Re: Re: tact and diplomacy

[Guest guest]

Heavy-duty nerd action below, so brace yourselves...

It was Ponce de Leon, Spanish conquistador, who came looking for the

Fountain of Youth in what was later to become Florida, which is now more

accurately, the Fountain of Medicare.

Balboa was a second-rate boxer/thug from Philadelphia played by Sylvester

Stallone, who, by the way, won an oscar for Best Picture, and racked-up a total

ten oscar nominations, and still landed the lead role despite all odds.

Bilbo is a hobbit of the Baggins clan; his grandfather, during a fight with

another clan, wacked the head off of his rival which landed in a hole, therefore

simultaneously winning the fight for his family and inventing the game of golf.

I think we are all Stallones/Rockys. We are all aspiring to something better,

despite the odds, and we are from the --streets-- of medicine, weary and worn.

May we all be able to shout ADRIAN when the medicolegalfinancial dust settles.

Charlie Vargas

lin, NC

Date: 2007/12/25 Tue PM 01:57:30 CST

To:

Subject: Re: tact and diplomacy

EXACTLY

TSB

--- lawrence lyon wrote:

> let's see--

> since my rep is so well-established, what can i say?

> the fact that some practices, particularly IMP's,

> feel the need to do cosmetic procedures in order to

> make ends meet, is merely another indication of the

> sad state of american medical practice and how we

> are underpaid.

> whether or not one is making it, the choice to do

> cosmetic procedures, or spirometry (as i am

> intending to do), must be consistent with being able

> to look oneself in the mirror every day.

> i just calls 'em like i sees 'em.

> LOLLL

>

> magnetdoctor@... wrote:

>

> Me too, glad I waited, as I was about to say some

> really nasty, and politically incorrect things,

> after feeling like I was called the Devil incarnate

> for doing cosmetic procedures. Thank you , more

> eloquently than I could put it.

>

> Cote' MD

> Four Corners Family Medicine, and Laser Aesthetics

>

> --------- Re: Setting basic

> rules of practice

> >

> > Gordon,

> > Thank you for your response! I do not run an IMP.

> > However, i have been involved an d monitoring this

> list

> > serve for approx 4 years. Implementing alot of the

> > ideas but also attempting to meet the specific

> needs

> > of this community and trying to stay alive.

> > I actually have formidable solutions for the three

> > issues that you present. My main performance

> measure

> > IS pt visits to the ER. I monitor the ER log and

> have

> > found that my patients visit the ER much less

> often

> > than other docs in the community. 1-2 per week and

> > usually it is unavoidable(broken bone, car

> accident)

> > or it is because the patient chose NOT to use the

> > services that I have made available.

> >

> > ACCESS

> > 4-5pm is my " work-in slot " I will see the pt

> before I

> > go home. I am faster, less conversive and right to

> the

> > point but I will see anyone who calls and request

> an

> > urgent visit at that time. Can be 10 at times or

> 0!

> >

> > EFFICIENCY

> > I see the pts who show up on time, on time. With

> some

> > exceptions(emergenies), I do what I have to do in

> the

> > alloted time. Most patients are very appreciative,

> > however, I am the one punished if they do not show

> up

> > on time. Often I remind these pt to be on time and

> > regularly get very crude responses. However, my

> > computer captures all relevant times and usually

> it is

> > clear cut.

> >

> > CONTINUITY

> > I tried a NP and a PA together. Then I spent most

> of

> > my time keeping them happy and paying them my

> profit

> > margin. They are gone. I see everyone and I am

> happy

> > as well as the pt. Previsit protocol sheets make

> sure

> > that I address ongoing issues and capture

> preventive

> > care services. The computer(eclinical works)

> really

> > helps with data management. Not perfect, it still

> > takes a large amount of man power to manage

> patients

> > to the standard of which I strive to acheive.

> >

> > I employee 7 staff to me(one provider)plus a

> diabetes

> > educator and prosthetist(my wife). After several

> years

> > of strategic maneuvering this is the best model

> that I

> > can do and it is working both from a patient

> > satisfaction stand point(yes, i ask) and from a

> > financial standpoint.

> >

> > One hint: I noticed that many of my patients were

> > participating in the local churches LIFESCREEN

> > services(Where a company comes in for cash does a

> > plethora of test on my patients). My patients were

> > extremely aggressive about getting in to do these

> > screenings. Many voiced anxiety about not getting

> on

> > the list. Well, it turned out that I offered the

> same

> > service that these places offered except I went by

> the

> > U.S. preventive task force recommendations. So I

> have

>

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