Sunday, June 5, 2011

Mature Physicians May Quit

Mature Physicians May Quit Rather than Recertify

Although many statistics elaborate on how much money physicians earn, these figures, and averages are very distorted.. Averages are very misleading. A few extremely high earners will distort the average. Real statistics including medians, standard deviations, probability factors would reveal the truth about physician earnings.  As overhead continues to rise and reimbursements decline, as well as patient volume being forced to expand Health Train   predicts a rapid decline in physician-surgeon numbers.

Many have already abandoned their private practices and have joined group practices, not only to relieve stress, but also as a transition to a non clinical or even non medical career, using their relatively free time to become educated in business or begin a career in technology, sales, or related biomedical career, consulting for pharma or other medically related business.

Orthopedic surgeon Lee Hieb, M.D., current president of the Association of American Physicians and Surgeons (AAPS), writes that she had to spend time studying theory of joint replacements, which she never does, instead of focusing on spine surgery, her specialty. Then she needed to hire a lawyer because bureaucrats were refusing to allow her to sit for the examination—for lack of a signature sheet on her application.

 

Recertification has become a cottage industry of bureaucrats and testing agencies, dragging with them a few university physicians,” she writes, in the summer 2011 issue of the Journal of American Physicians and Surgeons.

Many physicians are choosing not to recertify. According to the American Board of Internal Medicine, 23 percent of general internists and 40 percent of subspecialists are not renewing their internal medicine certification.

The added requirement of re-certification, while well intentioned, is expensive in it’s own right, and creates loss of income while preparing for the exam and absence from the practice. It is unnecessary and redundant. The addition of unsubstantiated ‘evidence based medicine’ is also ridiculous given the intense study and scientific method of peer reviewed journals in the training process.  Obviously whoever writes these ‘protocols’ is far out of the training loop, and exists in the past by at least a decade.   It should not be in the domain of insurance companies, nor Medicare to set standards when hospital credentialing and medical boards set a standard for medical licensure in each state by requiring documented CME every two years to be eligible for re-licensure. The American Boards were duped into providing these examination without taking these factors into account, rolling over fearing another government agency would take it over. Once again our ‘leaders’ who are mostly academics compromise to appear compliant and cooperative as agents of a government that is out of control.

If these entities want assurance that doctors are up to date let them query state medical licensing agencies, or hospitals. They now  represent consumers, rather than doctors. In California the power and authority have now been given to political figures on our licensing board, in the name of ‘enforcement’, alluding to physician inability to police themselves

In the airline industry who pays for pilot testing and recertification? The airlines. So perhaps hospitals and insurers should do the same for physicians.

Okay I am on the far left (or is it right?)  It really does not matter because I am way out on a limb bringing this up, but I  also know that in the elevator or in the doctor’s lounge, these major annoyance are always discussed by colleagues.

Okay so it may be worthwhile to certify or recertify in skills and newer procedures, but this is in the domain of hospital specialty departments, and is actually served better with peer pressure and education.

I am also getting  suspicious that doctor lounges and elevators are monitored. I know elevators have cameras…why not microphones. I am almost fearful my laptop is monitored with my camera, microphone, and maybe even a key logger….laugh if you will at my pseudo-paranoia, but think about the things that have happened in our dis-belief already.

Physicians & Surgeons alike are retiring early, frustrated, overwhelmed and discouraged, in an environment where physicians are in short supply. While there is an imbalance between numbers of PCPs and Specialists there is no over abundance of specialists. Take a look at wait times to see a specialist….there is your true indicator….not a meaningless misleading ratio.

Common sense must prevail, yet I see no indication that our representatives use common sense (or is it ‘evidence based medicine?) or fathom this simple measure.

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