
2013-12-10 09:23:48 PM  
1 votes:

machoprogrammer: artifishy: 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.

Where are you getting your information?

This EMR is popular and free.

In small doctor's offices, they install an EMR on a laptop on a roll stand and wheel it from room to room. I've helped to install them and they certainly don't cost anywhere near 10s of millions of dollars.

The major vendor EMRs are very expensive, is what I meant. There are exceptions, but the "big boys" are tens of millions.

The problem with OpenEMR is that if there is a problem, you either hire a developer to fix it or you wait until it is fixed.  Also, did you miss the big, red bold letters on that website about Meaningful Use Stage 2 not being done and needing funding? MU Stage 2 is pretty damn important right now.

I have worked in healthcare IT for quite a few years.


The big boys also come with guarantees that they will help you install, train you, offer to store your mountains of data offsite, etc etc.  Not to mention the guarantee that comes with having all the credentials.  I worked on one of these behemoths back in the middle of the 00s and the big issue was being able to promise that our customers would be compliant with whatever new regulations or protocols are in place.

That means that when Aetna changes what row 35 column 12 stands for in their claims form, the software needs to be updated...

The free ones are nice for small practices, but there are reasons that the major vendors are charging so much.
2013-12-10 09:21:12 PM  
1 votes:

phalamir: Nope. We want them to have decent doctors - that is why non-rural people tend to be quite happy to subsidize doctors who will work in rural areas. But, there is a certain segment of rural doctors who are there precisely because they have no competition. Either they are inept hacks who know they have a captive audience; or, they become inept hacks because no competition means they can slide by, and they atrophy. I've met some perfectly fine rural doctors - but I have met far more that would actually make me suggest that their patients visit the vet. The vet doea have competition, and so is on top of his game, and he probably has a better understanding of medicine than Doc Peckerwood.


You can often spot the hacks because they're also the local "coroner" if they managed to win the post away from the local funeral home director.
2013-12-10 09:03:50 PM  
1 votes:

bintherdunthat: 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.

Fancy, expensive equipment is one of the things that has contributed to the U.S. Post Office's problems.


No. A congressional mandate to pay for the pensions of workers who haven't even been born yet is the USPS's problem.
2013-12-10 09:01:39 PM  
1 votes:

machoprogrammer: artifishy: 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.

Where are you getting your information?

This EMR is popular and free.

In small doctor's offices, they install an EMR on a laptop on a roll stand and wheel it from room to room. I've helped to install them and they certainly don't cost anywhere near 10s of millions of dollars.

The major vendor EMRs are very expensive, is what I meant. There are exceptions, but the "big boys" are tens of millions.

The problem with OpenEMR is that if there is a problem, you either hire a developer to fix it or you wait until it is fixed.  Also, did you miss the big, red bold letters on that website about Meaningful Use Stage 2 not being done and needing funding? MU Stage 2 is pretty damn important right now.

I have worked in healthcare IT for quite a few years.


I will confess that I openly laughed at a client that was threatening to leave us for OpenEMR, and that was before meaningful use. Our support department is the reason that we have such high success rates with achieving meaningful use. I couldn't imagine an office trying to go about it alone.

That said, you don't need to spend a million dollars to meet meaningful use. Or even $100k. There are a ton of great American companies that do very well, and are owned by those "small business owners" that the republicans go on and on about, you'd think that they'd be all for this type of growth in an industry.

/almost MU2 certified
//private corporation
///one of the owners does basically the same thing I do there
2013-12-10 08:53:57 PM  
1 votes:

bintherdunthat: 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.

Fancy, expensive equipment is one of the things that has contributed to the U.S. Post Office's problems.


No, being forced, by republicans in congress, to carry an unreasonable amount of future funds for pensions has caused all of the post offices problems, but thanks for playing!
2013-12-10 08:15:01 PM  
1 votes:
HAHAHA.  I knew it had to be somewhere down around Somerset before I even clicked on the link.  This is the county that has racked up thousands of dollars in legal fees fighting the ACLU over the right to post the 10 Commandments in all the courthouses.  It's a freaky religious area.  There are honest-to-God snake handling Christian churches in that shiathole of an area.

Good riddance, Dr. Asshole.
2013-12-10 08:06:12 PM  
1 votes:

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.


Blackboard sucks
2013-12-10 07:18:40 PM  
1 votes:

urbangirl: Serious Black:

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


Somerset, KY


That's still impossible. They use dial telephones? Not one single person has a home PC? Hell, my aged grandmother can use a computer, and even program her smartphone with assistance.

And you don't have to "convert" ALL your files. You can just start from where you are, and add as you go. This guy is just being a dick.
2013-12-10 07:04:45 PM  
1 votes:
So how did this doctor stay informed with the latest medical literature?  Does the research people still do paper?
2013-12-10 06:48:34 PM  
1 votes:

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.


Where are you getting your information?

This EMR is popular and free.

In small doctor's offices, they install an EMR on a laptop on a roll stand and wheel it from room to room. I've helped to install them and they certainly don't cost anywhere near 10s of millions of dollars.
2013-12-10 06:35:29 PM  
1 votes:

Serious Black: 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.


Knowing this area I don't see how he wasn't using a computer to check KASPER,it prevents doctor shopping and shiat.
2013-12-10 06:33:43 PM  
1 votes:

Clever Neologism: I wonder if he was still taking chickens as payment...


I once read about a Civil War pension application in Kentucky where a divorce fee was paid with bales of hay.
2013-12-10 05:55:49 PM  
1 votes:

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


God damn, reading those comments made my brain hurt. Sometimes I forget how illiterate most of the rest of the internet is.
2013-12-10 05:55:15 PM  
1 votes:

skullkrusher: InmanRoshi: ox45tallboy: 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.


This.

One can romanticize the archetype of  the folksy rural doctor, but there's probably a reason why many of them plant themselves to a captive pool of patients who don't have many accessible alternatives (and far, far away from the nearest malpractice lawyer).

Because they like living in rural areas just as many people in other professions do would be the logical first guess. I suppose you'd be happier if rural people were left without a licensed physician to care for them and forced to see a veterinarian for their health care needs but most people aren't assholes like that.


*the point*
--------------
*your head*

I'd be happier knowing doctors in rural areas bothered to stay with the times. Even my shiat-splat town growing up in LA had doctors with electronic records.
2013-12-10 05:52:13 PM  
1 votes:

Turbo Cojones: 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.

Not in a service industry after THE DOCTOR PAYS HERSELF


A doctor's salary to themself isn't overhead, even if they're incorporated.
2013-12-10 05:35:41 PM  
1 votes:

ox45tallboy: 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.



This.

One can romanticize the archetype of  the folksy rural doctor, but there's probably a reason why many of them plant themselves to a captive pool of patients who don't have many accessible alternatives (and far, far away from the nearest malpractice lawyer).
2013-12-10 05:33:53 PM  
1 votes:

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.


Maybe it is an inconvenience for some doctors, but I was please this past year when I went to a doctor in a different hospital group and then were able to retrieve my electronic records from original doctor.  It saved me a lot of time and hassle.
2013-12-10 05:27:52 PM  
1 votes:

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?


What kind of doctor was that?
2013-12-10 05:24:46 PM  
1 votes:

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.


Heh. My Dad is the old, tech illiterate fart in his practice because he goes into his office and uses a keyboard when typing stuff up. The rest of the doctors are using iPads in the hallways between exam rooms these days. Their records have been electronic since the mid 90s- this guy is way out of the loop.
2013-12-10 05:12:12 PM  
1 votes:

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 05:11:45 PM  
1 votes:

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 05:08:49 PM  
1 votes:

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 05:07:22 PM  
1 votes:

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 05:05:44 PM  
1 votes:

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 05:04:15 PM  
1 votes:

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 05:01:22 PM  
1 votes:

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 05:00:50 PM  
1 votes:
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 05:00:14 PM  
1 votes:

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 05:00:11 PM  
1 votes:

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 04:53:51 PM  
1 votes:

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 04:53:50 PM  
1 votes:

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 04:51:50 PM  
1 votes:

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 04:46:55 PM  
1 votes:

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 04:42:16 PM  
1 votes:

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 04:34:44 PM  
1 votes:

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 04:33:11 PM  
1 votes:

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


That was interesting.
2013-12-10 04:31:38 PM  
1 votes:

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


Nice
2013-12-10 04:30:29 PM  
1 votes:
Eras end, old country doctor. And sometimes those eras get a little help ending.
2013-12-10 04:28:11 PM  
1 votes:
2013-12-10 04:28:06 PM  
1 votes:

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."
2013-12-10 04:26:48 PM  
1 votes:

DeaH: If his office has no computers, how does he accept insurance? Do insurance companies allow everything to be done via snail mail?

/double-plus fun that the requirement had nothing to do with the ACA


It's not the computers or the ACA, but people are stupid and think that every healthcare bill is the ACA
2013-12-10 04:25:32 PM  
1 votes:

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.
2013-12-10 04:23:59 PM  
1 votes:

Angry Drunk Bureaucrat: 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.

That was nearly my response too. Although, I said "Christ on a Bicycle" instead.


I like JTFC personally. There's no way Jesus wasn't a horny dude, and I think there's just something poetic about him blessing Mary Magdalene with a pearl necklace.
2013-12-10 04:21:43 PM  
1 votes:

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.


I suppose we could do what Finland did and just have every health care provider use VistA. It's in the public domain and, thus, is completely free to obtain and install.
2013-12-10 04:20:13 PM  
1 votes:

In other news, ancient, obstinate coot, forced to put up or shut up, shuts up.

2013-12-10 04:19:19 PM  
1 votes:

TrollingForColumbine: 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.

EpicFail

/pun intended


I see what you did there
2013-12-10 04:17:41 PM  
1 votes:

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.


One doctor, eighty-seven assistants writing out claims and looking up provider coverage numbers by hand.
2013-12-10 04:14:11 PM  
1 votes:

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?


You would obviously be surprised to discover that, despite computers being a workplace staple for at  minimum the last decade, there are still plenty of people who can barely comprehend what a computer is for, let alone how to use it for even the most basic of tasks.

/try working on a military base
//oh the horror
2013-12-10 04:13:57 PM  
1 votes:

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.
2013-12-10 04:12:38 PM  
1 votes:
Well, that's one way of getting the old codgers to retire.
2013-12-10 04:10:49 PM  
1 votes:
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?
 
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