Dr James Schaller
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Broken Medical Care – Want Something Better?

One of my staff recently said, "Three people I talked to today were stunned I called them back."

"Why would they be surprised?" I asked.

"They say almost none of their doctor's offices return their calls. None talks with them long enough to find solutions for their problems."

Before you blame physicians, get some insight into the real life of physicians. Some dreamers ignorantly think physicians are rolling in money, drive fancy cars, work low hours and live a jolly happy life.

A new post by Maggie Fox says that pediatricians, family doctors and internists are being so devastated that no one wants the job. New physicians refuse to take these positions. Many in these fields are looking for ways to get out. Why?

  • Declining incomes from Medicare, Medicaid and insurance cuts
  • Difficulties in handling massive numbers of patients
  • Massive overhead and staff to manage insurance, billing, labs ...
  • Malpractice insurance that can be more than three months wages
  • Impossible frenetic rushed office visits
  • State Board are also now legislating exact standards of care, including in areas in which they have no experience or training. Now malpractice carriers offer state board insurance for the lawyer. My policy offers 25,000.
  • If you have severe chronic pain, I hope you like surgery or spine injections or other "interventional" options. Why? The DEA and the "addict police" consider all strong pain medications to be corrupt medicine. Despite the fact this violates every major pain medical society in the world, and is 1950's thinking. You have no choice. The thought police have removed this option and your primary care doctors are not going to be treating your chronic pain. You will be asked to "cope" with the pain. You will be given weak and useless medications which the addict police like, but would not numb a snails nerve ...

Years ago, I realized this was all insanity, and opted for what was done in the old days. I offer a service for any amount of time requested or needed and get paid. No clerk with high school biology training is in a cubicle blocking my treatments. If this approach is good enough for my mechanic, electrician, lawyer, realtor and barber--it is good enough for me.

Some physician dinosaurs with a limited connection to real medicine think it is "bad" for a physician to not accept insurance. Yet last I checked, no insurance company was qualified to determine if I was a solid physician or a poor one. They are happy to have cattle or "employee" physicians with the basic training.

Who cares that the doctor has no time to call you back?

Who cares if the person you see is different every visit?

Who cares that the only "education" the doctor is getting comes from surgical devices companies or pharmaceutical companies who have a complete stranglehold on every aspect of USA medicine?

I like medications. I like as many tools in my box as possible to serve patients.

If an insurance company refuses to pay for an email or phone consult with a known patient, it is not because they "care" for the patient. It is because they could care less. They are happy to make you drive in for a prescription so the doctor can charge for his or her overhead.

American medicine is profound failure in the area of preventing serious disease. While I support PAP testing and prostate exams, to call this 2006 prevention is really sad. Of course, some feel that any prevention that does not have 400 double blind studies (funded by pharmaceutical companies J) is not a clear prevention.

So we are left with knee replacements instead of Lyme testing of joint nutrients started at 40 years of age. Medicare pays tens of thousands of dollars to cut off a diabetic's diseased limb, but pays little to help your family doctor control this person's blood sugar.

Over 1/3rd of family care physicians are nearing retirement. Perhaps some patients will decide to go back to the good old days and actually see their doctor as a part of their life. And their doctor's will take time to get involved in prevention in newer and solid aggressive ways, so 65 year old people will feel healthy--like mere middle aged folks.

But what do I know, I actually read thousands of medical articles a year, and do that instead of writing thousands of insurance letters and forms each year. Sorry, I have never seen anyone do both. Yet, I do miss the "high school" insurance reviewer, however, she always kept me up on the newest hip music. And her buddy Ned in the next cubicle was always up on NASCAR. It is a shame neither ever understood a word about medicine. But that's just me, I could be wrong.

And the next time you decide to vote against physicians and side with malpractice trial lawyers, please understand that once physicians leave your area – it is like a nuclear bomb went off. None ever return.

Currently, many areas have been identified as anti-physician counties or states. Individuals trying to find an obstetrician, a trauma specialist after a car accident or someone to perform micro-surgery for a severed finger ... will have to travel to "distant lands" to find a true expert.

Now you have a choice.

Get a doctor who returns your calls, who knows you and who is an aggressive learner or accept the free 3-5 minute sessions. Some traditional dinosaurs think the latter is "good medicine." I have had many relatives hurt by such limited and sloppy care. Do you and your family deserve better?

A few ideas based on an article from Reuters Health Information 2006. © 2006 Reuters Ltd

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