we have already seen the future of outsourcing

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we've already seen the results of outsourcing jobs to overseas workers. outsourcing has reduced the pool of patients with decent insurance payers. there are already radiologists in india reading digital scans from afar. if we don't dig in our heels, we are lost. corporate america and the insurance companies are only interested in the bottom line, to the detriment of america, and they want to destroy the middle class-- that includes us, and to make us all serfs. maybe we should learn from history. LL joanne holland wrote: Dear , Of course I am playing devil's advocate here. However, I really hope we all know what the direction is when we turn somewhere new. Unless all this distance medical management is certainly attached to the Dr/Patient relationship, we are setting ourselves up for a very sad fall. Note that the MD in Egypt is not here to be sued, that her malpractice costs do not exist like ours, and that her overhead is less...of course her advice is desirable to someone who only notes the cost. Every day I see patient who are coming to me (from increasingly long distances...it troubles me) who have been lost in the medical management shuffle. If all the information about their conditions comes only from "hamster wheel" medical systems,

and the decision making is done according to a paradigm found in a medical manual in Egypt, and there is little or no feedback from the patient...surely there will be terrible consequences for people with difficult diagnostic problems. Speaking of difficult problems; the very thin young lady with the myxomatous mitral valve has had her surgery, and is getting stronger every day. Her only bad event in the surgery process was with the CNA who took out her endotracheal tube and decided that just before taking it out was the proper moment to give her a lecture about how she almost died and was neglecting her health which put everyone in a terrible position....etc, etc. Of course, that is the kind of thing we need in our ICUs. Burned out personelle do the most peculular Eads <michelle.eadsworldnet (DOT) att.net> wrote: Joann, I suspect you are playing Devil’s advocate here In addition to what said, I would offer my

thoughts. I would argue that, although they (the corporations) may do that, it wouldn’t be a good idea because the essential patient-physician relationship (in person) would be lacking. It is an accepted standard for e-visits that the patient and physician doing the e-visit already have established a therapeutic relationship. To me, that requires prior face-to-face contact. I have

heard that there is a company out there that is trying to align primary care docs with patients whom they have never (and will never be) seen and conduct e-visits. I would not support this, even when webcams or whatever else technology brings us are employed – you just can’t beat that person-to-person, living, real-time, eye-to-eye, reach out and touch someone interaction. Some things you won’t know about a person until you are physically in their presence for some time. A. Eads, M.D. Pinnacle Family Medicine, PLLC phone fax P.O. Box 7275 Woodland Park, CO 80863 From: [mailto: ] On Behalf Of joanne hollandSent: Monday, February 26, 2007 12:10 PMTo: Subject: Re: Re Email and Phone visits: question from Drain So, for all of you working on the use of phone and e-mail MD visits: what is to stop a corporation that wants to save money from getting that privilege, and outsourcing the work to an unemployed Egyptian or Indian MD? If you think that can not happen, look at the management of social services in Wisconsin. The Governor in that state got permission to outsource the management of their chronically mentally ill patients to a Chicago company, and now when they call in because they are having problems, including

problems with their medications, they talk to someone...in India. Are we sure we want to be a part of outsourcing our own jobs? Joanne, the MD in Drain, Oregon Never miss an email again!Yahoo! Toolbar alerts you the instant new Mail arrives. Check it out. Need a quick answer? Get one in minutes from people who know. Ask your question on Yahoo!

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