I see two specialists:
(a) A urologist who spent hours with me when he first saw me and I was a lot sicker because other urologists hadn't managed things right. He would have 45 minute appointments, going over all the options, explaining catheterization techniques and many other options. We went through a lot of things, now I am basically cured from UTIs and have no problem catheterizing, mainly because of him. Now he sees me once a year to touch base for about 20 minutes, he's being very careful. He is one of the best specialists I've met and one of the few who have ever really helped me. He also does free consultation a few times a year when I have labs done if I'm feeling a bit under the weather (but these nowadays always self-resolve).
(b) A gastroenterologist, who sees me for literally 5 minutes. Does no exam, prescribes some random drug which never works, then I have to come back.
So what's my point? One good specialist, one bad one, who cares?
The point is this: Medicare reimburses doctors the same for each visit. A 5-minute visit that is unhelpful nets the doctor the same money as a 45-minute that cures the problem. So the gastroenterologist ends up making about 10 times what the urologist makes - even though the gastroenterologist doesn't cure my problems and the urologist does!
So that in a nutshell is what bugs me about the medical profession. It's the only profession I know where the worse a worker performs, the more money he makes.
I don't know the solution, but I think Medicare should pay for results, or for results and time spent, not just "appointments". A lot of us have very complex, unusual medical issues, and it frustrates me that the system seems stacked against doctors who want to help us.
An example of what's wrong with the way the medical profession works
(a) A urologist who spent hours with me when he first saw me and I was a lot sicker because other urologists hadn't managed things right. He would have 45 minute appointments, going over all the options, explaining catheterization techniques and many other options. We went through a lot of things, now I am basically cured from UTIs and have no problem catheterizing, mainly because of him. Now he sees me once a year to touch base for about 20 minutes, he's being very careful. He is one of the best specialists I've met and one of the few who have ever really helped me. He also does free consultation a few times a year when I have labs done if I'm feeling a bit under the weather (but these nowadays always self-resolve).
(b) A gastroenterologist, who sees me for literally 5 minutes. Does no exam, prescribes some random drug which never works, then I have to come back.
So what's my point? One good specialist, one bad one, who cares?
The point is this: Medicare reimburses doctors the same for each visit. A 5-minute visit that is unhelpful nets the doctor the same money as a 45-minute that cures the problem. So the gastroenterologist ends up making about 10 times what the urologist makes - even though the gastroenterologist doesn't cure my problems and the urologist does!
So that in a nutshell is what bugs me about the medical profession. It's the only profession I know where the worse a worker performs, the more money he makes.
I don't know the solution, but I think Medicare should pay for results, or for results and time spent, not just "appointments". A lot of us have very complex, unusual medical issues, and it frustrates me that the system seems stacked against doctors who want to help us.
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