Medicare Cuts
Restricting new Medicare patients is water torture - possibly effective but who will notice. While those who can't get in can be allies, our strongest allies are the ones who are in our practices, who know us and who value our relationship.
Handing out talking points is good - it is time we shared with our patients the information we have hesitated to because we didn't want to "politicize" the exam room - the time has come but we are restricting our audience. The messages (talking points) need to hit the local news, the paper, the radio station and the TV. Those not yet on Medicare need to know the upcoming reality. AARP and the baby boomers can be powerful allies if we give then the reality and the future downside.
If you need a resource, here is a video clip on my web site to which you can refer (take a look at it first) http://www.gafp.org/shannon.asp - click on Medicare video.
The AAFP position is http://www.aafp.org/online/en/home/media/releases/2008/senate-failure-to-address-medicare-payment.html
The AMA position is http://www.ama-assn.org/ama/pub/category/6583.html
These are well and good - but remember, the Academy is us. Waiting for the AAFP to win the day means you are waiting on yourself - so it is time to act. Depend on others to do your talking for you and you will get their solutions. Don't depend on our "brother" specialists to speak out for us. They haven't before - they won't now - until their position is comfortable and then it will be too late for us. They may actually fight our solutions while benefiting from our victories.
We have other options - see Family Practice Management for options, a discussion and how- to- do it's
http://www.aafp.org/online/en/home/publications/journals/fpm.html
Not wanting to desert our patients is good and professional ( although we may see massive dumping of Medicare patients anyway) - a massive movement to non-participating status may be a good first step - not denying care - just requiring payment from the ones who request and utilize it. They will get reimbursed (note - did not use the word paid - reimbursed is correct here) much later by a slowly moving bureaucracy that will fight them not to pay (sound familiar) It will require us to collect for services (how novel) and be paid by the users for our services. We also need to announce to our communities that we are doing this because of the lack of Congressional action and that we must do this to stay open to provide care. Information and education makes these moves effective. If we are going to act, we need to let the public know why.
Dropping out of Medicare system by private contracting has a two year front if I understand it correctly (see Family Practice Management) but it may come to that. Completely leaving a huge population of patients in the lurch without warning is not our style, our desire or our intention. We want to be able to care for them - hence the time is here to fight.
Be prepared to see limited practitioners (surgical subs, etc.) not accept Medicare payment. It may put us in a bind when their services are needed but we need to let patients know what and why and get releases signed that show what we recommend and that it was not available. Remember, those that help us out with our problems should benefit by seeing our patients who don't have the problems. It is kind of dumb to send our problems to the nice guys who want to help and then send the OK patients to the guys who turn down our patients but send us hams at Christmas.
This is the year when we elect a President, 1/3 of the senate, all the house. Next year - nothing. Now is the time - we need to get change for our patients' sake - now is not the time to settle for a paltry 1 % that bites deeper into our ability to survive. Get to the candidates - ask the tough questions - donate to those who understand and will work to meaningful solutions (GET RID OF SGR, etc.) - work to defeat those with lousy track records. Now is the time - if we complain and moan and don’t get active, we have no one to blame but ourselves. The Senate is in recess now - they will be in their home communities - find out their phone numbers and call them.
That's all I got to say about that (a.k.a. Forest Gump)….for now
George W. Shannon, M.D.
Handing out talking points is good - it is time we shared with our patients the information we have hesitated to because we didn't want to "politicize" the exam room - the time has come but we are restricting our audience. The messages (talking points) need to hit the local news, the paper, the radio station and the TV. Those not yet on Medicare need to know the upcoming reality. AARP and the baby boomers can be powerful allies if we give then the reality and the future downside.
If you need a resource, here is a video clip on my web site to which you can refer (take a look at it first) http://www.gafp.org/shannon.asp - click on Medicare video.
The AAFP position is http://www.aafp.org/online/en/home/media/releases/2008/senate-failure-to-address-medicare-payment.html
The AMA position is http://www.ama-assn.org/ama/pub/category/6583.html
These are well and good - but remember, the Academy is us. Waiting for the AAFP to win the day means you are waiting on yourself - so it is time to act. Depend on others to do your talking for you and you will get their solutions. Don't depend on our "brother" specialists to speak out for us. They haven't before - they won't now - until their position is comfortable and then it will be too late for us. They may actually fight our solutions while benefiting from our victories.
We have other options - see Family Practice Management for options, a discussion and how- to- do it's
http://www.aafp.org/online/en/home/publications/journals/fpm.html
Not wanting to desert our patients is good and professional ( although we may see massive dumping of Medicare patients anyway) - a massive movement to non-participating status may be a good first step - not denying care - just requiring payment from the ones who request and utilize it. They will get reimbursed (note - did not use the word paid - reimbursed is correct here) much later by a slowly moving bureaucracy that will fight them not to pay (sound familiar) It will require us to collect for services (how novel) and be paid by the users for our services. We also need to announce to our communities that we are doing this because of the lack of Congressional action and that we must do this to stay open to provide care. Information and education makes these moves effective. If we are going to act, we need to let the public know why.
Dropping out of Medicare system by private contracting has a two year front if I understand it correctly (see Family Practice Management) but it may come to that. Completely leaving a huge population of patients in the lurch without warning is not our style, our desire or our intention. We want to be able to care for them - hence the time is here to fight.
Be prepared to see limited practitioners (surgical subs, etc.) not accept Medicare payment. It may put us in a bind when their services are needed but we need to let patients know what and why and get releases signed that show what we recommend and that it was not available. Remember, those that help us out with our problems should benefit by seeing our patients who don't have the problems. It is kind of dumb to send our problems to the nice guys who want to help and then send the OK patients to the guys who turn down our patients but send us hams at Christmas.
This is the year when we elect a President, 1/3 of the senate, all the house. Next year - nothing. Now is the time - we need to get change for our patients' sake - now is not the time to settle for a paltry 1 % that bites deeper into our ability to survive. Get to the candidates - ask the tough questions - donate to those who understand and will work to meaningful solutions (GET RID OF SGR, etc.) - work to defeat those with lousy track records. Now is the time - if we complain and moan and don’t get active, we have no one to blame but ourselves. The Senate is in recess now - they will be in their home communities - find out their phone numbers and call them.
That's all I got to say about that (a.k.a. Forest Gump)….for now
George W. Shannon, M.D.
posted by George W. Shannon, MD at
10:20 AM
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