Thru the looking glass went Alice and so have I... today a beloved patient lost their insurance. Well, I should not be surprised that happens every day here in rural working class America, but this patient - patient X - cannot work... matter of fact this patient has a terminal illness and may die without access to medicine and medical support. When I called the insurance company I was informed that the patient had failed to turn in a form for review to be able to keep the insurance and so had been terminated from the plan due to sweeping state sponsored cuts. This form had not been completed because the patient was admitted in another hospital miles away from home fighting for survival. Oh, it did not matter, insurance still gone.
So, angry, I called a state senators office. No, the senator was not in. No, they could not be reached, but please send us the information and we will forward it to the insurance company and try to help.
I am really getting frustrated at this point. Our president is on the TV telling everyone how he is going to force health care reform and his plan looks awful to me as a practicing MD - more cuts and more forms and more "Mother may I please..." and a board to decide if my patients lives are worth enough to treat... So then, I have to go treat my next patient after being torn up over my patients loss of access to care and medicine. Wouldn't you believe that my very next patient is a 20's year old, who has been previously convicted insurance fraud, who needs something for pain.
I think that we have gone down the rabbit hole. When did we as a society forget how to work, when did young people want to be on disability and let the state and nation pay for them instead of having pride in themselves?
Health care reform needs to occur - I am not disagreeing with anyone on that. Less than 10% of a medical schools class goes into primary care now and of those less than 4% will go into a rural area to practice. In 7-10 years we will be facing a shortage of primary care (family medicine, general internist, general peds) doctors because everyone wants to be a specialist in America... Why it pays better... and when you come out of school on average $140,000 in debt you need to get paid. Now with physicians facing a 21% cut in pay looks like I should have been a specialist too. Every other civilized country pays for prevention and primary care first and as a result has better health care than the USA does. Yes that is right, among our peers - we always rank in the bottom for health care outcomes. Maybe the lawyers should consider that health care reform cannot occur without TORT reform. You cannot practice good medicine without being able to tell the fakers and drug seekers to get out. I spend 50% of my time on 30% of my patients and it is the same 30%. These are the patients that take their children to the ED in the middle of the night for a runny nose just because they can - Why not they have no co-pay like the rest of us do...
See the many problems you can get into with health care reform... I want the system fixed. I love my job and my patients. Why else would I have stopped in the middle of my day, gotten behind, and beaten my head against a wall for one person...
Thursday, February 25, 2010
Tuesday, February 23, 2010
Home again Home again
This past weekend has been a blast for me. I got to travel with some great Young Farmer and Rancher buddies from all across the great state of TN. To spend time meeting new friends from all over the nation. The goal learning to be better advocates for agriculture. It still blows my mind that we need advocates for agriculture, but then I go and hang out with my physician type highly educated friends and realize very much why we do what we do for Agriculture. The average American is 3 generations removed from the farm and relies heavily on mainstream media to get their information on what a farm is and does. I don't know about you but I think that makes as much sense as letting a bunch of lawyers reform our health care system as to continue to let Katie Couric be an educated source about agriculture.
Did you as know that in Congress there are only 12 elected officials that have spent at least six months on a working farm or ranch? And did you know that of those 12, 2 are retiring? The average Congress official and staffer need to hear from us about why the laws that they pass may not make sense in the real world.
We learned this weekend to take advantage of social media to promote what we do and to be better prepared to advocate for our industry. Yes we are a generation of farmers but that does not mean we are uneducated as is often perceived. I for example have a medical degree and a fellowship and believe me you do not want to watch me drive the tractor, let alone try to plow or bale hay with it. My Husband keeps up with birth weights for our cattle, breeding times and bloodlines, when fertilizer is applied and how much too apply, and that are just a few of the many health and environmental concerns that are his daily facts of life. Each aspect of production agriculture is just as technical anymore, but at the heart we are still the people who love our land. But I also know that the average educated MBA could not even figure out how to get a combine to start, let alone function for hours on end to get crops in.
I want to continue this way of life that I and my husband love, so we will continue to miss ball games and plays for Farm Bureau functions and medical conferences. I hope that somewhere out there in America there still is an America that cares about who we are and what we do. Cause I know how devoted we both are to agriculture and all I can ever remember wanting to be is a doctor. Now I see threats to both every day.
I've wanted to work as a doctor in my home town my whole life. But now due to health care issues in DC, I am facing severe economic difficulties with that choice. And its not just me its doctors everywhere dealing with cutbacks from Medicare and Medicaid programs while insurance companies and the center for Medicare wants more and more quality control. Its kinda like how I feel when I ride the tea cup rides with my two girls and we keep spinning around faster and faster, except here lately my life does not seem to stop. Remember that for the most part your doctor wants to keep you healthy and if they are like me they agree that we need health care reform. However, I refuse to believe what the President has proposed will help this country.
Every day I worry, and now most days I write. Change needs to come soon, or I fear there will be no one left who cares if changes occur...
Did you as know that in Congress there are only 12 elected officials that have spent at least six months on a working farm or ranch? And did you know that of those 12, 2 are retiring? The average Congress official and staffer need to hear from us about why the laws that they pass may not make sense in the real world.
We learned this weekend to take advantage of social media to promote what we do and to be better prepared to advocate for our industry. Yes we are a generation of farmers but that does not mean we are uneducated as is often perceived. I for example have a medical degree and a fellowship and believe me you do not want to watch me drive the tractor, let alone try to plow or bale hay with it. My Husband keeps up with birth weights for our cattle, breeding times and bloodlines, when fertilizer is applied and how much too apply, and that are just a few of the many health and environmental concerns that are his daily facts of life. Each aspect of production agriculture is just as technical anymore, but at the heart we are still the people who love our land. But I also know that the average educated MBA could not even figure out how to get a combine to start, let alone function for hours on end to get crops in.
I want to continue this way of life that I and my husband love, so we will continue to miss ball games and plays for Farm Bureau functions and medical conferences. I hope that somewhere out there in America there still is an America that cares about who we are and what we do. Cause I know how devoted we both are to agriculture and all I can ever remember wanting to be is a doctor. Now I see threats to both every day.
I've wanted to work as a doctor in my home town my whole life. But now due to health care issues in DC, I am facing severe economic difficulties with that choice. And its not just me its doctors everywhere dealing with cutbacks from Medicare and Medicaid programs while insurance companies and the center for Medicare wants more and more quality control. Its kinda like how I feel when I ride the tea cup rides with my two girls and we keep spinning around faster and faster, except here lately my life does not seem to stop. Remember that for the most part your doctor wants to keep you healthy and if they are like me they agree that we need health care reform. However, I refuse to believe what the President has proposed will help this country.
Every day I worry, and now most days I write. Change needs to come soon, or I fear there will be no one left who cares if changes occur...
Thursday, February 18, 2010
Working and Travel
Today is a busy day for me. It started off with a medical staff meeting which I got up early for. Made arrangements for Cord to get to daycare with Brian and still managed to walk in to the meeting as the meeting wrapped up. Apparently the head doc starts early and runs a quick meeting. BOY that made me feel stupid. Plus I had walked all over the hospital to find the meeting cause the memo that I got just said meeting - not where. Now I have gone on to being late to the office and now have snuck in a few minutes to blog about the stupidity of being late.
I had a difficult patient this am - the patient is going to have to change every thing about themselves and wanted a quick fix to do this. So many patients that I see are in a medical problem due to social behaviors and want an easy way out. As I had to tell this patient there is not one. When we indulge in bad behaviors we pay the price. Oh well, enough day job preaching...
Brian was out late last night working to get the farm ready for our trip to Tulsa. He was breeding cows at 9pm. He had them all synchronized and that is when they were ready. today he has to get all the hay out and feed set up for my father in law and get two girls set up for a long weekend with my in laws. Given my day job he gets to do a lot of the getting the kids ready duties. On a positive note, Cordell is flying with us this time.
The only major other issue facing me right now is whether or not Congress will fix the SGR. This is the very flawed formula on which physician payment is based. If there is no fix reached by March 1rst physicians will face a 21% pay cut in Medicare patients, this is unacceptable. This would force most doctors to stop treating medicare patients and since medicare rates are often used to set private insurance rates... See the problem. With that kind of cut in pay our office in our small town will no longer be able to practice with the current patient mix. Already two of my partners have stopped taking new Tenncare patients and I fear these SGR problems may force our practice into more budget decisions. So please, feel free to call your Congressman and let them know that you want physician payments from Medicare fixed at an appropriate level for 2010... if we can bail out banks we can save Medicare for our Seniors.
Oh well, now back to work till later then home to pack and ready to Fly to Tulsa in AM - Off for YF&R leadership ...
I had a difficult patient this am - the patient is going to have to change every thing about themselves and wanted a quick fix to do this. So many patients that I see are in a medical problem due to social behaviors and want an easy way out. As I had to tell this patient there is not one. When we indulge in bad behaviors we pay the price. Oh well, enough day job preaching...
Brian was out late last night working to get the farm ready for our trip to Tulsa. He was breeding cows at 9pm. He had them all synchronized and that is when they were ready. today he has to get all the hay out and feed set up for my father in law and get two girls set up for a long weekend with my in laws. Given my day job he gets to do a lot of the getting the kids ready duties. On a positive note, Cordell is flying with us this time.
The only major other issue facing me right now is whether or not Congress will fix the SGR. This is the very flawed formula on which physician payment is based. If there is no fix reached by March 1rst physicians will face a 21% pay cut in Medicare patients, this is unacceptable. This would force most doctors to stop treating medicare patients and since medicare rates are often used to set private insurance rates... See the problem. With that kind of cut in pay our office in our small town will no longer be able to practice with the current patient mix. Already two of my partners have stopped taking new Tenncare patients and I fear these SGR problems may force our practice into more budget decisions. So please, feel free to call your Congressman and let them know that you want physician payments from Medicare fixed at an appropriate level for 2010... if we can bail out banks we can save Medicare for our Seniors.
Oh well, now back to work till later then home to pack and ready to Fly to Tulsa in AM - Off for YF&R leadership ...
Monday, February 15, 2010
Day one - Trying this out
Well...
I have been told that I should try this and that I always have something to say but now I seem to be at a loss for words. I am simply what the title of this says a rural family doctor and a farmers wife. Some days I am prouder of one of those than the other, but mostly I am more proud to be my husbands wife. You see, he married me and stood by me when I was just plain old me. He never complained when I came home smelling like formalydehide and had weird stains on my scrubs that never went away. He never complained when my new best friends in medical school were gay. He put up with the long hours miles away from the farm and when he had to he drove the 2 plus hours home to put up hay or work cows and then drove home to crawl in bed with his new wife who more than likely at that point in my life was not proud of what he had been doing.
You see, I grew up in agriculture as a Vets daughter and granddaughter but I knew there was NO way that I was sticking my arm that far up anything. So by the time I met Brian, I had decided on a carrier in medicine which is no walk in the park. Even though the only thing he has ever wanted to be is an American Farmer on his family farm, he fell in love with me anyway. We have survived medical school, residency, and now we are surviving daily work in a rural area that we are both proud to call home. And I am proud to say that somewhere along the way, I have grown into agriculture. I can drive a tractor and put up hay. I know how to tell when an animal needs medical attention, but trust me I am still not putting my arm that far up anything. I'll leave that up to him and the hired high school help.
Home is something I hope to share with you. We are both very active in Farm Bureau and have been proud to represent our state at the national Excellence in Agriculture competition this year. We have three children that I hope to get you to know, and lots of funny family stories too.
There will be good times and bad times - but isn't that what we call life. Just today I had to call DCS. Believe me that is never my favorite phone call. Today was busy even with the snow, admissions, and office visits, and emails to senators kept work full. Then it was time to come home to diner and time with the family.
Ella, our oldest, had two of her teeth pulled today too. SO I had better go be the tooth fairy ...
I have been told that I should try this and that I always have something to say but now I seem to be at a loss for words. I am simply what the title of this says a rural family doctor and a farmers wife. Some days I am prouder of one of those than the other, but mostly I am more proud to be my husbands wife. You see, he married me and stood by me when I was just plain old me. He never complained when I came home smelling like formalydehide and had weird stains on my scrubs that never went away. He never complained when my new best friends in medical school were gay. He put up with the long hours miles away from the farm and when he had to he drove the 2 plus hours home to put up hay or work cows and then drove home to crawl in bed with his new wife who more than likely at that point in my life was not proud of what he had been doing.
You see, I grew up in agriculture as a Vets daughter and granddaughter but I knew there was NO way that I was sticking my arm that far up anything. So by the time I met Brian, I had decided on a carrier in medicine which is no walk in the park. Even though the only thing he has ever wanted to be is an American Farmer on his family farm, he fell in love with me anyway. We have survived medical school, residency, and now we are surviving daily work in a rural area that we are both proud to call home. And I am proud to say that somewhere along the way, I have grown into agriculture. I can drive a tractor and put up hay. I know how to tell when an animal needs medical attention, but trust me I am still not putting my arm that far up anything. I'll leave that up to him and the hired high school help.
Home is something I hope to share with you. We are both very active in Farm Bureau and have been proud to represent our state at the national Excellence in Agriculture competition this year. We have three children that I hope to get you to know, and lots of funny family stories too.
There will be good times and bad times - but isn't that what we call life. Just today I had to call DCS. Believe me that is never my favorite phone call. Today was busy even with the snow, admissions, and office visits, and emails to senators kept work full. Then it was time to come home to diner and time with the family.
Ella, our oldest, had two of her teeth pulled today too. SO I had better go be the tooth fairy ...
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