Re: Hospital privileges - should I drop them?

[Guest guest]

Almost all of our patients are admitted by a hospitalist.  A few VIP patients will be admitted by Steve.  Typically, those patients call us first, and steve advises them to tell the ER when they arrive that he will be admitting them.  You do need to keep your privileges, however, so you have to determine whether or not it is feasible to do so.  Steve is currently required to keep his privileges, due to our financial arrangement with the hospital, but probably will always keep them since the hospitalist situation can change at any time.

Pratt

 

Most others in my call group are talking about dropping their hospital privileges and using hospitalist.  If that leaves me as the only one seeing patients in the hospital then maybe I’m out of tune with the new world order.  While many of my patients would be fine with hospitalist, there are a few patients I feel like I need to admit. How have others have dealt with this situation?

  Neighbors, MDHuntsville, Alabama 

[Guest guest]

we  have so many rural  outpatient doc s  that hospital created  3 yr s ago a new staff category called active outpatietn staff   I can admit 12 a year Rarely  do anymore HAd a few sick asthma kids whose parents  did not like the pediatricians ...they are growing up and out of troubles... I go visit and coordinate if possible but  do not have the time or skills any longer  It is a  tough door to close though

 

Almost all of our patients are admitted by a hospitalist.  A few VIP patients will be admitted by Steve.  Typically, those patients call us first, and steve advises them to tell the ER when they arrive that he will be admitting them.  You do need to keep your privileges, however, so you have to determine whether or not it is feasible to do so.  Steve is currently required to keep his privileges, due to our financial arrangement with the hospital, but probably will always keep them since the hospitalist situation can change at any time.

Pratt

 

Most others in my call group are talking about dropping their hospital privileges and using hospitalist.  If that leaves me as the only one seeing patients in the hospital then maybe I’m out of tune with the new world order.  While many of my patients would be fine with hospitalist, there are a few patients I feel like I need to admit. How have others have dealt with this situation?

  Neighbors, MDHuntsville, Alabama 

--      MD          ph    fax

[Guest guest]

hospital privileges are required to be on panel in one high paying private

insurance.

i was the last one who stopped going to the hospital. though the hospitalist

service drive me crazy because of lack of continuity and patients end up calling

me anyway, it's freed up a lot of weekend time with my young family.

i admit some once in a while esp if they're doctors or if they are too

complex/difficult for the hospitalist and i need to do timely workup on some,

otherwise im happy i gave it up.

grace

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> > Most others in my call group are talking about dropping their hospital

> > privileges and using hospitalist. If that leaves me as the only one seeing

> > patients in the hospital then maybe I'm out of tune with the new world

> > order. While many of my patients would be fine with hospitalist, there are

> > a few patients I feel like I need to admit. How have others have dealt with

> > this situation?

> >

> >

> >

> > Neighbors, MD

> >

> > Huntsville, Alabama

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> >

> >

> >

> >

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>

>

> --

>

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> MD

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> ph fax

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>

[Guest guest]

,I hate to say it, but auto insurers and home insurance companies have deals struck with autobody shops and contractors. We had a leak when we first moved into our house, and while we had an option of a contractor to us for the repairs, the insurance had a list of "preferred" contractors. Same with the car when I was rear-ended a few years ago. So it seems that preferred providers does extend past medicine.

This is just another example of the carriers and the Boards and other inappropriately interfering entities inserting themselves as "Defacto Licensing Agencies" with NONE of the public accountability or oversight that real Gov't Agencies are subjected to. If one is cut off from the main source of one's income, restricting or in the case of Primary Care (unless able to go all cash and totally break free of our oppressors) just about completely cutting one off from all sources of revenue, income, they really have become point of fact, the real "Restrictor Plate" the real, most oppressive, and final "Gate Keeper" as to who does or does NOT get to practice medicine....

It is time to Occupy, CMS, the AMA, ALL of the Isurance rs, Hosptial and Specialty Boards once and for all and take back our right to properly and freely practice medicine as all of you were originally and Properly taught to do. These people has strayed far away from their original mandate and their original roles in the entire process and system. I don't seem to remember my asking my home owners or auto insurer to "Pre-Screen" my Roofer, my HVAC Contractors, Auto Mechanics or Body Shops..... Nor would any of us be thrilled or see it as appropriate for any similar entities to throw up similar road blockers between ourselves and such vendors, contractors and service providers.

In the end it should be the patient, the actual Consumer of the Services who gets to say if they care to continue retaining any given service provider for on going services. These other people shouldn't have much if any say in who can or does have or doesn't have access to any given doctor or doctors access to provide care for any given patient. In terms of hospitals, to actually Hire, Not Hire or to Fire is already a large enough amount of leverage on this access to the doctor patient relationship. Non-Admitting doctors in the 21st century should not have to be required to have hospital privileges just so at to be able to stay on panel with any given gov't or private insurance carriers, payors.... Nor should one have to maintain any form of Board Certification to do likewise.... Certification is supposed to be a completely Voluntary process that is "Not Necessary" as it has been for all of time previous

to private insurance, hospital nose picking and the like.

It is time to return the power of who is and is NOT truly ALLOWED by any and all real world constraints to the individual state licensing agencies who are responsible to the entire general public, are at least in theory able to be held accountable by public record, hearings and proceedings by any and all citizens both patients and providers in this case... those who access the service providers as well as the service providers of that gov't and state. Remember this is one of the MAIN supporting and most probably will perservere arguements by those docs fighting against the AMA and its RUC commitee and the unholy alliance between CMS and the AMA RUC. Percisely because they are NOT a publically accountable agency who are basically accountable to NOBODY, hearing and process held in secret, members not really pulically voted on by those they are supposed to represent, the representation is biased and not

equally weighted....

This is all the same reasons that hospital boards, private insurance carriers and specialty boards should not be allowed to use their private and unaccountable, in a manner that the general public nor the service providers who are controlled and measured, allowed or denied access to practice their own trade are able to properly over see, lobby, vote for, influence and so are basically unaccountable to everyone and anyone. That is WAY TOO MUCH hidden power and authority for any one entity... I mean I still don't understand how one could or would attempt to Democracially get themselves onto any of these specialty boards to serve even.... I don't remember any of you, my wife being sent papers and petitions to run, ballots to elect such people who then develop and determine what is now and will be the standard in the future to be able to sit for, take, and pass the boards, do any of you??? So if so removed

from any of us as well as an form of real accountability (vote them out at least if you really don't like their policies and procedures) no less open governance then they certainly should have not impact on ones access to income and the marketplace to ply one's trade.

This Crap has got to stop because it is just as removed and unaccountable and deaf as the gov't and the BANK, and other 1%'ers that has people Occupying in hundreds of cities around the country and thousand of cities around the world... The time to actual listen, be open and accountable, and to act and impliment policies and procedures that are in the best interest of the Majority of the people, to create a fair and just system of governance in all walks of life has come. Such unaccountable and deaf organizations and gov'ts are relics of the past to be looked back at in a questioning fashion as to how we allowed such things at one point in time.... Much like police clubbing and breaking up union activities in the 10's and 20's and sweatshops, voting rights and so many other now acceptable and considered normal like things.... The time has come to send this lack of transparency and accountability and

publically, democratically elected system of "Certifying" controlling and endenturing to servitude to the Junk Yard where they honestly belong....

To: Sent: Tuesday, October 25, 2011 10:09 AMSubject: Re: Hospital privileges - should I drop them?

hospital privileges are required to be on panel in one high paying private insurance.i was the last one who stopped going to the hospital. though the hospitalist service drive me crazy because of lack of continuity and patients end up calling me anyway, it's freed up a lot of weekend time with my young family.i admit some once in a while esp if they're doctors or if they are too complex/difficult for the hospitalist and i need to do timely workup on some, otherwise im happy i gave it up.grace> >> >> >> > Most others in my call group are talking about dropping their hospital> > privileges and using hospitalist. If that leaves me as the only one seeing> > patients in the hospital then maybe I'm out of tune with the new world> > order. While many of my patients would be fine with hospitalist, there are> > a few patients I feel like I need to admit. How have others have dealt with> > this situation?> >> >> >> > Neighbors, MD> >> > Huntsville, Alabama> >> >> >> > > >>

> > > -- > > > > MD> > > ph fax > >

[Guest guest]

Preferred but not almost totally Excluded by internal policy and market forces. Their perferred list saves a few dollars and steers some but not all folks in one direction or the other. But when an entire office visit, all of an entire family's office visits won't be paid for AT ALL, and furthermore, then that doctor can not write their meds and be covered or do their Auths and referals also in-network, that basically chases almost all but the most picky or loyal of patient clients away.... It is a huge difference.

We have a couple of the hospitals that pay in full for the employees who then use doc who have privileges at the same hospital or have a lower co-pay of $15 verses $25 dollars.... That is not enough to make most patients jump ship for like $40 to $80 bucks total in a year, ten bucks a pop let's say... But if the entire $125 dollar level 4 est'ed visit isn't covered for mutlitple visits on multiple family members, now you are discusing serious amounts of money in most folks' eyes.... a grand or more perhaps a year for a family of 4 to 6 members. That starts to make most working class families start to think twice before asking for an appointment again. And how often to you need a fender bender cleaned up verses how often do you and your kids need to hit the doctor for illness, C/U's, chronic issues, injuries???? See the difference?

And last but not least if these folks had any brains they would use our industry as lesson to learn from history instead of being doomed to repeat the same, and bust their collective butts anyway they can to resist these Bozos before they to get "Matriculated" in to something ressembling the "Medical Industrialized Complex" like all of us and Dr Neo already have.... I warn my Vet's office everytime I walk in there and see these nice glossy brouchors for Pet Insurance to be careful about getting in bed with the devil for what appears to be short term gains, and supposedly "Certain" but never is payments.

To: " " < >Sent: Tuesday, October 25, 2011 5:33 PMSubject: Re: Re: Hospital privileges - should I drop them?

,

I hate to say it, but auto insurers and home insurance companies have deals struck with autobody shops and contractors. We had a leak when we first moved into our house, and while we had an option of a contractor to us for the repairs, the insurance had a list of "preferred" contractors. Same with the car when I was rear-ended a few years ago. So it seems that preferred providers does extend past medicine.

This is just another example of the carriers and the Boards and other inappropriately interfering entities inserting themselves as "Defacto Licensing Agencies" with NONE of the public accountability or oversight that real Gov't Agencies are subjected to. If one is cut off from the main source of one's income, restricting or in the case of Primary Care (unless able to go all cash and totally break free of our oppressors) just about completely cutting one off from all sources of revenue, income, they really have become point of fact, the real "Restrictor Plate" the real, most oppressive, and final "Gate Keeper" as to who does or does NOT get to practice medicine....

It is time to Occupy, CMS, the AMA, ALL of the Isurance rs, Hosptial and Specialty Boards once and for all and take back our right to properly and freely practice medicine as all of you were originally and Properly taught to do. These people has strayed far away from their original mandate and their original roles in the entire process and system. I don't seem to remember my asking my home owners or auto insurer to "Pre-Screen" my Roofer, my HVAC Contractors, Auto Mechanics or Body Shops..... Nor would any of us be thrilled or see it as appropriate for any similar entities to throw up similar road blockers between ourselves and such vendors, contractors and service providers.

In the end it should be the patient, the actual Consumer of the Services who gets to say if they care to continue retaining any given service provider for on going services. These other people shouldn't have much if any say in who can or does have or doesn't have access to any given doctor or doctors access to provide care for any given patient. In terms of hospitals, to actually Hire, Not Hire or to Fire is already a large enough amount of leverage on this access to the doctor patient relationship. Non-Admitting doctors in the 21st century should not have to be required to have hospital privileges just so at to be able to stay on panel with any given gov't or private insurance carriers, payors.... Nor should one have to maintain any form of Board Certification to do likewise.... Certification is supposed to be a completely Voluntary process that is "Not Necessary" as it has been for all of time previous to private insurance, hospital nose

picking and the like.

It is time to return the power of who is and is NOT truly ALLOWED by any and all real world constraints to the individual state licensing agencies who are responsible to the entire general public, are at least in theory able to be held accountable by public record, hearings and proceedings by any and all citizens both patients and providers in this case... those who access the service providers as well as the service providers of that gov't and state. Remember this is one of the MAIN supporting and most probably will perservere arguements by those docs fighting against the AMA and its RUC commitee and the unholy alliance between CMS and the AMA RUC. Percisely because they are NOT a publically accountable agency who are basically accountable to NOBODY, hearing and process held in secret, members not really pulically voted on by those they are supposed to represent, the representation is biased and not equally weighted....

This is all the same reasons that hospital boards, private insurance carriers and specialty boards should not be allowed to use their private and unaccountable, in a manner that the general public nor the service providers who are controlled and measured, allowed or denied access to practice their own trade are able to properly over see, lobby, vote for, influence and so are basically unaccountable to everyone and anyone. That is WAY TOO MUCH hidden power and authority for any one entity... I mean I still don't understand how one could or would attempt to Democracially get themselves onto any of these specialty boards to serve even.... I don't remember any of you, my wife being sent papers and petitions to run, ballots to elect such people who then develop and determine what is now and will be the standard in the future to be able to sit for, take, and pass the boards, do any of you??? So if so removed from any of us as well as an form of real

accountability (vote them out at least if you really don't like their policies and procedures) no less open governance then they certainly should have not impact on ones access to income and the marketplace to ply one's trade.

This Crap has got to stop because it is just as removed and unaccountable and deaf as the gov't and the BANK, and other 1%'ers that has people Occupying in hundreds of cities around the country and thousand of cities around the world... The time to actual listen, be open and accountable, and to act and impliment policies and procedures that are in the best interest of the Majority of the people, to create a fair and just system of governance in all walks of life has come. Such unaccountable and deaf organizations and gov'ts are relics of the past to be looked back at in a questioning fashion as to how we allowed such things at one point in time.... Much like police clubbing and breaking up union activities in the 10's and 20's and sweatshops, voting rights and so many other now acceptable and considered normal like things.... The time has come to send this lack of transparency and accountability and publically, democratically elected system of

"Certifying" controlling and endenturing to servitude to the Junk Yard where they honestly belong....

To: Sent: Tuesday, October 25, 2011 10:09 AMSubject: Re: Hospital privileges - should I

drop them?

hospital privileges are required to be on panel in one high paying private insurance.i was the last one who stopped going to the hospital. though the hospitalist service drive me crazy because of lack of continuity and patients end up calling me anyway, it's freed up a lot of weekend time with my young family.i admit some once in a while esp if they're doctors or if they are too complex/difficult for the hospitalist and i need to do timely workup on some, otherwise im happy i gave it up.grace> >> >> >> > Most others in my call group are talking about dropping their hospital> > privileges and using hospitalist. If that leaves me as the only one seeing> > patients in the hospital then maybe I'm out of tune with the new world> > order. While many of my patients would be fine with hospitalist, there are> > a few patients I feel like I need to admit. How have others have dealt with> > this situation?> >> >> >> >

Neighbors, MD> >> > Huntsville, Alabama> >> >> >> > > >> > > > -- > > > > MD> > > ph fax > >

[Guest guest]

for me it doesnt make any sense.

i can see four or five people in the time i see one patient over there at the

hospital. besides, i cannot do the acuity anymore as it can occur at any time of

the day or night.

for me the money is not worth my time.

grace

> > > >

> > > >

> > > >

> > > > Most others in my call group are talking about dropping their hospital

> > > > privileges and using hospitalist. If that leaves me as the only one

> > seeing

> > > > patients in the hospital then maybe I'm out of tune with the new world

> > > > order. While many of my patients would be fine with hospitalist, there

> > are

> > > > a few patients I feel like I need to admit. How have others have dealt

> > with

> > > > this situation?

> > > >

> > > >

> > > >

> > > > Neighbors, MD

> > > >

> > > > Huntsville, Alabama

> > > >

> > > >

> > > >

> > > >

> > > >

> > >

> > >

> > >

> > > --

> > >

> > >

> > >

> > > MD

> > >

> > >

> > > ph fax

> > >

> > >

> >

> >

> >

>