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who is to blame and who could help? We ALL need to accept death is inevitable and concentrate instead on quality of life and practical treatments. Patients should be much more directly involved in decision making with the doctor and be fully informed of cost/benefit. Agencies and third party payers and ins companies do not have best interests of the individual in mind and should not be deciding
- Psychiatrist, MN
Obamacare will be the ultimate of the solo practioner and small practices
- Dermatologist, MO
The most important thing would be to eliminate third party payments. Patients and physicians should decide what tests need to be done and what treatment will be administered. The patient should pay the physician for service. Whether they then get reimbursed is between the patient and the third party payer. This would put patients and physicians in charge as it should be with healthcare.
- Cardiothoracic Surgery, IA
We need better control of what insurance company does
The big problem is the reimbursement. Diabolically wrong path I do adhere to the Hippocratic oath to my own devise out of principle. The way our leaders would have it =nonexisting (robotic)! No comparison to the old days (autonomy in your practice). Medicare/Medicaid patients will become laborious for negligible re-? Individuals' coverage will be limited and reimbursement major. Close the doors for admission to have school and set up an honor system, establish a people's insurance separate from gov.
- Internal Medicine, ME
emphasis on health/prevention of disease
- Cardiologist, CO
State Government is responsible for health insurances Need to work with chiropractic physicians like me. I am a board certified Chiropractic Neurologist
- Chiropractic Neurologist, PA
control ins company earnings. persue cost effective treatment. parity in payments
- Internal Medicine, MA
electronic med records: increase problems and wording and time individuals will still run to ER would insurance co. be willing to forfeit their salary or bonus take the blocks out to decrease our viability, 1. prescription ?, PT for physician, home care hospice sw physicians 85% of approved vs 100%
Obama is right for the country but the amount of micromanaging of doctors will need to let up
- Oncologist, WV
Limit insurance profitability and put control of patient care in MD's hands.
- Physical Therapist, CO
#16: new regulation? already disclose it but dont want it to be a regulation #26 - no but lower costs other: patient direct pay for services with reimbursement
- Chiropractor, WI
Federal option as competition to for-profit insurers would most improve medicine
- Psychologist, MA
#7: To blame for current problems: sickness paradigm, big pharm, litigous culture, systems lack of standardization #8: chiropractors are most likely to improve problems in medicine #24: due to lack of corporate incentives generosity to workers, no consumer economic improvement
- Chiropractor, SC
Going downhill because of complex multi-prong reasons bc of cost of care, aging?, increase too of technology, government regulations and you cannot survive as a PCP.
- Internal Medicine, MO
Already post prices. I found this survey very interesting. Some of the topics I needed to look up to even know what they were. As a physician in the alternative therapy category, it was very interesting to see some of the items traditional medical doctors are facing. As an alternative provider, I am taking the stance of eliminating most if not all insurance companies with the exception of Medicare and Medicaid. Medicaid has created enough obstacles that it is becoming harder and harder to even file as a chiropractor, thus it will go away on its own. Mediciare is still relatively easy to work with and is as good a provider as any other insurance. Major medical coverage by top insurers (BC/BS, Aetna, UHC, etc) have made filing insurance too expensive and too difficult to mess with. Most of my patients have co-pays that far exceed my cash price, thus patients are opting out of coverage. This pays me better and saves the patient money. Because of our low overhead, this option is available and our best plan. Patient responsibility for their health to me is the missing component in healthcare. We as a healthcare society, have made patients so dependent on our services they no longer take control of their own lives. They are like sheep and no longer will take the time to eat well, exercise and practice stress management. It is easier to pop pills and blame their physician for their problems. Until this mentality changes, there will be no change. Thank you for sending out this survey.
- Chiropractor, NC
43 yrs in private practice. educated four children, enjoyed a second home. to retire at age 74.
- Psychatrist, MA
Question #7: Congress 10% to blame; Lawyers 90%
- Family Practice, PA
more PAS NPS & larger scope of practice
- Family Practice, PA
Question #8 - president, congress IF they will care for patients and DOCTORS
- Pediatrician, FL
eliminate SGR, work on fixing what we have rather than government take over
- Family Practice, PA
Pay for performance without use of drugs
- Chiropractor, PA
Eliminate network contracting. It's not government but cooperation. Need health care not sick care.
- Chiropractor, FL
Doctors need to take more of a leadership role and stop insurance companies from blocking out providers.
- Psychatrist, FL
ACOs may destroy dermatology access in the middle of unrecognizable skin cancer epidemic. 27. I do not think it is legal; but we offer a discount to self pay patients. 28. Doctors are being forced to join large hospital groups - by economics and regulations.
- Dermatologist, NC
Socialism promotes and enhances loss, despair and death. Socialism is anti-hippocratic oath. Socialism is a lie, buried in a bed of lies. Socialism destroys hope, dreams and freedom. Socialism SINKS all boats Socialism destroys prosperity.
- Plastic Surgeon, FL
Did not go to school for 25+ years to be computer programmer for Federal Govt *Open all insurance co across state lines and competition and decrease insurance cost to patients *somehow unionize physicians
- Opthamologist, FL
I have to stay healthy since I can't afford to retire.
- Neurological Surgeon, IN
Eliminate first the federal govt, then state govt in health care. If one state started a free market system, it would put the rest to shame.
- OK
The best chance for controlling cost is limiting government interference and increasing patient responsibility for cost. If the patient pays at time of service and files an insurance claim on their own, it reduces the likelihood of superfluous utilization, AND reduces insurance company denials since the patient is following up on their own claim. Also, removing insurance purchasing from employers makes insurers responsible to policy holder, not employers. Government regulations increase cost by imposing burdens for practices ("compliance officers", etc) as well as increasing cost of doing business (FDA regs increase cost of medical equipment, for example), but the physicians cannot pass costs to patients because of insurer reimbursement model. The problem is multi-tiered, as will be the solution.
- General Surgery, GA
We need wellness care. Our nation is in a terribly crisis. We have yet to see the total impact of our lifestyle. Until we "get" that, we will see an increase in utilization, declining health and high sky rocketing prices.
- Chiropractor, SD
We try really hard to comply to Medicare Documentation, but it never seems like enough. It takes us more time and the patients get paid less.
- Chiropractor, SC
insurance companies have too much power and waste too much money
- Primary Care, ME
Americans need to stop taking payment for healthcare for granted. It is no longer a Right but a luxury.
-Rheumatologist, TN
Educating patients should be where the government spends its money. Physicians do this every day (hopefully) with their patients, but there should be regular public service announcements and a full out campaign (much like anti-smoking) for better nutrition choices, exercise, weight loss, etc.. How could anybody honestly argue this wouldn't significantly improve the situation????
- Chiropractor, SD
AMA sold out
- Pain Management, MO
HIPAA is a joke regarding privacy. Patient consent tor disclosure needs to be reinstated.
- Psychatrist, MO
Fear it is too late to save.
- Opthamologist, ID
Quit FORCING doctors to provide care to ILLEGAL aliens without payment for services. THey also must pay income taxes to help fund Medicare and Medicaid coffers.
- General Surgery, NC
My view is probably skewed since I haven't taken any third party payment for over 11 years.
- Family Practice, TN
question above somewhat misleading and biased and does not focus enough on need for national health care or need for natioanl payor system The questions and survey choose quetoi whic tned to reflect a built in bias of the survey . I support a national health care system or single payour system and feel money and economics and physician practices and increase specialization and technology had led to a dehumanization of medicine and increase costs. We need to return to a system where most practitioners are not specialists but in primary care. We have an inverted pyramid in medicine with too much specialist and over use of techonology which as sacrificed the primary physician patient relationship.
- Pyschatrist, NY
Decrease power of insurance companies to dictate health care.
- General Surgeon, MI
Financial situation - stressed
- Podiatrist, FL
The Federal tax code is the culprit forcing everyone to get insurance through their employer. We need a market insurance sys that allows 1000 insurance companies offering a variety of packages to meet needs of each patient. Give doctors tax incentives to treat the indigent and empower them to compete based on skills.
- Chiropractor, SD
Do not socialize medicine in this country!
- Chiropractor, MO
I would not consider letting my teenagers become physicians. My husband is also a physician.
- Anesthesiologist, WI
Employer-based insurance, a relic of WW2, is the primary cause of both pre-existing illnesses and inability to purchase insurance if unemployed. A simple change in tax law giving the same tax treatment of insurance premiums to individuals and businesses would be extremely beneficial in reducing pre-existing illnesses.
- Bariatric surgeon, IA
Pts need skin in the game. Nothing else in America exists where a 3rd party assumes responsibility for someone, not even food and shelter.
- OB/GYN, NJ
Less government will mean better and less expensive medical care. Government is the problem are there any long term Government run programs that aren't riddled with inefficiency and corruption?
- General Surgeon, IL
I don't know from what source all this foolishness about "uninsured" patients arises. I have never denied standard medical care to a patient in my life based on the family's ability to pay a fee, and I have never seen a hospital refuse to treat a needy patient. Leave us alone and we will take care of all the patients.
- Pediatrician, NC
Euthanasia is becoming prevalent but is disguised as patient autonomy and is being made part of hospice and palliative care. This is condoned and promoted by government and third parties in order to reduce their costs.
- Primary Care/Internist, PA
1. The principal source of medical expenditure comes from excessive numbers of tests ordered because of fear of lawsuits from the medical malpractice industry. 2. Institutions such as hospitals, nursing homes & clinics are so overburdened with regulations and the treat of underfunding and fines that the great majority of effort is put into paper compliance rather than a culture of seeking to improve the patient's experience & outcomes. 3. Too many issues come between the patient and the doctor. (Fear of litigation, insurer rejection or delay of therapies & needed testing, changing of physicians due to insurance changes) 4. The main reason new patients now give to our practice for coming to us is a change in health insurance plan. It has nothing to do with the doctor-patient relationship or referrals based on quality of care. 5. The American Medical Association speaks of the "Hassle Factor" regarding excess paperwork. The actions of the health insurance industry indicate that using hassle factor tactics is actually part of their business plan. [hassle ---> frustration ---> patient drops complaint & pays more - and during the period in question, the money in play earns interest for the insurance company]
- Geriatric Medicine, NY
We have to improve healthcare and avoid a british or canadian system.
- General Surgery, IN
I have a valuable practice doing hysteroscopic surgery, and with an associate joined a teaching hospital and now make more than I made in private practice, with better benefits, less 3rd party hassle, and access to better equipment than the prior hospital would provide.
- OB/GYN, MO
The government should get out of any direct involvement in healthcare finance, allow market forces to function to bring prices down; healthcare systems should all be made for-profit to pay fair share taxes. Govermnment could reimburse low-income citizens with
- General Surgeon, NC
If physicians do not put patients' needs first, its over. That includes fighting for patients' rights to control the flow of their health information in electronic health systems, in the cloud, online, and via mobile devices
- Psychiatrist, TX
i'm disgusted with my fellow doctors; instead of delivering good quality care, many are looking out just for themselves and that includes myself.
- Plastic Surgeon, FL
Single payer system is the most cost effective system
- Preventive Medicine, IL
Get third party payers/govt out from between physician and patient. Patients should pay for their health care directly and use health insurance only to protect against catastrophic financial loss due to illness or injury. Prices for health care will become competitive when patients have free choice AND responsibility for their own health care. Also the cost of dellivering care will decrease when doctors don't have to have so much employee time devoted to billing/complying with third parties etc.
- Anesthesia, TX
If the government wants to be involved in medicine have them purchase catastrophic insurance for people (the only kind of medical insurance that should be sold) and let all people be responsible for their own medical bills. Vested interest would make them more responsible about their health. Health care is important but it is not a right just like unlimited food and water is not a right and its even more important.
- Orthopedics, MO
it will get worse before it gets better. not encouraging to the young doctors.
- General Surgery, NJ
the power of hospitals is huge and has destroyed physician's autonomy and his ability to demand improvements in health carre
- General Surgery, NC
I have been in practice for 28 years and medicine is now the worst for doctors it has ever been and I don't see it getting any better. We needed insurance reform not health care reform, we got neither
- Orthopedics, TX
ACA is destroying the practice of medicine and thus the healthcare of all US citizens.
- Family Practice, AK
I believe we will have to move into a two tier system without really announcing it. Government control of payments largely exists already, it will need to expand, but more controls to limit spending. The decisions of what to cover etc will have to be taken out of politics, no one would be reelected if limiting care, but has to be limited to make it affordable, we cannot simply keep lowering payments. If people want to pay for things not covered by government, then they can pay, that would make it then a two tier system. General surgeons are taking a beating financially because of general relatively low reimbursement and large amount of no pay emergency room urgent surgeries with are promoted as safety net and walk in services but no reimbursement for the private surgeons.
- General Surgeon, IL
The federal government needs to get the HELL out of the practice of medicine. Here's the bottom line: you cannot give away free medical care. Until they stop entitlements, this whole system is doomed, unfair, and chaotic.
- Internal Medicine, WA
We need to repeal 'Obamacare'. Need to have access to major medical insurance purchasable across state lines, with minimal mandates. Need Health Savings Accounts. Need to use technology (iPads, etc) to do home visits with trained home assistants facilitating (recruited through the patients church, etc). Need to diagnose and treat addictive disease. Need to require normal urine drug screens for anyone getting public money, including food stamps. Thanks for your work!
- Family Practice, OR
Defensive medicine is a fact that all of us do which costs > $200 Billion/year. In order to survive, both medicine as we know it as well as the US finacially, we need national tort reform and a medical court system. Also, ER and EMT abuse has to stop. As a retired surgeon and part time rural Er Doc, 80% of the people we see would go home and take a Tylenol if they: 1. were charged $10 up front for the EMTALA screening, and 2. were taught general health and first aid in high school with an emphasis on COMMON SENSE.
- Emergency Medicine, LA
I am 80% of the way towards being third-party free and am optimistic about my practice's future. The rest of medicine still beholding to the insurance giants are in a straight jacket with no chance for release.
- Internal Medicine, IL
Repeal PPACA and EMTALA, establish charity care/government care at all hospitals that train residents. Patients will have access, though it may not be the most convenient. Allow all patients that carry their own insurance to receive their care on a free-market basis, limit health insurance to major medical plans with no first-dollar coverage. Costs will come down, just as they have for plastic surgery, LASIK, and other non-covered care,
- General Surgery, LA
There is no incentive for young students to go into high risk but critical subspecialties. Unacceptable liability risks,long sacrificial hours,and now no financial reward! Who would be that stupid? Certainly no longer the best and brightest!
- General and Vascular Surgery, FL
these questions , the latter half, are quite biased. Clearly, there is much less focus on actual quality , safety, and patient-centeredness, which will improve our system , than there is on physician autonomy and reimbursement, which though important , are lacking in vision.
- Primary Care Provider, IL
Patients need to have more control of their health care dollars with price transparency to make their own medical decisions. This will reduce the cost. No mandated insurance coverage-one size high cost for patients. Central management of medical care will be disastrous for patients and doctors, as has been the case in other countries. There are free market solutions to address the cost of medical care. Obamacare must go.
- Psychiatrist, NC
I am already a casualty. My best year was 1997 and I have seen my ability to generate income steadily decline since then. Having practiced 20 years I finally shut down my private practice and joined a large hospital system. Erosion in Medicare reimbursement and exponential increase in regulations have necessitated leaving private practice.
- Physical Medicine & Rehabilitation, SC
There needs to be more emphasis on patient responsibility for their health.
- Endocrinologist, PA
We should establish a National Health Plan or Medicare for all to lessen cost and burden of supporting private Healtlh Insurance Industry
- Internal Medicine, LA
Doctors and appropriate pt care needs to take priority. Less use of "popular but expensive treatments that have no proven benefit. Too much marketing of techniques and not on outcomes.
- General Surgery, NY
eliminate tort,increase individual responsibility for consumption of resources
- General Surgeon, CO
Universal health coverge is essential also greater pay for primary care. A Canadian style system would be ideal. Anyone opposed to obama care needs to have a better alternative the assures coverage for all.
- Family Practice, NY
I am only in the black as I dropped Medicare 4 years ago. Else, I'd be the patient today from burnout/MI/Ulcer or other disease.
- Orthopedics, TX
I personally believe that the coming Obamacare will be a disaster for patient and doctor alike including the economy.
- Naturopathic Doctor, CO
I would be happy to treat indigent patients for nothing if they let me deduct my fair market work product from my income taxes
- Pain Management, NY
need higher primary care payments and lower non-primary specialist payments.
- Family Practice, NY
Headed in the wrong direction
- Pediatrician, GA
medicine like education and many other large needs must be controlled from the bottom up NOT op down
- OB/GYN, AZ
Lack of price transparency (NO PAYER other than Medicare\Medicaid, which ONLY give physician fees and NO OTHERS) will tell what ALLOWABLE prices are by contract so NO ONE knows cost, and patients have NO skin in the game to care - even if we could tell them the costs.
- Otolaryngology, LA
A society is only as good as the way it treats it's least privileged citizens. We are a capitalist country. Physicians must align incentives to heal with incentives to flourish as citizens.
- Internist, FL
doctors should run medicine. not government, not hospitals, not consumer groups.
- OB/GYN, NY
This is excellent. It is time for competent non physicians including marketing people to take control to allow surgeons to FOCUS all of their energies on people without worrying on a daily basis which patient will destroy them, or if a coding error will destroy them. Thank you for doing this.
- Podiatrist, LA
As long as health care is perceived my the majority of voters as a "right", we will descend into fully nationalized care. Nothing will stop it.
- Family Practice, FL
any and all third party payors (including medicare) should provide catastrophic care much like homeowners and auto insurance. then the free market will help establish fair market values and ultimately reduce cost. Don't we all just want to be left alone?
- Dermatologist, OH
Government should be removed from the delivery of health care. health insurance should be sold like auto or home insurance, covers only catastrophic events not routine maintenace. Should have incentives for individual to live healthy to minimize catastrophic events
- Pathologist, OH
The only answer is to get government out of medicine 100%.
- Primary Care, MN
need socialized medicine
- OB/GYN, NC
When I first began the practice of medicine, there was a law that no-one could practice medicine except a licensed physician. Today, everybody ‘practices’ medicine. I truly believe that what has occurred in medicine over the past forty years has been a gradual and steady plan to use medicine as the catalyst the government needed in order to set themselves up as dictators. The doctors are their pawns. When you control medicine, you have the wedge between government and the people. I saw this coming many years ago but when you present a theory of this magnitude, most doctors look at you as though you were half a bubble off plumb. We as a group believe in helping and in good and it is practically inconceivable for physicians to identify with dealings that nefarious plus if they do, they feel helpless to do anything about it and they have never had the money to support a lobbyist to fight for them. I feel that medicine as we learned it has been turned into a charade.
- Family Practice, SC
The major problem is the politicians equating health "insurance" with health "care". I opted out of all insurance 6 years ago and really enjoy practicine medicine again. I have found that many people that do not have insurance are quite happy to pay a reasonable fee for their care.
- Family Practice, SC
Medicare and health insurance companies have taken over control of healthcare. I spend 6-8 hours weekly trying to get insurance companies to cover most of the cost of medications that my patients need just to be able to function at a minimal level. Medicare D insurance companies have a vested interest in refusing to pay for psychiatric medication - if the patient decompensates and needs hospitalization Medicare pays for the medication directly, letting the Medicare D companies off the hook. Insurance companies must have some oversight to control the cost of healthcare while not operating autonomously in their own self-interests.
- Psychiatrist, MA
Free market solutions are our only hope
- General Surgeon/Phlebologist, TX
Medical insurance should be just that: for catastrophic events. Sell insurance across state lines. get government out of subsidizing. Allow a true free market without government or third party payers involved in routine care. When government pays(when nobody pays directly) abuses and inflation follow. The patients and physicians don't care how much it costs (someone else is paying for it). Hence our system 47 years later is unsustainable. I'm a General Internal Medicine trained and boarded now working urgent care. I HATE paperwork.
- General Internal Medicine, TX
It would be nice to restore patient doctor relationship. We should model like dentists, have a fee schedule that we can display
- Urologist, VA
As a solo doc, I am being forced out of my practice by the bureaucracy and regulations we are and will be responsible for. Those that suffer will be the patients
- Ophthalmologist, PA
Congress has failed. We need to leave Medicare and band together. Preserve the right to practice free from government or insurane for future Doctors. When we are referred as providers and not surgeons, the government considers us a replaceable commodity
- Ophthalmologist,, FL
doctors are their own problem
- Internal Medicine, NJ
If the current Pryor systems continue & Government continues their legislating more pressures on doctors, medicine in the US will come to a halt. There will be a two tier system: those that can pay for private medical care & everybody else (in the socialized system.) I will not participate in socialized medicine.
- Neurology, FL
Mostly negative, way too much government, rules are nonsensical, payments too low
- Endocrinologist, CA
We don't need more laws and regulations. We need to repeal them. We need a flat income tax so we can get rid of the tax incentives that make it so that health insurance is always tied to employment and restricted by state lines.
- IL
I think that the doctors need to stand up and fight with a united front instead of taking these changes lying down. With the direction we are going, we will have the worst medical system in the world where the nurses will rule.
- Podiatrist, FL
Unfortunately as regulations have increased there has been a direct impact on the cost of care increasing. The best way to assure quality is to let individual patients pay physicians directly and let the patients decide.
- Anesthesiology, KY
Government control healthcare doen't work Patients should be responsible for their health It's better for the patients to pay for their health care than the 3rd party or the Government!
- Pediatrics, TX
The future is bleak!
- Anesthesiology and Pain Medicine, CA
its becoming cookbook and judgement is no longer valued
- OB/GYN, AZ
capitalism, compassion and Christianity can cure our medical system
- Urgent Care/Emergency Medicine, TX
Patients would be more thoughtful consumers if they had more "skin" in paying for health care. This is why lots of patients who never took generics are now taking them
- OB/GYN, OH
Medicine is circling the drain for a variety of reasons. Heaven help us all as we age.
- Sports Medicine, KS
Medicine has become big business and doctors have become workers who are exploited by big business.
- Psychiatrist, CT
American healthcare is finished. The damage done by government/corporate control is irreversible. They have too much power to allow change. Only the powerful will have decent medical care (government employees)
- Neurologist, FL
Only way to restore the Profession is to eliminate third party contracts with physicians. No signing on with the Feds or the managed care companies. No discounts to third parties, only to patients on an individual as-needed basis. Third party contracts are UNETHICAL.
- Endocrinologist, TX
Foster individual responsibility in al manifestations. Penalize contrary behaviors (smoking, no helmet, mva, etc)
- Family Practice, KS
I share the exact same opinions of medicine and other parties controlling medicine as those expressed by Dr Hendricks in Ayn Rand's "Atlas Shrugged" ( quote ref page 744), where he presciently describes the same sentiments why I am ready to change careers now.
- Orthopaedic Spine Surgeon, CA
Right now, the patient is the 4th party payer. Ultimately the patient pays the bills, but with our present system, has absolutely no control over how that money gets spent. Doc <- insurance co/mcare/mcaid <- taxpayer/employer <- patient (premiums/reduced wages/taxes). This completely insulates the patient from the costs of care, and now because of the hidden layers of bureaucracy, separating the patient from the care, each layer with its hand in the till, patients (and their doctors) haven't a clue how much a given treatment costs and without a cost to compare to the benefit, we cannot make sound medico-financial decisions, and the result is what we have today: health care is a "right," "I'm entitled to it," and if I don't have the money to pay for the costs, or make suitable arrangements to pay for the costs of care (intelligent selection of savings/insurance planning), oh well, I get it for free anyway. The end result is those laboring to provide that service (physicians and supporting staff) work under terms dictated by the collective insurance/government, at a rate they are willing to pay, and we have zero say in it, if we want to continue working in a field we passionately love. Eventually, as costs mount due to this extra paperwork requirement, and that extra regulatory requirement, and payments for invoices decreases, a point will be reached where people will leave the field. An example of how this works: a business wished to provide health insurance for its employees, but did not wish to provide abortion coverage. It found out that it could not offer maternity coverage without also providing abortion coverage. It then decided to not provide maternity coverage, but would pay any bills as tendered by the treating OB. When their first employee got pregnant, the company got a call from the practice billing office requesting insurance forms. They were told to send a bill for care and they would be paid the following Friday. No HIPAA, no medical necessity, if the physician felt it was necessary, do it, and bill us. Once word of that got around the company was inundated with solicitations from the area OBs. The cost of insurance/government overhead/meaningful use/medical justification/documentation of physician judgment in ethical practice probably equals the direct cost of providing and care, if it doesn't exceed it. And this is what we need to fix before we all go bankrupt.
- Oncologist, MN
Medicare should be means tested. It is ridiculous that someone who can afford waterfront condos and late model mercedes has medicare. Medicare needs to be separated from Social Security. No one should have to forfeit Social Security if they don't want to go on Medicare.
- Anesthesiologist, MD
I am out of network on the private side, and I am a non-participater in Medicare. I don't have a Medicaid number. Patients should be able to buy low cost major medical type insurance, not expensive pre paid medical coverage.
- Opthamologist, NJ
We, as doctors, still have the power to affect the process because we see the patients. But, we must be willing to trust our ability to give quality care and not accept 3rd party payments which are unreasonable, and we must band together under a single consistent banner of a Tort reform platform.
- Opthamologist, GA
I went to medical school to become a doctor. I did NOT go to "health care provider school". I know how to take care of sick and injured people. PLEASE, let me do my job the way I was trained to do it. I am so sick and tired of people with vastly inferior training, or no medical training whatsoever, telling me how to treat my patients - and all of them have their own agenda: Power and/or money. Some days I just want to run to Africa or Mexico and just take care of sick people, and not have to explain myself to a dozen bureaucrats who don't even know what I am doing. "Third parties", whether private (insurance companies) or public (government), have destroyed the physician patient relationship. Obamacare will destroy the best medical system the world has ever seen, and it will bankrupt the nation.
- Family Practice, CO
It's really depressing. It bothers me several to many times every day, "Why the hell did I invest 34 years to be a very low level 99%er?"
- Orthopedics, NY
what a mess, it's hospitals that have become corporate and want ALL of the money they can get from EVERY patient at EVERY encounter that is the problem; they don't want primary care because that is "leakage" in their systems, keeping them from maximizing profit; hospitals seem to be run by the Ferengi
- Family Practice, FL
The complete government take over of medicine must be stopped. I want to focus on what is best for my patients and not what a government official deems cost effective. I want liability (tort reform). This is what is missing from the Presidient's plan. I would be willing to do charity care weekly for the poor and underinsured if there was tort reform.
- Immunology, OR
If MD's want to regain control of healthcare they need to resign from all third party payers including medicare and medicaid and only accept payment from patients. There is NO OTHER solution and physicians will never regain control of medicine or their own lives unless they do this. Follow the American Association of Physicians and Surgeons. They are the only national society that understands the actual situation and solution.
- Cardiothoracic Surgery, IA
We need decreased regulatory burden, less hassle to get paid what we're owed, tort reform and tax breaks for all of the government programs that don't cover our cost of doing business.
- General Surgeon, GA
I think it is out of the physicians hands and never has been controlled by physicians at any time.
- Orthopedics, TX
ACO is HMO spelled backwards. ACO payments are capitation all over again. Government gets away with rationing by making doctors the scapegoats when someone alleges that an ACO made a profit by skimping on care.
- Internist Hospitalist, NH
Obamacare=Soviet system.
- Pediatrician, CA
Two factors that preclude meaningful healthcare reform: 1. politicians use their power to distort market forces in healthcare, and 2. Physicians are making the transition from wanting to be business owners to those wanting to be employees. I was in solo private practice for 20 years before reluctantly taking a salaried job at our county hospital.
- General Surgeon, CA
Physicians belonging to large groups seem to be relegating more patient interaction to PAs and other ancillary personnel, often to the discomfort of patients and their families.
- Anesthesiologist, CA
Only the free market will fix this mess. We need to eliminate government and government protected corporate greed from medical care. Fiscal responsibility must return to patients and their providers in a free market environment.
- OB/GYN, TX
The greatest help would be to get the government out of medicine.
- Primary Care, MN
One of the reasons the USA is lagging behind in the health of it's citizen, includes the high cost to deliver services to patients, the redundant and unneccessary testing and the hight threat of being sued. Malpractice fear is just one reason for the over testing of our patients. But, insurance demands for triplicate paper work and overanalyizing physician decisions with non qualified RN's is tedious and delays really neccessary treatment.
- Chiropractor, PA
We are dumbed down and our freedoms are restricted.
- Neurosurgeon, CA
until people start taking responsibility for their own health instead of relying on pills to stay alive...nothing will change
- Chiropractor, MO
We need separation of government and health care.
- Optometrist, CA
Government at any level should have no role in medicine except medical licensing and business licenses. Period!
- Orthopedics, MN
Physicians should be independent of hospitals and insurance companies. The system needs more competition between hospitals, insurance companies and doctors. The government has given the hospitals and insurance companies a protected status by limiting competition and they don't have to improve quality or become more efficient. Doctors have lost control and are being told what to do by hospitals insurance companies and the govt. who only care about money not patients.
-Orthopedics, MN
EMR has no place in a psychiatric practice. Judges with legal degrees have no business making medical decisions. Ban ambulance chasing lawyers from advertising and encouraging lawsuits with no risk to plaintiffs. Allow doctors to practice medicine without a third party in the room with them. Evidence based medicine should be a guide NOT the only way one may practice. Stop allowing people with no medical knowledge, i.e. politicians, attorneys, and bean counters from dictating how doctors should practice.
- Psychiatrist, MA
I have recently gone the direct pay route. I expect my income to increase, although it is currently fairly low, being in the first year. If I stayed in the other model of third-party controlled care, I would be expecting my income to decline in the future.
- Dermatologist, MA
Insurance should go back to it's original intention to pay for hospitalizations or expensive procedures. My patients should be able to pay me at the time of their visit and save us from the expenses of billing and collections. Credit cards are accepted everywhere. Billing for an office visit of less than $100 is very inefficient. People pay for car repairs before they get their car without problems. Women spend hundred on hair treatments and give a tip on a regular basis. If people paid for their care they would get better care. Doctors would take more time to answer their questions and wouldn't be able to bill for a level 4 visit when they actually spent 5 minutes and copied an old note. Also ICD 10 will make things worse and ICD 11 is already in the works. These changes will not do anything to improve the healthcare of our patients and will take time away from patient care to do coding for the benefit of insurers.
- Neurologist, MO
we can't fix healthcare by simply blocking expansion of government intrusion. doctors and patient need to see there is an alternative to "insurance" and that its better for them. key is to reduce barriers to sustainable direct practices
- Opthamologist, AZ
I own a 4 physican FP group; I will be out of business when Obamacare is fully implemented; we got out of Medicare this year
- Family Practice, TX
The less interference with the doctor/patient relationship the better. Patients need to take responsibility for their own good health. They should not believe that they can live any lifestyle they desire and have others pay for their health misfortunes that result from this lifestyle.
- Anesthesiology, TX
patient centered healthcare only occurs when patients control the money, AND the Dr ONLY works directly for that patient...anything else is make believe sophistry-the laws of markets and value ditribution dictate this-pols have no clue about this most basic capitalistic premise
- Internal Medicine, MN
Evidence based medicine, not convention, also not defensive medicine. Tort reform to reduce the cost of doing business.
- Chiropractor, VA
The fundamental problem with health care is third party payment (created by government). Most patients should pay themselves for most medical care. Insurance should be used only to protect against large unexpected financial losses. Although it may seem flippant, this would solve almost all of the problems we face today. Also, government pay propagates government control. Federal gov has no constitutional authority in health care AT ALL (includeds medicare and medicaid).
- Radiologist, MN
ALLEGED "FACTS" ABOUT LOWER CARE IN USA ARE PURE FALLACY. Cancer care, heart disease, infant care in US is second to NONE! Other countries dont count those who die before they see a doc, or have as many hopeless drug addicted babies due to Maternal Chem depency! The USA Major media should hang its head in SHAME for lying to US public! tort reform required before any other med insurance changes. like other countries have! No insurance charity care should be allowed to forfit any lawsuits! Obvious, emergency and Life saving surgeries should be IMMUNE from lawsuits! Electronic med records should be trashed or at least not connected to outside electronic world to help avoid confidentiality abuse.
- Neurologist, MO
Get back to the doctor patient relationship. Eliminate all the middle men parasites.
- Family Practice, MO
When the airlines were taken over by business instead of being run by pilots, the industry went to hell. Same thing has happened to "healthcare" -- doctors used to run hospitals and their practices. Now they are "providers" and really only make money for Pharma. We need to scrap the entire system and start over. More bandaids is not the answer. Use the ancient Chinese method: Pay doctors to keep patients WELL and when they get sick, doctors care for them for free.
- Family Practice, OH
Medicine is no longer about treating and taking care of patients . I spend more time telling patients about additional paperwork they need to fill out to have treatment covered and telling them more and more what is not covered by their insurance. In my practice over the last 3 years, patients have paid 75 percent of what is collected even though I am in network for most insurance and medicare.
- Chiropractor, MO
There should be much less cronyism and favoritism between medical organizations and government. The PPACA is a monstrous bill designed to give government COMPLETE control over our lives. The ultimate goal is for there to be a SINGLE-payor system, a.k.a. SOCIALIZED medicine, which would be a complete disaster for this country. Ironically, there are 1000 waivers which have been allotted to unions and religious groups, in addition to our entire Congress being excluded from this health care mandate. We, as health care professionals, need to STAND UP NOW an UNITE against this power grab which has NOTHING to do with improving health CARE and EVERYTHING to do with TAXES, GOVERNMENT CONTROL, AND POWER.
- Endocrinologist, FL
I am optimistic only because I am third party payor free, and have been since 2002. Patients are constantly complaining about my colleagues being too rushed, looking only at the EMR, and "not caring" about them. I doubt that the latter is true, they are just overburdened with things that don't positively impact the patient's experience.
- Internal Medicine/Pediatrics, FL
People (patients) need skin in the game. Giving them care or insuranc isn't the answer - they need to have a vested interest. Copays, etc. do this. Mandated Obamacare does not.
- OB/GYN, NJ
I have been shrugging for the past 8 years. There is nothing to suggest the practice of medicine will improve in the near future. I feel sorry for those who are valiantly trying to practice good medicine in such a dysfunctional system.
- AK
I am opted out and cash based for 12 years now as an internal medicine practice. I have never been busier, deliver a high quality consultative product, am financially secure, and cannot wait to go to work everyday. I will practice until I am 70-75 years of age and live a very healthy lifestyle. Much of what you ask no longer applies to me.
- Internal Medicine, MN
EMRs do not improve care. Neither do regulations. Patients do not feel cared for under current climate.
- Urologist, TN
A couple small changes would improve the situation: 1-It should be illegal for health care organizations to discount their fees for insurance companies. The discounted fees amount to extortion because if patients do not buy health insurance, they cannot afford health care. 2-Fees shuold be transparent to doctors and patients. 3-High deductible policies with patients paying out of pocket will naturally rein-in expenditures and obviate the need for pay for performance, or other government oversight. The net savings should be more than enough to be able to be applied to help poor of chronically ill patient's pay their medical bills.
- Pathology, MA
Total hands off medicine by the government, i.e., a true Capitalist system, will work. Third party payers are not the problem expect when regulated to any degree by the government. True insurance for anything is a great business model if it makes a profit in a free economy. It is a disaster when control by the government.
- General Surgeon, CA
I see what happened to martial law in the Philippines where regulatory ocntrols by the government dictated the practice of medicine already happening here with the passing of Obamacare.
- Pediatrician, OH
