Administrators are Furloughing Doctors or Cutting Their Pay
I am hearing more and more stories about employed doctors getting fired, put on leave (furloughed) or getting massive pay cuts. I have some very trusted sources telling me this.
Here are my questions:
- Are administrators getting the same treatment themselves? Answer: Probably not. Really, who needs 99% of them during this time? Or any time, actually?
- Hospitals are begging for bailouts already. They will get it. Will they pay doctors back? Answer: Don’t count on it.
- Will Administrators beg these same doctors to come back if the crisis gets works to fill in for others? Answer: Yes. And they will have no shame or guilt in doing it.
If you have any stories or thoughts on this I would love to hear it.
As I read the articles on the responses to Covid-19, I notice that many practices are using a lot more telemedicine. How long do you think it will be before the insurance companies decide that if we can use it during this time, why not make it the standard of care in the future? Of course this will be with drastic cuts in reimbursement and with NP’s covering the computer terminals. Unfortunately, with this we will see a large decline in the quality of care and a large upswing in missed diagnoses.
I can recall multiple instances where I would not have picked up on an important clue if I was just seeing my patient on a monitor. When we see a patient, we use all of our senses in examining them. I have diagnosed many new onset diabetics by smelling the acetone when I walked into the room. Same with an occult strep infection, or the smell of gangrene where the patient then decides to show you the “small sore” on their foot after you ask. What about the pill rolling tremor you might not see using telemedicine or the suspicious mole you happen to glance while seeing a patient for a routine BP med refill? This actually happened to me recently with a patient who is a good friend of mine. While listening to her heart, I noticed a spot on her foot. After overcoming her objections, I did a biopsy and it was a malignant melanoma. How about the child that just does not look right when seen in person but looks fine on the monitor, or seeing a family member roll their eyes when a patient gives you blatantly incorrect information?
Sadly, many of these things will not be noticed when using telemedicine. When looking at “cost benefit ratios”, the administrators in medicine will decide that the losses are acceptable in the “cost of doing business”. So I guess it is time when can stop teaching students about the archaic act of doing a physical exam. It is no longer needed now that we have a computer monitor.
I’m just noticing this myself.
My office phone is ringing off the hook, patients desperate for routine medication refills, to find out their doctor’s office is closed. They’re calling me, just to find a doctor’s office that is open.
I don’t mean sick calls, I mean routine calls.
It’s time to abandon traditional hospitals and let them crumble. Doctors should form care groups with dynamic scheduling. Could it really be less well run than modern hospitals??
I doubt it, even if half the staff didn’t show up, I think it would be a lateral move.
That’s a cool idea, if someone could find the capital. The trick would be to find a way to be excluded from state laws, and thereby Medicare/‘ caid restrictions and mandates.