It will all be worth it...

[PrincessFiona]

It's called bullshit here.

[Sheherezade]

It will all be worth it...

I think part of the problem with this discussion is how we each define "worth it". The changing landscape of healthcare definitely makes this era of training and practice unique, too.

[ides]

Yeah. What about the bundling of surgeries for one fee. Vomit.

Anyhow, I can't really answer the question. There have been a lot of bad things due to medicine but it's also part of our lives and I can't say our lives would be better if dh took a different path. Its not something I can know. I do know he wouldn't do surgery again if he could do it all over again. Probably medicine but a non-surgical speciality like PM&R. Something less stressful. The constant fear/worry of doing something wrong/bad outcome really wears on him.

[Thirteen]

Blessing and curse to us because: a good score indicates happy patients, which in turn leads to more business and a fuller patient load, and often a bonus.
Curse, because if someone complains (often based on unwillingness to hand out controlled substances, or refusing to comply with anything, and getting discharged as a result), scores go down and probation or pay can be directly affected.


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[PrincessFiona]

Thirteen, here the biggest downside has been dealing with the a1c values for diabetics.

Also, currently providers bonus is tied to whether or not their patients sign up for their online chart access (mychart). Our neighbor swears she will simply refer patients to someone else if they don't sign up. I hope she's kidding, but I know she's frustrated that her pay is tied to whether or not they sign up for an online chart.

[Thirteen]

See, that sounds terrible! I'm sorry to hear it.


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[Sheherezade]

Are these requirements established by the institution? So far, DH's only complaint has been about the bundled surgeries and getting dinged for re-admissions. Since he's always taken on "hard" cancer cases, they have re-admissions. I suppose the new standard would be to not offer them care at all.

[PrincessFiona]

The mychart thing is institution specific as far as I know.

[Vanquisher]

These requirements are by CMS and universal as a part of meaningful use. We've starting pimping out our patient portal for this reason. There are several core measure that providers have to meet in order not to be penalized on all Medicare payments.

[Sheherezade]

I realize that they are linked to Medicare for the hospitals but 'm guessing how they trickle down to providers is institution specific. So far, since DH is a strict salaried employee with no RVU component, we've not seen any effect other than coaching the staff to avoid certain things.

I know most people make more money with RVUs and DH did too, but he was so much less stressed when he went off that system of payment.

[HouseofWool]

The mychart thing is institution specific as far as I know.

Nope, part of the CMS requirements.

[Sheherezade]

For private practice? I'm not sure how this doesn't affect my husband? Cleveland Clinic is definitely on MyChart, but they aren't pushing it that hard through the docs.

[HouseofWool]

Not sure about the difference. He is employed, right? If so, it is likely tied to the institution's contract with Medicare.

[HouseofWool]

Right now the requirement is that 5% of patients use an online portal. My guess is that something like CC will easily get that amount.

[MrsK]

Why would patients signing up for online accounts make a difference? I always figured that the patient portals and on line access were for the patien's convenience and I've never signed on for it. Does that mean my providers get penalized?

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