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Showing posts from January, 2010

Fee-for-Service or Salaried Medicine? Part I

I am qualified to opine on physician compensation formulas, because I’ve spent hard time on both sides of the payment seesaw. For the first 10 years of my career, I was on salary. We were told, however, that we could earn productivity ‘bonuses’, but these rewards were trivial. An ‘employee of the month’ parking spot near the entrance would have been worth more, especially during the frigid Cleveland winters. After 10 years, I moved over to the dark side , where I was paid for each service I provided. In Part I this week, I present pros and cons of salaried medicine. I suspect that I've overlooked some of the advantages and drawbacks of paycheck medicine, so  I hope that readers will correct my errors and omissions. Good Stuff About Paying Gastroenterologists a Salary Lowers health care costs by underpaying specialty physicians Eliminates financial conflicts of interests. The colonoscope is not a capitalist tool. Reduces unnecessary medical procedures as gastro docs would rathe

Why Did Coakley Bomb in Massachusetts? Ask Aesop

One day a hare saw a tortoise walking slowly along and began to laugh and mock him. The aftershocks from the political earthquake that just occurred in Massachusetts will extend to the first Tuesday this November. Democrats are dazed and reeling from what should have been their easiest electoral victory in the nation. Martha Coakley, their candidate, was 30 points ahead in the race only weeks ago. Look up the word complacency in the dictionary and you may see her photograph alongside the definition. [For younger Whistleblower readers, a dictionary is a large volume that fossilized folks like myself still consult for word definitions and correct spellings.] The hare challenged the tortoise to a race and the tortoise accepted. They agreed on a route and started off the race. After Coakley prevailed in the primary election by 19 points on December 8 th , she vanished. I guess she felt entitled to a Senate seat that Democrats controlled for nearly 6 decades. While she was AWOL, Scott

Should We Pay For Organ Donation?

Could this man increase organ donation? Photo Credit Choose the best answer. To stimulate organ donation, we should provide organ donors with: Cold, hard cash Upgrades to business class on any flight within the continental United States for 1 year College tuition discounts for up to 3 children Income tax relief First row Bruce Springsteen concert tickets A certificate of appreciation There is a reason that we don’t ask families of kidnapped victims what our policy should be with regard to hostage negotiations. Any family in this situation, including mine, would favor paying the ransom. While this would serve an individual family’s interest, it would conflict with the public’s interest as it would encourage more kidnappings. Thus, the greater good would be compromised. Similarly, families seeking an organ for a loved one are not the proper source of policy recommendations for organ procurement. Understandably, they want an organ at any cost. Certainly, if my child ne

Haiti

American Red Cross Doctors Without Borders Mercy Corps Photo Credit

Tort Reform: A Plaintiff’s Lawyer’s View

Whistleblower readers know my views on the medical liability system. I have devoted more posts to tort reform than to any other issue. Readers, whose blood pressures are adequately controlled, are invited to review those posts on this blog under the Legal Quality category. (I was tempted to name the category Legal Abuse, but wanted to keep the category names consistent.) I review many legal blogs, most of which are ideological rants against physicians that express steadfast fidelity to the current system. If the medical community were as united and focused as the trial lawyers are, our future would be more sanguine. Gerald Oginsky is a plaintiff’s attorney who sues physicians. I have never met him and he has never sued me. Gerry left a comment on one of my Legal Quality posts, which demonstrated fairness and reasonableness. This lured me to his blog, where these same two qualities are evident. For this week’s Whistleblower, I am sharing a recent posting from Gerry’s blog . While

Health Care Reform Musings from Dixie

Blogging now from South Carolina, the cradle of the Confederacy.  This was the first southern state to secede from the Union on December 20, 1860.  We all remember the portentous headline from the Charleston Mercury that rattled the nation and President-elect Lincoln, who was still 3 months away from taking office.  Prior to his inauguration, 6 sister states would join South Carolina to form a confederacy.  They would try by force to form a new nation.  And we think President Obama has a heavy load?   I learned years ago, during one of my yearly historical sojourns, that strong echoes of the Confederacy survive. We came to a Charleston, South Carolina to a Bed & Breakfast and were greeted by the proprietress. We exchanged pleasantries and told her we were anxious to see some of  the area’s civil war treasures.  With a steely demeanor, she admonished me. “Round here,” she said, “we call it the War of Northern Aggression.”  Her statement was much more powerful heard in her slow, s