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  1. #1
    I play pretty, no? TeyshaBlue's Avatar
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    Short, but interesting read. Never heard of lo tenens as a alternate career path.

    http://money.cnn.com/2013/04/25/smal....html?iid=Lead

  2. #2
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    why would lo be superior to what he found in Australia?

  3. #3
    I play pretty, no? TeyshaBlue's Avatar
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    I don't claim that it is. I was just unaware of the practice.

  4. #4
    I cannot grok its fullnes leemajors's Avatar
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    Sure took his sweet time even attempting to move to electronic records.

  5. #5
    Cinnamon Girl mrsmaalox's Avatar
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    Lo tenens has been real popular in nursing and allied health for as long as I can remember. For doctors I think it's relatively new, but I don't really know as I have only ever worked at teaching hospitals and never experienced a doctor shortage.

    The thing that strikes me from that article is that he says only one third of his patients were Medicare patients, but yet changes in those was enough to bust his practice. I can only assume the other two thirds were insured? I would think he was very well reimbursed from them.

    Doctors are not famous for being business savvy. When I was in nursing school I worked parttime for one of the most prominent pulmonologists in the state. My job was to make rounds of the various hospitals and have his patients sign their Medicare/insurance papers to be submitted. The Medicare papers were submitted immediately and reimbursed immediately, no questions asked. The insurance papers ac ulated on the desks for months, because they required so much more do entation, and then after months of back and forth "negotiations" were eventually reimbursed. I think the guy in the article could have been the same way, made his business too dependent on the easy money.

  6. #6
    Cinnamon Girl mrsmaalox's Avatar
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    And he did not "give up on healthcare in America". He gave up on how/what he got he paid for his job.

  7. #7
    W4A1 143 43CK? Nbadan's Avatar
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    Mrs Maalox coming in with the solid take. Healthcare is a monopoly and everyone gets screwed except for big insurance.

  8. #8
    W4A1 143 43CK? Nbadan's Avatar
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    In this case privatization without regulation and oversight has failed.

  9. #9
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    lo is quite popular is over-doctored countries like France. very hard to find a spot to start a practice, so young doctors sub for vacationing docs.

    in under-served rural areas, villages give free housing and exemptions to property taxes for doctors.

  10. #10
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    for-profit health care has failed, sucking wealth from Americans, per capita cost 50% more than other countries with worse results

  11. #11
    I play pretty, no? TeyshaBlue's Avatar
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    lo is quite popular is over-doctored countries like France. very hard to find a spot to start a practice, so young doctors sub for vacationing docs.

    in under-served rural areas, villages give free housing and exemptions to property taxes for doctors.
    Sounds like teaching in Alaska.

  12. #12
    Esse quam videri ploto's Avatar
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    The thing that strikes me from that article is that he says only one third of his patients were Medicare patients, but yet changes in those was enough to bust his practice. I can only assume the other two thirds were insured? I would think he was very well reimbursed from them.

    Doctors are not famous for being business savvy. When I was in nursing school I worked parttime for one of the most prominent pulmonologists in the state. My job was to make rounds of the various hospitals and have his patients sign their Medicare/insurance papers to be submitted. The Medicare papers were submitted immediately and reimbursed immediately, no questions asked. The insurance papers ac ulated on the desks for months, because they required so much more do entation, and then after months of back and forth "negotiations" were eventually reimbursed. I think the guy in the article could have been the same way, made his business too dependent on the easy money.
    The doctor is full of it. Software for an electronic medical record system does not cost $100,000. And Medicare reimburses faster than most private insurance companies and at a higger rate than some.

  13. #13
    W4A1 143 43CK? Nbadan's Avatar
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    And Medicare reimburses faster than most private insurance companies and at a higger rate than some.
    Pretty much what she said...imo...

  14. #14
    I am that guy RandomGuy's Avatar
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    Short, but interesting read. Never heard of lo tenens as a alternate career path.

    http://money.cnn.com/2013/04/25/smal....html?iid=Lead
    That kind of brain drain bodes ill for the US.

    Less supply + more demand = higher prices.

    WHen you are talking about doctors that can add up real quick.

    I do get that from a lot of what I read about doctors, and what I see personally with my own PCP.

    Too business-y.

    You have some serious information assymetry issues, and the fact that health care demand tends to be very inelastic (not sensitive to price)

    WH posted a really good, if long, article about the business of health providers.

    Our problem is that we can do a lot for things we didn't used to be able to do anything about 50 years ago.

    Being a doctor is a LOT more complicated for that reason.

  15. #15
    I am that guy RandomGuy's Avatar
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    Lo tenens has been real popular in nursing and allied health for as long as I can remember. For doctors I think it's relatively new, but I don't really know as I have only ever worked at teaching hospitals and never experienced a doctor shortage.

    The thing that strikes me from that article is that he says only one third of his patients were Medicare patients, but yet changes in those was enough to bust his practice. I can only assume the other two thirds were insured? I would think he was very well reimbursed from them.

    Doctors are not famous for being business savvy.[emphasis mine-RG] When I was in nursing school I worked parttime for one of the most prominent pulmonologists in the state. My job was to make rounds of the various hospitals and have his patients sign their Medicare/insurance papers to be submitted. The Medicare papers were submitted immediately and reimbursed immediately, no questions asked. The insurance papers ac ulated on the desks for months, because they required so much more do entation, and then after months of back and forth "negotiations" were eventually reimbursed. I think the guy in the article could have been the same way, made his business too dependent on the easy money.
    Yeah, I get that impression.

    I am HIGHLY tempted to go into the business of health care business consulting. B-School meets Med-school.

    Doctors are no different than any other small business.

    I always tell people that it takes two skill sets to run a successful small business.

    One is that you need to have the skills to sell. If you are a printer you need to know printing, if you are a doctor, you need to have medical knowledge, etc.

    The other, and this is where small business people tend to fail is that they need to have knowledge of how to make money at selling that skill/product. That requires some knowledge of accounting that most people lack.

    For me it was always extremely rewarding to help people with their businesses, because I have exactly that skill set to help people.

    I think the fact that medical records are still not computerized screams about how poorly doctors tend to run their practices from a business perspective.

  16. #16
    🏆🏆🏆🏆🏆 ElNono's Avatar
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    I guess I'm supposed to feel sorry for a guy that can't make ends meet making $150K/year?

  17. #17
    🏆🏆🏆🏆🏆 ElNono's Avatar
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    On the other hand, I'm glad that he seems genuinely happy of finding a new career path.

  18. #18
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    I guess I'm supposed to feel sorry for a guy that can't make ends meet making $150K/year?
    doesn't say whether $150K is his gross or net.

  19. #19
    Esse quam videri ploto's Avatar
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    Pretty much what she said...imo...
    I agreed with her.

  20. #20
    Esse quam videri ploto's Avatar
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    The other, and this is where small business people tend to fail is that they need to have knowledge of how to make money at selling that skill/product. That requires some knowledge of accounting that most people lack...

    I think the fact that medical records are still not computerized screams about how poorly doctors tend to run their practices from a business perspective.
    Part of the problem is that many doctors think they are smarter than everyone else and will not listen to other people who know more about running a business than they do.

  21. #21
    W4A1 143 43CK? Nbadan's Avatar
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    Physician says Affordable Care Act an 'experiment' that will fail

    DAWES, W.Va. -- The Affordable Care Act is an experiment that will fail, the head of an organization that advocates for a single-payer health system argued Thursday.

    "People will not be able to afford the health insurance that they're being pushed to buy," Dr. Andrew Coates, president of Physicians for a National Health Program (PNHP), said during a visit to West Virginia on Thursday. "And when they do buy it, it won't be good enough to cover health-care calamity."

    Under the ACA, health insurance premiums and deductibles will not be affordable, Coates argued.

    "I think it's a big experiment to drive people to (the health insurance) marketplace but the health insurance marketplace hasn't worked for years now and I don't see any evidence that's going to change," he said.

    <snip>

    "People say (a single-payer system) can't work here," said Dr. James Binder of the West Virginia chapter. "That's not true.
    "
    http://www.wvgazette.com/News/201304250121

  22. #22
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    I want to the Repugs scream, and holler and and defund ACA and thereby lay the groundswell for hard-core public public health insurance option for everybody, even allowing employees to opt out employer group plans.

    next would be govt health care, like the VA, with salaried, coordinated care, computerized doctors, not fee-for-excessive-service doctors.

    We need back the predatory health care industry as hard as they have been ing and sucking our wealth for decades.

  23. #23
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    Exclusive survey: Practice expenses



    Primary care physicians spent more than half of their 2002 practice revenue on operating expenses, according to the latest Medical Economics Continuing Survey, which samples MDs and DOs in office-based practice. Doctors in the specialty fields we analyzed—invasive and noninvasive cardiology, gastroenterology, general surgery, and orthopedic surgery—fared a bit better. But even those doctors spent from 43 to 50 percent of their earnings on overhead.

    The biggest outlay was for office payroll, which easily outpaces the other two high-priced items: rent (or mortgage payments) and malpractice insurance premiums. "Without question, the greatest rise in expenses in California and Arizona over the past 24 months has been related to staffing and insurance," says Judy Capko, a consultant in Thousand Oaks, CA.
    "Workers' compensation has nearly doubled, and unemployment costs are increasing even more rapidly," she adds.

    "Some practices are reducing fringe benefits and limiting pay hikes to the increase in the Consumer Price Index."The situation is the same in the Northeast. Rising health insurance costs are pushing staff expenditures skyward, according to Kenneth Bowden, a consultant in Pittsfield, MA.

    "It used to be a fairly minor line item; now it's way off the charts. As a result, some doctors are asking employees to pay as much as 50 percent of their health insurance premiums." Malpractice costs, too, are "out of control," Bowden notes, "especially in Connecticut and Massachusetts, to the point where it's driving doctors out."



    - See more at: http://medicaleconomics.modernmedici....EslNt2Pk.dpuf


    http://medicaleconomics.modernmedici...ctice-expenses

  24. #24
    Cinnamon Girl mrsmaalox's Avatar
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    Yeah, I get that impression.

    I am HIGHLY tempted to go into the business of health care business consulting. B-School meets Med-school.

    Doctors are no different than any other small business.

    I always tell people that it takes two skill sets to run a successful small business.

    One is that you need to have the skills to sell. If you are a printer you need to know printing, if you are a doctor, you need to have medical knowledge, etc.

    The other, and this is where small business people tend to fail is that they need to have knowledge of how to make money at selling that skill/product. That requires some knowledge of accounting that most people lack.

    For me it was always extremely rewarding to help people with their businesses, because I have exactly that skill set to help people.

    I think the fact that medical records are still not computerized screams about how poorly doctors tend to run their practices from a business perspective.
    That's a great idea, there is a great need. Your biggest obstacle, however, would probably be busting the "doctor's wife as office manager" business model. While they may have some bookkeeping/secretarial type skills, usually their strongest skill in the business is to quell any possible NEW wife/office manager from emerging from the ranks

  25. #25
    Esse quam videri ploto's Avatar
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    That's a great idea, there is a great need. Your biggest obstacle, however, would probably be busting the "doctor's wife as office manager" business model. While they may have some bookkeeping/secretarial type skills, usually their strongest skill in the business is to quell any possible NEW wife/office manager from emerging from the ranks

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