Healthcare represents one of the biggest expenditures in the US economy. As such, it seems everyone wants to grab a piece of the profits. Some would think that doctors would be big winners in this financial scene but this is not the case. Doctors are used merely as chess pieces for others’ benefit.
Currently, estimated show that less than 30% of doctors stay in private practice. And those who do are struggling to remain afloat. Employed doctors are seen as tools to generate profits for other entities. Most often, they are judged based on RVUs (relative value units). The more RVUs the better it is because this translates into revenue. Employers of doctors manipulate patient care that these doctors offer. They often dictate how many patients a doctor should be seen every hour.
Hospitals are another big pawn player. they issue bylaws to keep their doctors in line. Rather than aiming at patient safety, these bylaws are generated to comply with insurance company guidelines, ie, lengths of stay, readmissions, etc. This again is targeting hospital revenue. When a new department is created in the hospital, such as an invasive cardiac suite, the main game is increasing income to the hospital. Hospitals do not establish new procedures as a service to the community. It is about their bottom line.
Big Pharma is another entity looking for their check mate off of doctors’ backs. Ever listen to a pharmaceutical rep pitch a presentation? It is all about convincing doctors to prescribe their products than the dissemination of new information. They are selling products and their jobs depend on the prescriptions doctors will write. They may come with nice looking charts. But again, their end point is profits.
Insurance companies are perhaps the kings of the chess board. Doctors to them are mere marionettes. They pay doctors bottom of the barrel, the least amount they think we will tolerate. And they make us jump through hoops to get paid. Some estimates put denied claims at around 10% of all claims. Some of the biggest companies lost class action suits for the end games they play with paying claims. Yet, they continue. Not only is it a nightmare to get paid for our services, insurance companies now place high road blocks in front of us to order tests for our patients and even prescribing medications. Again, this is done as a means of increasing profits.
The Queen bee on the chess scene would be the federal government. They are the hoop maker of all hoop makers. They issue mandates with little foresight or any direct knowledge into the practice of medicine. As the biggest expenditure in the US economy, the government hopes to rein in healthcare costs to help the national economy. History shows that they failed many attempts in this regard. They miscalculated the SGR and almost bankrupted the Medicare system. Now, they repealed the SGR and passed the MACRA bill. The MACRA bill is now law but, we do not know what this law consists of. In fact, the lawmakers do not know either. They are meeting next month to decide this. Yet, it is law and whatever they come up with, doctors must comply. How is this even legal?
Doctors are being used on many fronts for corporate profits and political agendas. As we get moved around the chess board, patients fall victims. The more we are moved, the less options patients possess. Using doctors as chess pieces will do nothing to fix our broken healthcare system. Perhaps, it will bring about its final collapse. And patients will be buried under the rubble unless we fight back.
Copyright secured by Digiprove © 2016 Linda Girgis, MD, FAAFP
