Reality Check 2 Posted June 30, 2016 Share Posted June 30, 2016 I would like to hear from our Canadian colleagues on the single payer system and life for them. Single payer systems DO work in the world but the mindset has to change and with our political system full of clowns - that is not likely. The 1%ers cannot possibly understand how the majority of Americans live or struggle. Germany's system is actually quite good. Link to comment Share on other sites More sharing options...
delco714 Posted June 30, 2016 Share Posted June 30, 2016 This really is a big problem. However we have to ask ourselves why it is a problem. Ultimately, it came down to doctors neglecting the business side of medicine. So to fill the void people with undergrad and master level business degrees come in and try to solve the problem without a medical education. Then we create "healthcare administration" degrees to at least familiarize them with the world of healthcare, but the problem only gets worse. What we really need are 3 year MBA/PA programs. We must encourage people who want to go into healthcare administration to be both providers and business savvy, because both are necessary to advance healthcare, but both are dangerous without the other. I really believe there is a niche for business savvy PAs to solving this serious and growing problem. So encourage PAs around you to own their own practices. Support schools that mix MBAs and PAs. PAs can answer this problem. I would have done that. That's where I see myself. going back for mba/mha seems daunting now.. Emed would call me a wuss :-P Link to comment Share on other sites More sharing options...
sk732 Posted June 30, 2016 Share Posted June 30, 2016 I would like to hear from our Canadian colleagues on the single payer system and life for them. Single payer systems DO work in the world but the mindset has to change and with our political system full of clowns - that is not likely. The 1%ers cannot possibly understand how the majority of Americans live or struggle. Germany's system is actually quite good. I am salaried for one...in fact all of us (PA's) are. When I was in family med, I was expected to see a minimum patient load, anything beyond that was good by my bosses. I never really worried about metrics at the time, just my mentally challenged org chart. Docs that do fee for service here are getting hammered a lot lately in the press and by the governments of the various provinces - Ontario Docs have been locked in a negotiation war for sometime - and there is a lot of systemic mismanagement from regional on up to ministerial levels. Patients get what they need, but not always in a timely manner...and certainly not as quick as if they paid for it out of pocket. Again, money mismanagement, stove piping of empires, too many f&^king management layers, etc. Good side, very little dealing with the insurance clowns that toss 1 in 3 claims into the waste bin - direct billing under whatever code. Docs here in Manitoba get a stipend yearly for each patient they manage with multiple/complicated medical issues, plus bill visits. Rural folks have a pay code for being in rural/underserviced areas. Obviously, it varies province to province. Knowing it takes awhile to get certain tests (MRI/CT etc) in some places is actually good, since it keeps the McDonald's mentality to a minimum - I can get a scan very quickly if it's NEEDED, if it's wanted, the person is often doing better by the time they get it (I don't MRI every joint injury that walks in the door - I was trained very well to have good MSK exam skills). Just had someone in the other day who's son was an ER doc in the States who insisted they needed a scan for something that hadn't even been treated with any conservative measures - a few McKenzie extensions later, they were feeling much better than when they arrived and no rads needed or money wasted. The issue on both sides of the border is we've got to get rid of the folks with the business/customer service mentality and are running our lives because they couldn't get into or survive training or clinical life. Conversely, proper management and leadership principles need to be applied by the powers that be to ensure money is spent wisely, non-performers are jacked up for it or let go, and stove piping is stopped because it interferes with how we deliver care. $0.02 Cdn SK Link to comment Share on other sites More sharing options...
BruceBanner Posted June 30, 2016 Share Posted June 30, 2016 You need only look at what has been happening since the advent of the so-called ACA. If we move to a single payer system, you will be told how many patients to see, how long you may spend with each of them, and will treat everyone according pathway algorithms that leave you with no judgement. You will be evaluated on these metrics and will be disciplined if your patients complain...and they will, because patients will know their care sucks. Don't worry, though, patients will be treated even worse than you. Your job will be to placate them, but their complaints will fall on deaf ears. You will become a simple technician. Single payer healthcare= government healthcare. It works ok for fractures, lacerations, and UTIs, but God forbid you should get cancer, diabetes, heart disease or other complex illnesses. Government cares about votes, not people. Truest post ever. I dont trust the US government, and I think a top-to-bottom single-payer system---while attractive on paper---would be a disaster. The US isnt as nice as Canada. We are greedy, self-centered, megalomaniacs. Like you said, we will be told how many patients to see, what care we are allowed to offer, our wages will tighten up like a drum, and I predict that many private practices would go out of business because of lost income. There would be no more rich dermatologists taking in $250k a month with an army of PAs. Oh and dont forget that ~50% of our paychecks that will no longer be ours. Link to comment Share on other sites More sharing options...
JohnnyM2 Posted June 30, 2016 Share Posted June 30, 2016 Of course. Medical providers at all levels have generally been well paid for their expertise. Once providers become mere technicians taking their marching orders from management and getting their treatment plans and diagnoses from a computer screen, there will be no need for high salaries. In many practice environments, it's already happening. Sent from my SM-G900V using Tapatalk Link to comment Share on other sites More sharing options...
sk732 Posted June 30, 2016 Share Posted June 30, 2016 Time to go somewhere that appreciates us...like Africa, Antarctica. A guy I knew in the Army was on an op in Sierra Leonne helping train the new SL Army's medics and he was asked one day if he'd stay and be the Surgeon General of the SLA. When he mentioned he wasn't a doctor, the Defence Minister just shrugged and said."Oh don't worry, we can fix that easily". Thought I'd just toss that out there... SK Link to comment Share on other sites More sharing options...
Maverick87 Posted July 1, 2016 Share Posted July 1, 2016 Time to go somewhere that appreciates us...like Africa, Antarctica. A guy I knew in the Army was on an op in Sierra Leonne helping train the new SL Army's medics and he was asked one day if he'd stay and be the Surgeon General of the SLA. When he mentioned he wasn't a doctor, the Defence Minister just shrugged and said."Oh don't worry, we can fix that easily". Thought I'd just toss that out there... SK That sounds fun! Link to comment Share on other sites More sharing options...
sk732 Posted July 1, 2016 Share Posted July 1, 2016 I'd love to have a pile of my own minions trained in my own image and methodology..."Do No Harm; Do Know Harm" SK Link to comment Share on other sites More sharing options...
Guest Paula Posted July 1, 2016 Share Posted July 1, 2016 then you should not blasphemeand use the name of the Lord in vain Huh? Link to comment Share on other sites More sharing options...
Cideous Posted July 2, 2016 Author Share Posted July 2, 2016 Since I started this thread, I will update it. My supervising physician QUIT today. I wish I could of been there to see the look on their faces when she said it. They had called her into their office to go over the schedule. They started by telling her that their "needs had changed" since their official agreement and that she was now going to have to work a completely different schedule. No debate. That was the last straw. She quit. So it's just me now.... Should be a fun week coming up! Corporate Medicine is going to kill this field. The eternal quest to squeeze every last red cent out of patients is just sickening. I should of saved more earlier in my career so I was ready to retire now vs in 10 years. Don't know if I will make it. Link to comment Share on other sites More sharing options...
Reality Check 2 Posted July 2, 2016 Share Posted July 2, 2016 Cideous - WHO is your new supervising doc? Do you get any say in it? Make sure they sign the proper papers asap so you are kosher and legal and all that. If your doc is truly GONE and has left - then you have no one for the moment unless you have alternates. Play this to your favor as well as safety. "Well, you guys drove my doc away - what are you going to do now?".......... Link to comment Share on other sites More sharing options...
8404PA Posted July 2, 2016 Share Posted July 2, 2016 This is horrible. Unconscionable. Despicable. There needs to be a rebellion. Anyone who works in a place that institutes these behaviors and practices, who doesn't immediately quit, needs to simply say "no". Unequivocal, no debate, just say NO. This is unacceptable and dangerous, I refuse. Do that until they fire you. We have no reason to listen to any of it. The office manager with the HS degree cannot see patients, cannot write a script, nor finish an H&P. If everyone refuses to be subjected to their BS, they'll have no option. If any candidate they attempt to hire objects to their practices, they'll be left optionless. Unfortunately we may need to start wielding the power of our medical licenses to hold them hostage; if they feel that treating providers AND patients in such a way is acceptable. If we suffer this silently, both our position as providers of quality healthcare and subsequently those who we are attempting to deliver it to will ultimately suffer. **** Standing ovation ***** Link to comment Share on other sites More sharing options...
Cideous Posted July 2, 2016 Author Share Posted July 2, 2016 Cideous - WHO is your new supervising doc? Do you get any say in it? Make sure they sign the proper papers asap so you are kosher and legal and all that. If your doc is truly GONE and has left - then you have no one for the moment unless you have alternates. Play this to your favor as well as safety. "Well, you guys drove my doc away - what are you going to do now?".......... I have another guy already loaded from another clinic that will punch my charts until they hire a new guy for my clinic, but the chances of me being there in a few months are slim and none. Besides, I've got my eye on this nifty job at Burger King. I mean I've already got the ling down......."Ok a Whopper with cheese, diet coke and fries.....Would you like a Z-pk with that today?" See....I'm in baby. Link to comment Share on other sites More sharing options...
corpsman89 Posted July 2, 2016 Share Posted July 2, 2016 So discouraging. I am currently applying to PA school this cycle, and while I am excited, I am also beginning to become very apprehensive. As a Medical Laboratory Technician I often have a hard time explaining what I do (similar to a PA explaining what they do to a regular non-medical person), and often times even fellow hospital employees don't understand fully what we do in the lab. On the flip side, I have an awesome 7 on 7 off schedule that I enjoy, and my pay is almost near 30 bucks an hour (not bad for an associates degree). My lab director and supervisor also bend over backwards for me because they know that if I decide to leave, it will take them months, or more to fill my shoes. How can these people decide to treat you like this? Don't they value your work? It just seems Ludacris to me! I am really starting to worry that I may in fact run into a worse situation as a PA with the same lack of respect I have now, but with management that doesn't even understand the value of my job. That's scary! Link to comment Share on other sites More sharing options...
Maverick87 Posted July 2, 2016 Share Posted July 2, 2016 So discouraging. I am currently applying to PA school this cycle, and while I am excited, I am also beginning to become very apprehensive. As a Medical Laboratory Technician I often have a hard time explaining what I do (similar to a PA explaining what they do to a regular non-medical person), and often times even fellow hospital employees don't understand fully what we do in the lab. On the flip side, I have an awesome 7 on 7 off schedule that I enjoy, and my pay is almost near 30 bucks an hour (not bad for an associates degree). My lab director and supervisor also bend over backwards for me because they know that if I decide to leave, it will take them months, or more to fill my shoes. How can these people decide to treat you like this? Don't they value your work? It just seems Ludacris to me! I am really starting to worry, that I may in fact run into a worse situation as a PA with the same lack of respect I have now, but with management that doesn't even understand the value of my job. That's scary! There are some jobs where you are respected. I currently work at one of them. Link to comment Share on other sites More sharing options...
corpsman89 Posted July 2, 2016 Share Posted July 2, 2016 Maverick: this is good news! I also wonder how different these forums are from the real world. Is this just the case of people who get upset about their situation finding a place to vent, and this happens to be the place? Is it possible that reading the negative things on this forum a little too much can cause some amplification of future worries within the PA community? Link to comment Share on other sites More sharing options...
SHU-CH Posted July 2, 2016 Share Posted July 2, 2016 Corpsman89 - As you suggest, internet fora (like patient satisfaction surveys) tend to select out the extreme ends of human experience - the really happy and really angry. However, there are a lot of really smart people on here with a lot of experience. I try to get my students to come on here and read this stuff so they get some "real world" experience. People go to PA school because they have a great heart and want to help people. They often mistakenly assume that is why everyone is involved with medicine. The sooner they learn this is not the case, they better. Link to comment Share on other sites More sharing options...
Joelseff Posted July 2, 2016 Share Posted July 2, 2016 I love Medicine... That is, the doctorin' part. Always have.... This $#! + that it's become though is a nightmare. When patients became clients is when it ended. I hate that crap like how much press ganey and yelp scores play into our performance reviews is sickening. I'm forecasting another 10 years of this $#! + (if I can last that long) and I'm getting out... I dunno what I would do though. I have been in Medicine since I was 17 and besides a 5 year stint in real estate (worse than Medicine) I dunno what else I would do... ???? Sent from my SAMSUNG-SM-G870A using Tapatalk Link to comment Share on other sites More sharing options...
corpsman89 Posted July 2, 2016 Share Posted July 2, 2016 SHU-CH: wise words, and thank you for contributing to this website as much as you do! As someone who is applying to PA school for the first time, I am immensely grateful for this website, and especially its members. I have probably learned more from you than I ever could anywhere else outside of actually being a PA. Being involved in health care as an EMT, hospital corpsman, and now lab tech I am unfortunately well aware of this "real world" you mention, but I am simply troubled by some members stories, and half heartedly question if am making the right move. I have an intense desire to provide care for patients, but I also want to be respected, and not be told that I have to report to someone who may not fully understand my job, scope of practice and purpose. I will still push through with my plans, as I have wanted to take this step for sometime, I just wonder how different this forum is from other PAs that aren't on here? Link to comment Share on other sites More sharing options...
Maverick87 Posted July 2, 2016 Share Posted July 2, 2016 Maverick: this is good news! I also wonder how different these forums are from the real world. Is this just the case of people who get upset about their situation finding a place to vent, and this happens to be the place? Is it possible that reading the negative things on this forum a little too much can cause some amplification of future worries within the PA community? I think it depends on your job, your attitude, and your unique situation. Some people end up in bad situations because they take jobs just for the money or they are tied to one location (and that location happens to be a bad area for PAs) or they are not good at choosing employers, etc. Unfortunately, as a profession, we don't have a whole lot of guidance and we generally have to learn from experience. Some of the older people here had it really bad because they started out at a time where PAs were completely crapped on. So they may be more jaded based on these earlier experiences. From my experience and observations, the biggest land mines in medicine are not bureaucracies, incompetent administrators, or overzealous NPs. I worry most about frivolous lawsuits that are potentially career-ending. I will do what I can for each patient, but the moment I am sued for something out of my control, regardless of the outcome, is the moment that I will leave medicine. Many PAs try to fight it or push onward in their careers. I won't. I'm done after that. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted July 2, 2016 Moderator Share Posted July 2, 2016 There are some jobs where you are respected. I currently work at one of them. Me too, I currently work at 3 of them, but it took me 20 years to get here. I've suffered through a lot of bad jobs on the way here... Link to comment Share on other sites More sharing options...
Maverick87 Posted July 2, 2016 Share Posted July 2, 2016 Me too, I currently work at 3 of them, but it took me 20 years to get here. I've suffered through a lot of bad jobs on the way here... Yeah, I definitely lucked out with mine. Link to comment Share on other sites More sharing options...
Reality Check 2 Posted July 6, 2016 Share Posted July 6, 2016 And we round back full circle to the point that our national organization is not representing us fully to the powers that be or the public and our profession is entering a stagnant phase while NPs have HUGE lobbies full of RNs and continue to promote themselves into our jobs and bully us with their doctorate degrees (for whatever purpose). The real news is that PAs are by and large smart, motivated, numerous and willing to adapt - some of chomping at the bit to move forward. The US Healthcare System is a mess and there are 300 million people who need medical care. Commercial insurance company CEOs pull down 7 figure incomes and horrifying "bonuses" that are largely based on denying services to their premium paying customers. Therein lies the problem - health care has to be about health - not dollars. So, PAs need to progress and evolve into the independent providers we are perfectly qualified to become in order to serve the US population but we have to have a major shift in ideology in order to serve all these people in the most effective manner. I just carry the soapbox around with me now...... Link to comment Share on other sites More sharing options...
Joelseff Posted July 8, 2016 Share Posted July 8, 2016 From my experience and observations, the biggest land mines in medicine are not bureaucracies, incompetent administrators, or overzealous NPs. I worry most about frivolous lawsuits that are potentially career-ending. I will do what I can for each patient, but the moment I am sued for something out of my control, regardless of the outcome, is the moment that I will leave medicine. Many PAs try to fight it or push onward in their careers. I won't. I'm done after that. ^^^^ this! Sent from my SAMSUNG-SM-G870A using Tapatalk Link to comment Share on other sites More sharing options...
GetMeOuttaThisMess Posted July 8, 2016 Share Posted July 8, 2016 Have bags packed, regardless of how careful you try to be. It happens whether you do anything wrong or not. You, I, and the rest of us signed up to be a roulette wheel number. Link to comment Share on other sites More sharing options...
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