Tuesday, September 30, 2008

government cheese

"Why should I pay you for a visit, when I can go to the doctor up the road with my medicare and get the visit for free?" asked the cute little lady whom I've grown to love despite her arguments and noncompliance. I asked her if she remembered government cheese. I tried to tell her that she's welcome to go to the doc up the road, and might very well do fine there, and I in fact like the doc up the road. But if she's looking for something else in healthcare, something different in her visits, she could pay to come here. Maybe, with healthcare, we are getting to a point where the government subsidized plan isn't the best one for everyone (I said carefully without trying to offend those still participating the government program). So I tried to parallel government healthcare with government cheese.
Turns out she loved "ronnie's cheese" as she called it, gave me a good recipe for veggies with melted government cheese, and wished me luck. I'll miss her, truly, but maybe she'll be back...
or maybe she'll make the best of the change.
Today is my last day as a medicare participating provider, and boy am I glad september is over. I'm still bogged down in charts to copy, issues to follow up on, and getting Connor to do his work, but I feel, at least, like I can move forward.

Thursday, September 25, 2008

"are you crazy?"

So I've been thinking about trying to capture all my thoughts and ideas about what's going on with the practice, how it effects (affects?) my life and the life of those around me, thoughts on medical economics and "healthcare", maybe if it all makes sense I can avoid reliving some of the mistakes I've made in the past, and repeat some of the more positive stuff. I also want to track my hours worked, patients seen, and overall satisfaction, to see if all this effort is worthwhile. So this is the start.
Here's the baseline: graduated residency 2000 West Jersey Family Practice Resiency (Virtua), joined a group in Cape May County, decided I wasn't a team player, so bought out the "satellite" office down here in Cape May Courthouse. Was going along fine until I realized that I needed to be spending a bit more time with my patients in order to make sure I was doing a thourough job, so I spaced out my schedule to allow it. Then I realized that I didn't really get paid enough per visit to see less patients so in 05 I started dropping insurance plans, and up till now have been down to 3 plans, medicare, and 2 others. Starting october 1, I will be "opting-out" of medicare, and the other two plans will terminate in early november. I'll be all cash. People keep saying "are you crazy?" It is a little scary, and very hard to hear people say "I just cant afford to pay you" (and lots of other stuff). But scarier to think about how much I work for so little money.
So now it's 10:09 pm, I've got about 40 more minutes of paperwork, in addition to trying to process the charts of people who are transferring.

Future topics may include: what to charge, patient reactions, reactions of other docs, scanning charts, my dream practice