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	<title>Comments on: Another Facet of the Health Care Crisis: Miserable Doctors</title>
	<link>http://blogs.discovermagazine.com/realitybase/2008/11/19/another-facet-of-the-health-care-crisis-miserable-doctors/</link>
	<description>A blog about science, politics, and how to let each help the other without compromising them both.</description>
	<pubDate>Thu, 08 Jan 2009 09:41:38 +0000</pubDate>
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		<title>By: badnicolez</title>
		<link>http://blogs.discovermagazine.com/realitybase/2008/11/19/another-facet-of-the-health-care-crisis-miserable-doctors/#comment-4321</link>
		<dc:creator>badnicolez</dc:creator>
		<pubDate>Tue, 16 Dec 2008 19:47:40 +0000</pubDate>
		<guid>http://blogs.discovermagazine.com/realitybase/2008/11/19/another-facet-of-the-health-care-crisis-miserable-doctors/#comment-4321</guid>
		<description>Scott, great points.  

What we need is a simple, quick, cheap, reliable OTC test for the common cold.  Then docs could require test results from patients before scheduling appointments.  This would also cut down on transmission of the virus to the staff and in the waiting rooms at clinics.

I still have friends and family who, when sick with a cold, rush straight to the doc who invariably gives them an rx for antibiotics.  I tell them it won't help, but sure enough, when they feel better in a few days, they credit the drugs and then stop taking them!  When I tell them they're doing more harm than good, they don't believe me.  People think antibiotics are harmless and a cure-all.  We need better education on this, and that starts with the doctors.</description>
		<content:encoded><![CDATA[<p>Scott, great points.  </p>
<p>What we need is a simple, quick, cheap, reliable OTC test for the common cold.  Then docs could require test results from patients before scheduling appointments.  This would also cut down on transmission of the virus to the staff and in the waiting rooms at clinics.</p>
<p>I still have friends and family who, when sick with a cold, rush straight to the doc who invariably gives them an rx for antibiotics.  I tell them it won&#8217;t help, but sure enough, when they feel better in a few days, they credit the drugs and then stop taking them!  When I tell them they&#8217;re doing more harm than good, they don&#8217;t believe me.  People think antibiotics are harmless and a cure-all.  We need better education on this, and that starts with the doctors.</p>
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		<title>By: Scott</title>
		<link>http://blogs.discovermagazine.com/realitybase/2008/11/19/another-facet-of-the-health-care-crisis-miserable-doctors/#comment-4113</link>
		<dc:creator>Scott</dc:creator>
		<pubDate>Tue, 25 Nov 2008 22:01:13 +0000</pubDate>
		<guid>http://blogs.discovermagazine.com/realitybase/2008/11/19/another-facet-of-the-health-care-crisis-miserable-doctors/#comment-4113</guid>
		<description>There are many frustrations in health care. There always have been,but since I returned to the US in 2005(I was overseas from 2001-2004), I have been dumfounded by the number of times I find insurance companies practicing medicine.  If they want to change a patients medication or testing regimen, they should be responsible for the consequences.  medical providers are.  We also have restrictions on providing medical care without an evaluation.  If insurance companies were held to the same standard, their meddling would cease.
Also, after 15 years as a clinician, I'm beginning to think certain illnesses should not be seen by medical providers.  Take the common cold, for instance.  There is no evidence that anything, with the possible exception of over the counter decongestants, makes a difference.  Isn't that a waste of patient visits that could be used for patients that have treatable illnesses?</description>
		<content:encoded><![CDATA[<p>There are many frustrations in health care. There always have been,but since I returned to the US in 2005(I was overseas from 2001-2004), I have been dumfounded by the number of times I find insurance companies practicing medicine.  If they want to change a patients medication or testing regimen, they should be responsible for the consequences.  medical providers are.  We also have restrictions on providing medical care without an evaluation.  If insurance companies were held to the same standard, their meddling would cease.<br />
Also, after 15 years as a clinician, I&#8217;m beginning to think certain illnesses should not be seen by medical providers.  Take the common cold, for instance.  There is no evidence that anything, with the possible exception of over the counter decongestants, makes a difference.  Isn&#8217;t that a waste of patient visits that could be used for patients that have treatable illnesses?</p>
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		<title>By: John P. DeFede, RN</title>
		<link>http://blogs.discovermagazine.com/realitybase/2008/11/19/another-facet-of-the-health-care-crisis-miserable-doctors/#comment-4107</link>
		<dc:creator>John P. DeFede, RN</dc:creator>
		<pubDate>Tue, 25 Nov 2008 05:43:49 +0000</pubDate>
		<guid>http://blogs.discovermagazine.com/realitybase/2008/11/19/another-facet-of-the-health-care-crisis-miserable-doctors/#comment-4107</guid>
		<description>I sometimes wonder why students ever keep going into the health care field in this country. I know they have chosen this career. I have worked in CCU/ICU, a MD's office(Cardiology), home health and as a supervising nurse in two different sized hospitals. One is a large 350+ bed hospital and the other a small 50 bed hospital. Patients and staff wonder why doctors come in to visit late at night or early in the am. Many private doctors start rounds in the early am before clinic starts, then go to clinic, lunch is spent continuing rounds or procedures, then back to clinic. After clinic closes at 5-6-7pm they go back to the hospitals to see new pts. If they are smart they go home to see their families for a short bit (they do have families, and showing their presence helps maintain family stability). 

More often than not I see physicians coming in to the hospital to see pts. in the wee hours of the morning (2-3am). Especially, the doctors with critical care pts. People get sick at all hours of the day or night, and families want to know what is going to happen to their loved ones. 

I agree with Martin Jones as to the paper work. I call it the 80/20 rule. 80% paper work/20% direct patient contact. Even as a nurse in home health I could spend an hour in the home but spend 5-6 hours doing the paper work(admission, followup, supervisor visits with home health aides, and recerts, etc..). Like myself, physicians, continue working in the health care field because it is a part of their being. But there is plenty of frustration and paper work to go around.</description>
		<content:encoded><![CDATA[<p>I sometimes wonder why students ever keep going into the health care field in this country. I know they have chosen this career. I have worked in CCU/ICU, a MD&#8217;s office(Cardiology), home health and as a supervising nurse in two different sized hospitals. One is a large 350+ bed hospital and the other a small 50 bed hospital. Patients and staff wonder why doctors come in to visit late at night or early in the am. Many private doctors start rounds in the early am before clinic starts, then go to clinic, lunch is spent continuing rounds or procedures, then back to clinic. After clinic closes at 5-6-7pm they go back to the hospitals to see new pts. If they are smart they go home to see their families for a short bit (they do have families, and showing their presence helps maintain family stability). </p>
<p>More often than not I see physicians coming in to the hospital to see pts. in the wee hours of the morning (2-3am). Especially, the doctors with critical care pts. People get sick at all hours of the day or night, and families want to know what is going to happen to their loved ones. </p>
<p>I agree with Martin Jones as to the paper work. I call it the 80/20 rule. 80% paper work/20% direct patient contact. Even as a nurse in home health I could spend an hour in the home but spend 5-6 hours doing the paper work(admission, followup, supervisor visits with home health aides, and recerts, etc..). Like myself, physicians, continue working in the health care field because it is a part of their being. But there is plenty of frustration and paper work to go around.</p>
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		<title>By: Ken Kenigsberg</title>
		<link>http://blogs.discovermagazine.com/realitybase/2008/11/19/another-facet-of-the-health-care-crisis-miserable-doctors/#comment-4106</link>
		<dc:creator>Ken Kenigsberg</dc:creator>
		<pubDate>Tue, 25 Nov 2008 04:36:44 +0000</pubDate>
		<guid>http://blogs.discovermagazine.com/realitybase/2008/11/19/another-facet-of-the-health-care-crisis-miserable-doctors/#comment-4106</guid>
		<description>another strong argument for a single payer system</description>
		<content:encoded><![CDATA[<p>another strong argument for a single payer system</p>
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		<title>By: Marie Tovaas, RN</title>
		<link>http://blogs.discovermagazine.com/realitybase/2008/11/19/another-facet-of-the-health-care-crisis-miserable-doctors/#comment-4102</link>
		<dc:creator>Marie Tovaas, RN</dc:creator>
		<pubDate>Tue, 25 Nov 2008 01:45:45 +0000</pubDate>
		<guid>http://blogs.discovermagazine.com/realitybase/2008/11/19/another-facet-of-the-health-care-crisis-miserable-doctors/#comment-4102</guid>
		<description>My own experience with Nurse Practitioners has been that they give excellent care to patient's with the very time-consuming "ordinary" complaints.  Colds, flu, routine well-baby care and immunizations, ear infections, urinary tract infections, diabetes, the list goes on and on.  The NP with both a Bachelor's and Master's degree in Nursing and years of experience dealing with patients before she ever became an NP translate to a highly qualified front line caregiver who can take the load off the medical doctors.  As for the Physician's Assistant, many of them are also excellent caregivers, and some have made incredibly valuable assistant surgeons in specialized areas. but the PA, with only two years of education in the field (think English majors who get a specialzed Master's in PA) and varying experience in the healthcare field, has to work under the direct supervision of the physician whereas NP's have independent practice licensure.

More use of both of these practitioners can make healthcare more accessible AND more interesting to the MD's and DO's.

It is extremely unfair to compare a Nurse Practitioner with a PT Assistant who has a two year degree at best and cannot even write a legal order out from a physician.

Please take these things into your consideration.  Thank you</description>
		<content:encoded><![CDATA[<p>My own experience with Nurse Practitioners has been that they give excellent care to patient&#8217;s with the very time-consuming &#8220;ordinary&#8221; complaints.  Colds, flu, routine well-baby care and immunizations, ear infections, urinary tract infections, diabetes, the list goes on and on.  The NP with both a Bachelor&#8217;s and Master&#8217;s degree in Nursing and years of experience dealing with patients before she ever became an NP translate to a highly qualified front line caregiver who can take the load off the medical doctors.  As for the Physician&#8217;s Assistant, many of them are also excellent caregivers, and some have made incredibly valuable assistant surgeons in specialized areas. but the PA, with only two years of education in the field (think English majors who get a specialzed Master&#8217;s in PA) and varying experience in the healthcare field, has to work under the direct supervision of the physician whereas NP&#8217;s have independent practice licensure.</p>
<p>More use of both of these practitioners can make healthcare more accessible AND more interesting to the MD&#8217;s and DO&#8217;s.</p>
<p>It is extremely unfair to compare a Nurse Practitioner with a PT Assistant who has a two year degree at best and cannot even write a legal order out from a physician.</p>
<p>Please take these things into your consideration.  Thank you</p>
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		<title>By: David</title>
		<link>http://blogs.discovermagazine.com/realitybase/2008/11/19/another-facet-of-the-health-care-crisis-miserable-doctors/#comment-4099</link>
		<dc:creator>David</dc:creator>
		<pubDate>Mon, 24 Nov 2008 22:40:47 +0000</pubDate>
		<guid>http://blogs.discovermagazine.com/realitybase/2008/11/19/another-facet-of-the-health-care-crisis-miserable-doctors/#comment-4099</guid>
		<description>I agree with Dr. Jones, and I also like to point out that MD's with Northern European names like Jones, are going away, slowly but surely. Look at Kaiser's web site and check out the MD's, just about 90%+ are educated in some other country, I'm not saying they aren't qualified, they have to pass the exams here the same as American MD's. But;

 I like to hear plain ol'English, spoken by someone with a soft Tennessee or California or New England accent. It will be soon, when there will be 10 to 15 PA's/NP's to one MD supervisor, like the Physical Therapy Clinics do already with their physical therapy aids. 

Yep, quality care is dropping...as we move further into socialism...</description>
		<content:encoded><![CDATA[<p>I agree with Dr. Jones, and I also like to point out that MD&#8217;s with Northern European names like Jones, are going away, slowly but surely. Look at Kaiser&#8217;s web site and check out the MD&#8217;s, just about 90%+ are educated in some other country, I&#8217;m not saying they aren&#8217;t qualified, they have to pass the exams here the same as American MD&#8217;s. But;</p>
<p> I like to hear plain ol&#8217;English, spoken by someone with a soft Tennessee or California or New England accent. It will be soon, when there will be 10 to 15 PA&#8217;s/NP&#8217;s to one MD supervisor, like the Physical Therapy Clinics do already with their physical therapy aids. </p>
<p>Yep, quality care is dropping&#8230;as we move further into socialism&#8230;</p>
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		<title>By: Martin Jones MD</title>
		<link>http://blogs.discovermagazine.com/realitybase/2008/11/19/another-facet-of-the-health-care-crisis-miserable-doctors/#comment-4097</link>
		<dc:creator>Martin Jones MD</dc:creator>
		<pubDate>Mon, 24 Nov 2008 20:38:28 +0000</pubDate>
		<guid>http://blogs.discovermagazine.com/realitybase/2008/11/19/another-facet-of-the-health-care-crisis-miserable-doctors/#comment-4097</guid>
		<description>I agree with this article. The state medicaid system &#038; the feds for some reason have taken the tact of reducing doctors reembusements in order to stem the increasing medical costs (they think). They are already 6 years behind inflation &#038; increased cost to do business adjustments based on the 
CPI. In order to see a medicaid Patient in Michigan, we have to come out of pocket $12-15 to pay office expenses for each patient seen because of the states paltry reembusement ( then you wonder why many doctors limit the number of medicaid patients they see, if they will see them(which many do  not). When i retired I spent 1-2 hours afer patients had gone to do all the required paper work(Of course unreembursed time). I was getting less for an hour consultation from medicare than plumbers, electricians, car mechanics etc. If they want to cut costs, go after insurance co. administrative salries, hospital charges &#038; inefficiencies, etc. If they don't wise up there won't be any doctors left who can afford to see medicaid &#038; medicare patients! I miss seeing patients and working out their problems and sometimes turning their lives aroound, but the insurance cos &#038; government can jam it, i'll stay retired!</description>
		<content:encoded><![CDATA[<p>I agree with this article. The state medicaid system &#038; the feds for some reason have taken the tact of reducing doctors reembusements in order to stem the increasing medical costs (they think). They are already 6 years behind inflation &#038; increased cost to do business adjustments based on the<br />
CPI. In order to see a medicaid Patient in Michigan, we have to come out of pocket $12-15 to pay office expenses for each patient seen because of the states paltry reembusement ( then you wonder why many doctors limit the number of medicaid patients they see, if they will see them(which many do  not). When i retired I spent 1-2 hours afer patients had gone to do all the required paper work(Of course unreembursed time). I was getting less for an hour consultation from medicare than plumbers, electricians, car mechanics etc. If they want to cut costs, go after insurance co. administrative salries, hospital charges &#038; inefficiencies, etc. If they don&#8217;t wise up there won&#8217;t be any doctors left who can afford to see medicaid &#038; medicare patients! I miss seeing patients and working out their problems and sometimes turning their lives aroound, but the insurance cos &#038; government can jam it, i&#8217;ll stay retired!</p>
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