Doctor, if you have recently had occasion to be granted a visit with upper hospital management in the plush executive suite, most surely it was you who stood out quite conspicuously. Being greeted, hopefully politely, by one of the administrative secretaries, you were asked to be seated and wait along with others—consultants, lower-level management, salesmen, business associates, insurance executives, and maybe even golf buddies. Notable was that you, the physician, …
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Before a discussion of entitlements and welfare programs is started, a primer on the fiscal situation of the country seems appropriate. Service on the national debt is now second only to Social Security as a government expenditure. The debt is now about $36 trillion. Government revenues are 18 percent of GDP. Spending is 25 percent of GDP. Seventy-six percent of spending has been mandatory, leaving 24 percent as discretionary. The …
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It is presently fair to ask the question, do doctors participate in our society as individuals being free? If this is no longer the case, why and what are the consequences? If a doctor is employed, he answers to an employer. If there is participation with Medicaid and Medicare, the rules must be followed. These are rules, mandates, and regulations created by the administrative state, politicians, and faceless bureaucrats. If …
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There was an article published recently addressing the shortage of pediatricians. Though the article focused on this specific shortage, it actually raised many additional questions regarding the physician workforce in general. It is difficult to disagree that continuing to decrease reimbursement, increasing maddening payment schemes, and increasing regulatory requirements to pediatricians and physicians in general will have predictable results. There will be physician shortages, and patient access will be compromised.
Hospitals …
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There are difficult issues confronting physicians generally, regardless of whether they are primary care physicians or specialists or employed or in private practice. The list is long and growing as more and more requirements, costs, mandates, and regulations are being inflicted in an environment of decreasing compensation. All of these lend to the rapidly lost freedom and autonomy for a medical profession where these are foundational.
It seems clear that the …
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