Medical Practices Operating in a Vice That Doesn’t Let Up

side effects obamacare The typical scenario one would view from the medical trenches, secondary to the sequester cuts (with more to come on an annual basis through 2021) is not a pretty scene; not that it ever was. The pressure to get away from the ‘fee for service’ model and adopt the ‘socialistic healthcare’ model, is more than palpable. Ironically, England has recently passed legislation to incorporate privatisation of the NIH, which has the country up in arms. Are we going backwards?

In England, parliament realizes that socialized medicine is too expensive for their budgets and now looking for private bidding of contracts in order to better manage healthcare costs. England’s public does not like the changes, which is expected as they are used to their current system which has been in place for sometime. The US is at the opposite end of the pendulum from England and moving away from privatization and giving the government more power in managing our healthcare system. The socialized diagnostic codes that the healthcare system is being forced to change to, which places us on the same coding system as socialistic medicine countries around the world, will be updating to a newer version soon, therefore, the US will be behind with foreseeable changes right at the start of implementation. Who has fallen into the rabbit hole now? The government and its consequent layers of changes/regulations is so fixated on pushing ahead that the big picture has become clouded.

The providers have moved to the bottom of the totem pole and are floundering with all the demands and nothing but bleak outlooks of the future. Rising costs of supplies/staffing/insurance, less payment for services, mandated electronic health records and more and more regulations which are to the point of choking a normal person. If we took all these changes and applied them accordingly to congress, senate and the governing body, what do you think would happen? Would there be smooth sailing while they still tried to do their jobs in addition to dealing with the complete remake of their industry? How would they like taking money from their personal pockets to keep their industry afloat? How about a direct line from the public to the governing bodies? How would they deal with the constant barrage of complaints in addition to making changes and  in addition to trying to care for the public’s’ healthcare needs?

Has anyone ever considered putting a price freeze on supplies, services and salaries so that all the issues of sequestration, EHR, as well as new demands and regulations can settle out, thus allowing for development of logical and/or thought out changes  (not just acute or emergent for survival purposes) at the trench levels and not from those indirectly involved? How about allowing the medical personnel tax credit for the care they give away on a regular basis to those not being able to afford care? There is absolutely no consideration and hasn’t ever been, tax credit for free care from the government, to those who have provided such services. Why is the industry being turned upside down instead of taking one issue at a time and making it better vs re-inventing the wheel with no guarantee it will be any better?

The practices/healthcare bodies I have been in contact with are all perplexed on how to handle the ‘beyond common sense demands’ placed on them by the government. They’re financially unable to hire more help to handle the burdens,  putting in the mandated, costly electronic health records (many different software programs from many vendors with consequent linking issues) which they are finding is very expensive to run, has many more problems taking far more time than paper charts and communication with other personnel via phone, as used in the past. All of these methods of communication still require human interaction, which isn’t perfect and is now being taxed with the need for additional skill levels and higher salaries with no monies available to allow this.

When healthcare records are inaccessible for whatever the reason, the medical personnel caring for people still have to order tests etc in order to make appropriate diagnosis as well as protect themselves from potential frivolous lawsuits. Torte reform would be a nice solution for helping to contain rising malpractice insurance and claims but the chances of that happening is like finding a needle in a haystack. Look at how many attorneys are employed within the governing bodies. Is no one looking at other cause and effects linked to the big picture? When will the finger-pointing stop and all involved step up to the plate and make ‘real’ team decisions?

There are a lot of questions and will be for some time. Where is hope for those in the healthcare industry who are in a state of chaos? The issues are so complex that the public doesn’t have a clue and won’t until they are personally affected. That day will come. I truly hope that everyone realizes that healthcare as we knew it is ceasing to exist and regulations are now in place that will raise hurdles that were not there before. In my opinion,  ‘numbers or the bottom line’ are now more important than people, so not sure as to whether or not the people’s voice can undo the expected damages to come. Now is a Great Time to incorporate prevention into you and your families’ lifestyles, if you haven’t already. I just hope that healthcare personnel will be able to shoulder the burdens, rather than choosing to leave the profession which has lost its primary goal of managing healthcare, to the non medically licensed government.



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