Guest guest Posted August 11, 2012 Report Share Posted August 11, 2012 yes it's here check the website will be great when all the kinks are worked out! I am using it for billing now. It's always a shock when things have been working well for some time and suddenly a jillion moving parts need to be adjusted. ________________________________ > To: > CC: nellegreen@... > From: nellegreen@... > Date: Fri, 10 Aug 2012 17:10:39 -0700 > Subject: RE: Bad week everywhere? > > > > Did you mention AC PM--as in Amazing Charts Patient Management? They've > been promising PM for a long time?!? > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 11, 2012 Report Share Posted August 11, 2012 I've done some beta testing but I wasn't brave enough to do that one. I'll wait. You are a brave soul. To: "practiceimprovement1 " <practiceimprovement1 > Sent: Saturday, August 11, 2012 12:01 PM Subject: RE: Bad week everywhere? yes it's here check the website will be great when all the kinks are worked out! I am using it for billing now. It's always a shock when things have been working well for some time and suddenly a jillion moving parts need to be adjusted. ________________________________ > To: mailto:%40yahoogroups.com > CC: mailto:nellegreen%40earthlink.net > From: mailto:nellegreen%40earthlink.net > Date: Fri, 10 Aug 2012 17:10:39 -0700 > Subject: RE: Bad week everywhere? > > > > Did you mention AC PM--as in Amazing Charts Patient Management? They've > been promising PM for a long time?!? > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 11, 2012 Report Share Posted August 11, 2012 good idea I would say don't do it yet ________________________________ > To: > From: myriaemeny@... > Date: Sat, 11 Aug 2012 12:04:38 -0700 > Subject: Re: Bad week everywhere? > > > > I've done some beta testing but I wasn't brave enough to do that one. > I'll wait. You are a brave soul. > > > To: " practiceimprovement1 " > <practiceimprovement1 > > Sent: Saturday, August 11, 2012 12:01 PM > Subject: RE: Bad week everywhere? > > > > yes it's here > check the website > will be great when all the kinks are worked out! > I am using it for billing now. > It's always a shock when things have been working well for some time > and suddenly a jillion moving parts need to be adjusted. > > ________________________________ > > To: mailto:%40yahoogroups.com > > CC: mailto:nellegreen%40earthlink.net > > From: mailto:nellegreen%40earthlink.net > > Date: Fri, 10 Aug 2012 17:10:39 -0700 > > Subject: RE: Bad week everywhere? > > > > > > > > Did you mention AC PM--as in Amazing Charts Patient Management? They've > > been promising PM for a long time?!? > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 11, 2012 Report Share Posted August 11, 2012 So, what will it do?Sharon good idea I would say don't do it yet ________________________________ > To: > From: myriaemeny@... > Date: Sat, 11 Aug 2012 12:04:38 -0700 > Subject: Re: Bad week everywhere? > > > > I've done some beta testing but I wasn't brave enough to do that one. > I'll wait. You are a brave soul. > > > To: " practiceimprovement1 " > <practiceimprovement1 > > Sent: Saturday, August 11, 2012 12:01 PM > Subject: RE: Bad week everywhere? > > > > yes it's here > check the website > will be great when all the kinks are worked out! > I am using it for billing now. > It's always a shock when things have been working well for some time > and suddenly a jillion moving parts need to be adjusted. > > ________________________________ > > To: mailto:%40yahoogroups.com > > CC: mailto:nellegreen%40earthlink.net > > From: mailto:nellegreen%40earthlink.net > > Date: Fri, 10 Aug 2012 17:10:39 -0700 > > Subject: RE: Bad week everywhere? > > > > > > > > Did you mention AC PM--as in Amazing Charts Patient Management? They've > > been promising PM for a long time?!? > > > > > > > > > > ------------------------------------ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 12, 2012 Report Share Posted August 12, 2012 Egads. I find no humor in the irony that is spending hrs trying to get out of medicare while spends the same to get in, while its' recent administrator decries waste and lack of cooperation I do remain crabby I am not burnt outI am very sorry to hear people closing their doors!Sharon, the residents may be inspired by IMP but they rarely practice They become ER docs and hospitalists The increase in PCPs here is that some have left the hospital to open privately and the hospital replaces them AND three have left then returned! One closed her practice, sold it to the hospital and took some position somewhere- and is back. One left with his NP honey for allegedly better place - and is back 1 yr later Which may tell me what it is like Out There. Saradarian -you are a better sucker upper( survivor?) than I . A personality fault o f mine to tilt at a world that SHOUld be better but isn;t ,still I just took a call from a Mom becasue ortho here is a Neanderthal ; I was frustrated at the calls and endless endless faxes of the day I wrote when I WAS on vacation and someone went to the er because she couldn't get me The call dropped at the garage and I called he r back within 4 minutes and while she is old and worried and I understand , I just go under at the " I couldn't get you " stuff. ,sorry about the typing. I really struggle ; I struggle at work becasue I tend to listen not type/manage the MU questions etc Dragon is really slow I cannot get it to go fast,I just cannot sit here waiting and waiitn g for it t o type. I realize it annoys people. It annoys me! I do not encourage anyone anymore to do this work and stand my ground. I will not Noone should take this job Maybe that will make change I get up every day and resolve to do better .I plan to reinvent and slog on for a while I am glad I got a nurse despite the payroll crap to learnI think that my practice needs a little staff to be better to patietns. Wish I could afford a nurse every day Patients here need to schmooze and I cannot, they exhaust me . I think the practice would be better for patients with staff .Gordon(moore) was disagreeing with me about this recently but he is wrong .I do not have high functioning educated people here .And when they a re with me I need to do work.This is very hard for them I think that is an error in how I set this practice up but not sure I can do much about it... When some practices succeed and have nothing replicable they can share for those that fail we are doing somethign dreadfuly wrong in this countryMarrying well /concierge / charging/firing patients/ the happy md are fine but are but tiny plugs in the huge rent in the fabric of health care in this country. I suppose it will even get worse before it gets better I wish it would get worse fast Let s get it over withFor anyone interested, this week in JAma ,an article for by Goroll about the vested interests that slow down change for pcps Also a good read really well done last week a essay also in JAMA by someone ,about the crap in emr notes the nonlinealrity / cut and paste garbage with endless repetition of lists of useless data that is what now constitutes a note DEpressing but well done Jean So, what will it do?Sharon good idea I would say don't do it yet ________________________________ > To: > From: myriaemeny@... > Date: Sat, 11 Aug 2012 12:04:38 -0700 > Subject: Re: Bad week everywhere? > > > > I've done some beta testing but I wasn't brave enough to do that one. > I'll wait. You are a brave soul. > > > To: " practiceimprovement1 " > <practiceimprovement1 > > Sent: Saturday, August 11, 2012 12:01 PM > Subject: RE: Bad week everywhere? > > > > yes it's here > check the website > will be great when all the kinks are worked out! > I am using it for billing now. > It's always a shock when things have been working well for some time > and suddenly a jillion moving parts need to be adjusted. > > ________________________________ > > To: mailto:%40yahoogroups.com > > CC: mailto:nellegreen%40earthlink.net > > From: mailto:nellegreen%40earthlink.net > > Date: Fri, 10 Aug 2012 17:10:39 -0700 > > Subject: RE: Bad week everywhere? > > > > > > > > Did you mention AC PM--as in Amazing Charts Patient Management? They've > > been promising PM for a long time?!? > > > > > > > > > > ------------------------------------ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 12, 2012 Report Share Posted August 12, 2012 Why did you call me a suck up? What did I miss? Saradarian From: [mailto: ] On Behalf Of Sent: Saturday, August 11, 2012 8:11 PMTo: Subject: Re: Bad week everywhere? Egads. I find no humor in the irony that is spending hrs trying to get out of medicare while spends the same to get in, while its' recent administrator decries waste and lack of cooperation I do remain crabby I am not burnt outI am very sorry to hear people closing their doors!Sharon, the residents may be inspired by IMP but they rarely practice They become ER docs and hospitalists The increase in PCPs here is that some have left the hospital to open privately and the hospital replaces them AND three have left then returned! One closed her practice, sold it to the hospital and took some position somewhere- and is back. One left with his NP honey for allegedly better place - and is back 1 yr laterWhich may tell me what it is like Out There.Saradarian -you are a better sucker upper( survivor?) than I . A personality fault o f mine to tilt at a world that SHOUld be better but isn;t ,still I just took a call from a Mom becasue ortho here is a Neanderthal ; I was frustrated at the calls and endless endless faxes of the day I wrote when I WAS on vacation and someone went to the er because she couldn't get me The call dropped at the garage and I called he r back within 4 minutes and while she is old and worried and I understand , I just go under at the " I couldn't get you " stuff. ,sorry about the typing. I really struggle ; I struggle at work becasue I tend to listen not type/manage the MU questions etc Dragon is really slow I cannot get it to go fast,I just cannot sit here waiting and waiitn g for it t o type. I realize it annoys people. It annoys me! I do not encourage anyone anymore to do this work and stand my ground. I will not Noone should take this job Maybe that will make changeI get up every day and resolve to do better .I plan to reinvent and slog on for a whileI am glad I got a nurse despite the payroll crap to learnI think that my practice needs a little staff to be better to patietns. Wish I could afford a nurse every day Patients here need to schmooze and I cannot, they exhaust me . I think the practice would be better for patients with staff .Gordon(moore) was disagreeing with me about this recently but he is wrong .I do not have high functioning educated people here .And when they a re with me I need to do work.This is very hard for themI think that is an error in how I set this practice up but not sure I can do much about it... When some practices succeed and have nothing replicable they can share for those that fail we are doing somethign dreadfuly wrong in this countryMarrying well /concierge / charging/firing patients/ the happy md are fine but are but tiny plugs in the huge rent in the fabric of health care in this country. I suppose it will even get worse before it gets betterI wish it would get worse fast Let s get it over withFor anyone interested, this week in JAma ,an article for by Goroll about the vested interests that slow down change for pcps Also a good read really well done last week a essay also in JAMA by someone ,about the crap in emr notes the nonlinealrity / cut and paste garbage with endless repetition of lists of useless data that is what now constitutes a note DEpressing but well done So, what will it do?Sharon good idea I would say don't do it yet________________________________> To: > Date: Sat, 11 Aug 2012 12:04:38 -0700> Subject: Re: Bad week everywhere?>>>> I've done some beta testing but I wasn't brave enough to do that one.> I'll wait. You are a brave soul.>> > To: " practiceimprovement1 " > <practiceimprovement1 >> Sent: Saturday, August 11, 2012 12:01 PM> Subject: RE: Bad week everywhere?>>>> yes it's here> check the website> will be great when all the kinks are worked out!> I am using it for billing now.> It's always a shock when things have been working well for some time> and suddenly a jillion moving parts need to be adjusted.>> ________________________________> > To: mailto:%40yahoogroups.com> > CC: mailto:nellegreen%40earthlink.net> > From: mailto:nellegreen%40earthlink.net> > Date: Fri, 10 Aug 2012 17:10:39 -0700> > Subject: RE: Bad week everywhere?> >> >> >> > Did you mention AC PM--as in Amazing Charts Patient Management? They've> > been promising PM for a long time?!?> >> >> >>>>>------------------------------------ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 12, 2012 Report Share Posted August 12, 2012 No no not calling you names!You said suck it up as in grow up get on with it stop whining etcI was try to say you probably just get your work done without sweatingthe stuff that I let get to meSent from my iPod Why did you call me a suck up? What did I miss? Saradarian From: [mailto: ] On Behalf Of Sent: Saturday, August 11, 2012 8:11 PMTo: Subject: Re: Bad week everywhere? Egads. I find no humor in the irony that is spending hrs trying to get out of medicare while spends the same to get in, while its' recent administrator decries waste and lack of cooperation I do remain crabby I am not burnt outI am very sorry to hear people closing their doors!Sharon, the residents may be inspired by IMP but they rarely practice They become ER docs and hospitalists The increase in PCPs here is that some have left the hospital to open privately and the hospital replaces them AND three have left then returned! One closed her practice, sold it to the hospital and took some position somewhere- and is back. One left with his NP honey for allegedly better place - and is back 1 yr laterWhich may tell me what it is like Out There.Saradarian -you are a better sucker upper( survivor?) than I . A personality fault o f mine to tilt at a world that SHOUld be better but isn;t ,still I just took a call from a Mom becasue ortho here is a Neanderthal ; I was frustrated at the calls and endless endless faxes of the day I wrote when I WAS on vacation and someone went to the er because she couldn't get me The call dropped at the garage and I called he r back within 4 minutes and while she is old and worried and I understand , I just go under at the "I couldn't get you" stuff. ,sorry about the typing. I really struggle ; I struggle at work becasue I tend to listen not type/manage the MU questions etc Dragon is really slow I cannot get it to go fast,I just cannot sit here waiting and waiitn g for it t o type. I realize it annoys people. It annoys me! I do not encourage anyone anymore to do this work and stand my ground. I will not Noone should take this job Maybe that will make changeI get up every day and resolve to do better .I plan to reinvent and slog on for a whileI am glad I got a nurse despite the payroll crap to learnI think that my practice needs a little staff to be better to patietns. Wish I could afford a nurse every day Patients here need to schmooze and I cannot, they exhaust me . I think the practice would be better for patients with staff .Gordon(moore) was disagreeing with me about this recently but he is wrong .I do not have high functioning educated people here .And when they a re with me I need to do work.This is very hard for themI think that is an error in how I set this practice up but not sure I can do much about it... When some practices succeed and have nothing replicable they can share for those that fail we are doing somethign dreadfuly wrong in this countryMarrying well /concierge / charging/firing patients/ the happy md are fine but are but tiny plugs in the huge rent in the fabric of health care in this country. I suppose it will even get worse before it gets betterI wish it would get worse fast Let s get it over withFor anyone interested, this week in JAma ,an article for by Goroll about the vested interests that slow down change for pcps Also a good read really well done last week a essay also in JAMA by someone ,about the crap in emr notes the nonlinealrity / cut and paste garbage with endless repetition of lists of useless data that is what now constitutes a note DEpressing but well done So, what will it do?Sharon good idea I would say don't do it yet________________________________> To: > Date: Sat, 11 Aug 2012 12:04:38 -0700> Subject: Re: Bad week everywhere?>>>> I've done some beta testing but I wasn't brave enough to do that one.> I'll wait. You are a brave soul.>> > To: "practiceimprovement1 "> <practiceimprovement1 >> Sent: Saturday, August 11, 2012 12:01 PM> Subject: RE: Bad week everywhere?>>>> yes it's here> check the website> will be great when all the kinks are worked out!> I am using it for billing now.> It's always a shock when things have been working well for some time> and suddenly a jillion moving parts need to be adjusted.>> ________________________________> > To: mailto:%40yahoogroups.com> > CC: mailto:nellegreen%40earthlink.net> > From: mailto:nellegreen%40earthlink.net> > Date: Fri, 10 Aug 2012 17:10:39 -0700> > Subject: RE: Bad week everywhere?> >> >> >> > Did you mention AC PM--as in Amazing Charts Patient Management? They've> > been promising PM for a long time?!?> >> >> >>>>>------------------------------------ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 12, 2012 Report Share Posted August 12, 2012 Like you Are tougher stuff than me Sent from my iPod Why did you call me a suck up? What did I miss? Saradarian From: [mailto: ] On Behalf Of Sent: Saturday, August 11, 2012 8:11 PMTo: Subject: Re: Bad week everywhere? Egads. I find no humor in the irony that is spending hrs trying to get out of medicare while spends the same to get in, while its' recent administrator decries waste and lack of cooperation I do remain crabby I am not burnt outI am very sorry to hear people closing their doors!Sharon, the residents may be inspired by IMP but they rarely practice They become ER docs and hospitalists The increase in PCPs here is that some have left the hospital to open privately and the hospital replaces them AND three have left then returned! One closed her practice, sold it to the hospital and took some position somewhere- and is back. One left with his NP honey for allegedly better place - and is back 1 yr laterWhich may tell me what it is like Out There.Saradarian -you are a better sucker upper( survivor?) than I . A personality fault o f mine to tilt at a world that SHOUld be better but isn;t ,still I just took a call from a Mom becasue ortho here is a Neanderthal ; I was frustrated at the calls and endless endless faxes of the day I wrote when I WAS on vacation and someone went to the er because she couldn't get me The call dropped at the garage and I called he r back within 4 minutes and while she is old and worried and I understand , I just go under at the "I couldn't get you" stuff. ,sorry about the typing. I really struggle ; I struggle at work becasue I tend to listen not type/manage the MU questions etc Dragon is really slow I cannot get it to go fast,I just cannot sit here waiting and waiitn g for it t o type. I realize it annoys people. It annoys me! I do not encourage anyone anymore to do this work and stand my ground. I will not Noone should take this job Maybe that will make changeI get up every day and resolve to do better .I plan to reinvent and slog on for a whileI am glad I got a nurse despite the payroll crap to learnI think that my practice needs a little staff to be better to patietns. Wish I could afford a nurse every day Patients here need to schmooze and I cannot, they exhaust me . I think the practice would be better for patients with staff .Gordon(moore) was disagreeing with me about this recently but he is wrong .I do not have high functioning educated people here .And when they a re with me I need to do work.This is very hard for themI think that is an error in how I set this practice up but not sure I can do much about it... When some practices succeed and have nothing replicable they can share for those that fail we are doing somethign dreadfuly wrong in this countryMarrying well /concierge / charging/firing patients/ the happy md are fine but are but tiny plugs in the huge rent in the fabric of health care in this country. I suppose it will even get worse before it gets betterI wish it would get worse fast Let s get it over withFor anyone interested, this week in JAma ,an article for by Goroll about the vested interests that slow down change for pcps Also a good read really well done last week a essay also in JAMA by someone ,about the crap in emr notes the nonlinealrity / cut and paste garbage with endless repetition of lists of useless data that is what now constitutes a note DEpressing but well done So, what will it do?Sharon good idea I would say don't do it yet________________________________> To: > Date: Sat, 11 Aug 2012 12:04:38 -0700> Subject: Re: Bad week everywhere?>>>> I've done some beta testing but I wasn't brave enough to do that one.> I'll wait. You are a brave soul.>> > To: "practiceimprovement1 "> <practiceimprovement1 >> Sent: Saturday, August 11, 2012 12:01 PM> Subject: RE: Bad week everywhere?>>>> yes it's here> check the website> will be great when all the kinks are worked out!> I am using it for billing now.> It's always a shock when things have been working well for some time> and suddenly a jillion moving parts need to be adjusted.>> ________________________________> > To: mailto:%40yahoogroups.com> > CC: mailto:nellegreen%40earthlink.net> > From: mailto:nellegreen%40earthlink.net> > Date: Fri, 10 Aug 2012 17:10:39 -0700> > Subject: RE: Bad week everywhere?> >> >> >> > Did you mention AC PM--as in Amazing Charts Patient Management? They've> > been promising PM for a long time?!?> >> >> >>>>>------------------------------------ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 12, 2012 Report Share Posted August 12, 2012 Oh. I thought I told you to go out in your garden or take a vacation; not suck it up and stop whining. I’ve recently fired a couple of patients who I just got sick of abusing me. It was very uplifting. And then, I get mad at the patient who sends an e-mail that she went to another doctor after I refused to call in an ABT for her usual sinusitis and bronchitis as I tried to explain that they are viral and don’t need antibiotics. The other doctor told her she has bronchitis and sinusitis and gave her an antibiotic. Of course she saw the other doctor too.   I get pissed.  But when patients just start getting me mad, I know it’s past time for a vacation. Saradarian From: [mailto: ] On Behalf Of Sent: Saturday, August 11, 2012 9:35 PMTo: Cc: < >Subject: Re: Bad week everywhere? Like you Are tougher stuff than me Sent from my iPod Why did you call me a suck up? What did I miss? Saradarian From: [mailto: ] On Behalf Of Sent: Saturday, August 11, 2012 8:11 PMTo: Subject: Re: Bad week everywhere? Egads. I find no humor in the irony that is spending hrs trying to get out of medicare while spends the same to get in, while its' recent administrator decries waste and lack of cooperation I do remain crabby I am not burnt outI am very sorry to hear people closing their doors!Sharon, the residents may be inspired by IMP but they rarely practice They become ER docs and hospitalists The increase in PCPs here is that some have left the hospital to open privately and the hospital replaces them AND three have left then returned! One closed her practice, sold it to the hospital and took some position somewhere- and is back. One left with his NP honey for allegedly better place - and is back 1 yr laterWhich may tell me what it is like Out There.Saradarian -you are a better sucker upper( survivor?) than I . A personality fault o f mine to tilt at a world that SHOUld be better but isn;t ,still I just took a call from a Mom becasue ortho here is a Neanderthal ; I was frustrated at the calls and endless endless faxes of the day I wrote when I WAS on vacation and someone went to the er because she couldn't get me The call dropped at the garage and I called he r back within 4 minutes and while she is old and worried and I understand , I just go under at the " I couldn't get you " stuff. ,sorry about the typing. I really struggle ; I struggle at work becasue I tend to listen not type/manage the MU questions etc Dragon is really slow I cannot get it to go fast,I just cannot sit here waiting and waiitn g for it t o type. I realize it annoys people. It annoys me! I do not encourage anyone anymore to do this work and stand my ground. I will not Noone should take this job Maybe that will make changeI get up every day and resolve to do better .I plan to reinvent and slog on for a whileI am glad I got a nurse despite the payroll crap to learnI think that my practice needs a little staff to be better to patietns. Wish I could afford a nurse every day Patients here need to schmooze and I cannot, they exhaust me . I think the practice would be better for patients with staff .Gordon(moore) was disagreeing with me about this recently but he is wrong .I do not have high functioning educated people here .And when they a re with me I need to do work.This is very hard for themI think that is an error in how I set this practice up but not sure I can do much about it... When some practices succeed and have nothing replicable they can share for those that fail we are doing somethign dreadfuly wrong in this countryMarrying well /concierge / charging/firing patients/ the happy md are fine but are but tiny plugs in the huge rent in the fabric of health care in this country. I suppose it will even get worse before it gets betterI wish it would get worse fast Let s get it over withFor anyone interested, this week in JAma ,an article for by Goroll about the vested interests that slow down change for pcps Also a good read really well done last week a essay also in JAMA by someone ,about the crap in emr notes the nonlinealrity / cut and paste garbage with endless repetition of lists of useless data that is what now constitutes a note DEpressing but well done So, what will it do?Sharon good idea I would say don't do it yet________________________________> To: > Date: Sat, 11 Aug 2012 12:04:38 -0700> Subject: Re: Bad week everywhere?>>>> I've done some beta testing but I wasn't brave enough to do that one.> I'll wait. You are a brave soul.>> > To: " practiceimprovement1 " > <practiceimprovement1 >> Sent: Saturday, August 11, 2012 12:01 PM> Subject: RE: Bad week everywhere?>>>> yes it's here> check the website> will be great when all the kinks are worked out!> I am using it for billing now.> It's always a shock when things have been working well for some time> and suddenly a jillion moving parts need to be adjusted.>> ________________________________> > To: mailto:%40yahoogroups.com> > CC: mailto:nellegreen%40earthlink.net> > From: mailto:nellegreen%40earthlink.net> > Date: Fri, 10 Aug 2012 17:10:39 -0700> > Subject: RE: Bad week everywhere?> >> >> >> > Did you mention AC PM--as in Amazing Charts Patient Management? They've> > been promising PM for a long time?!?> >> >> >>>>>------------------------------------ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 12, 2012 Report Share Posted August 12, 2012 We had this problem with the hospitals, and I sent a couple nasty grams and talked to the head of the hospitalist group, and it is mostly resolved. We are notified on admission, and are receiving a full D C summary. Our hospitals are 80 miles away. It is now part of the Meaningful use, standard of care that any patient transition is suppose to be seamless. If they are not providing you with what you need, tell them to or change groups if you can. ________________________________________ From: [ ] On Behalf Of [jnantonucci@...] Sent: Sunday, August 12, 2012 8:27 AM To: Subject: Re: Bad week everywhere? I think the fact that you have been practicing so long in difficult NJ is a tribute Kath and I sure mean not offense just the opposite It was that I think that I am entitled to be told when someone is in the hospital.This is where I could be wrong. The nonsystem here is that I would have to install a hospital printer and go look every day at a report that would tell me a list of names that would be everything from Suzie Q needing 3 stiches on her hand to JOhn admitted for MI Maybe some of you think that is great. I contend not. This ain;t a third world country. They cannot send me something paperless to tel l me who was admitted or in the ER and for what ,without some other machine/ some other place to go look .Think of the errors we make when overloaded with interruptions to adjust to some other institutions work systems. It is possible I should be grateful to have a machine available this is the suck it up part, and go get the paper off it and get up and go look at it and open the hospital data base and go see what happened to who but I don;t think so A local office invovled in the PCMH pilot has this printer but the doc still had no idea he could tell who was admitted Nonsytems that demand more work and more nonsense flurrying around to attend to the computer. are nuts! However if I am trying to do care coordination I should rightly KNOW if a patietn is admitted and discharged eh? In some offices I know that the nurses check this thing and print out reams of reports and put them on the docs desk I am not sure that improves care or follow up And it don;t do much for expenses. I just cannot do one more fragmetned thing to get my work done You were saying oh suck it up get the printer installed This maybe why you stay in practice Kath some things should be sucked up SOme things infuriate me when I have to do MORE work and disrupt my work flow to get my work done well Jeez i coudl do alot if no real people ever came in.I could chase faxes and attach them to charts and copy and paste etc. Some offices just get stuff done- but I am sure leaving other stuff by the wayside i complain becasue it is stupid and I want to make change PCPs have been lying down like rugs for yrs.. You want me to keep people from being readmitied? Well tell me when they are, so I can follow up , Needy patients get needy. we do our best to be helpful Yes Ihad a woman who owed me 57.00 for a year HAs horrbile conflicts about fear of her htn vs fear of meds and could use more of a therapist than I can be for her. Cries fearful , angry AND then lost her job. Through the resp co. last year I was asked who would like a free holiday dinner and I sent her one But then she sneds nasty nasty emails when I snet her a third personal from me letter to please for the last time see if she could call my biller just call and answer the bills and pay 5.00? Just talk to us is all I ever ask of patietns Sent me emails that my letters are threatening and that if she had been told she could pay a little at a time she would; how dare i threaten her. And you guys want to talk NCBF?? Dream on . She has now paid her bill 5.00 by 5.00 and lives in an angry conflicted world- and sees a hosp clinic where she sees docs who are paid handsomely see her for 5.00 Sigh. Ah lets see the guy whose wife I saw through incredible stuff had a visit to quit tobacco which he did Owed me 80 for a yr Got insuracne Came in Was told the copay was 20 and there was an old bill of 80 as well. 1 yr later He said- this is almost funny -- " but you siad I could pay it when I could " well uh yess.... He stormed out saying I hate men Trouble is that in a rural area one person likes this tells 20 and it is hard to fill a schedule when you actually cannot see them for 5.00 and there is bad shit all over town. about you the job is really really hard the visits are busy with many demands and the pay and respect and nonsystems suck right now Even if the pay were good the systems superb and the specialist and resepct better it is just a hard job and gets to us. Will get off email and stop bothering you guys HAppy sunday On Sat, Aug 11, 2012 at 11:25 PM, Kathy Saradarian > wrote: Oh. I thought I told you to go out in your garden or take a vacation; not suck it up and stop whining. I’ve recently fired a couple of patients who I just got sick of abusing me. It was very uplifting. And then, I get mad at the patient who sends an e-mail that she went to another doctor after I refused to call in an ABT for her usual sinusitis and bronchitis as I tried to explain that they are viral and don’t need antibiotics. The other doctor told her she has bronchitis and sinusitis and gave her an antibiotic. Of course she saw the other doctor too. I get pissed. But when patients just start getting me mad, I know it’s past time for a vacation. Saradarian From: <mailto: \ > [mailto: <mailto:@yahoogr\ oups.com>] On Behalf Of Sent: Saturday, August 11, 2012 9:35 PM To: <mailto: \ > Cc: < <mailto:@...\ m>> Subject: Re: Bad week everywhere? Like you Are tougher stuff than me Sent from my iPod On Aug 11, 2012, at 8:43 PM, " Kathy Saradarian " > wrote: Why did you call me a suck up? What did I miss? Saradarian From: <mailto: \ > [mailto: ]<mailto:[mailto:Practiceimprovement\ 1 ]> On Behalf Of Sent: Saturday, August 11, 2012 8:11 PM To: <mailto: \ > Subject: Re: Bad week everywhere? Egads. I find no humor in the irony that is spending hrs trying to get out of medicare while spends the same to get in, while its' recent administrator decries waste and lack of cooperation I do remain crabby I am not burnt out I am very sorry to hear people closing their doors! Sharon, the residents may be inspired by IMP but they rarely practice They become ER docs and hospitalists The increase in PCPs here is that some have left the hospital to open privately and the hospital replaces them AND three have left then returned! One closed her practice, sold it to the hospital and took some position somewhere- and is back. One left with his NP honey for allegedly better place - and is back 1 yr later Which may tell me what it is like Out There. Saradarian -you are a better sucker upper( survivor?) than I . A personality fault o f mine to tilt at a world that SHOUld be better but isn;t ,still I just took a call from a Mom becasue ortho here is a Neanderthal ; I was frustrated at the calls and endless endless faxes of the day I wrote when I WAS on vacation and someone went to the er because she couldn't get me The call dropped at the garage and I called he r back within 4 minutes and while she is old and worried and I understand , I just go under at the " I couldn't get you " stuff. ,sorry about the typing. I really struggle ; I struggle at work becasue I tend to listen not type/manage the MU questions etc Dragon is really slow I cannot get it to go fast,I just cannot sit here waiting and waiitn g for it t o type. I realize it annoys people. It annoys me! I do not encourage anyone anymore to do this work and stand my ground. I will not Noone should take this job Maybe that will make change I get up every day and resolve to do better .I plan to reinvent and slog on for a while I am glad I got a nurse despite the payroll crap to learn I think that my practice needs a little staff to be better to patietns. Wish I could afford a nurse every day Patients here need to schmooze and I cannot, they exhaust me . I think the practice would be better for patients with staff ..Gordon(moore) was disagreeing with me about this recently but he is wrong .I do not have high functioning educated people here .And when they a re with me I need to do work.This is very hard for them I think that is an error in how I set this practice up but not sure I can do much about it... When some practices succeed and have nothing replicable they can share for those that fail we are doing somethign dreadfuly wrong in this country Marrying well /concierge / charging/firing patients/ the happy md are fine but are but tiny plugs in the huge rent in the fabric of health care in this country. I suppose it will even get worse before it gets better I wish it would get worse fast Let s get it over with For anyone interested, this week in JAma ,an article for by Goroll about the vested interests that slow down change for pcps Also a good read really well done last week a essay also in JAMA by someone ,about the crap in emr notes the nonlinealrity / cut and paste garbage with endless repetition of lists of useless data that is what now constitutes a note DEpressing but well done Jean On Sat, Aug 11, 2012 at 5:51 PM, Sharon McCoy > wrote: So, what will it do? Sharon On Sat, Aug 11, 2012 at 12:30 PM, Lynn Ho > wrote: good idea I would say don't do it yet ________________________________ > To: <mailto: \ > > > Date: Sat, 11 Aug 2012 12:04:38 -0700 > Subject: Re: Bad week everywhere? > > > > I've done some beta testing but I wasn't brave enough to do that one. > I'll wait. You are a brave soul. > > > > To: " practiceimprovement1 <mailto:practiceimprovement1@...\ m> " > <practiceimprovement1 <mailto:practiceimprovement1@...\ m>> > Sent: Saturday, August 11, 2012 12:01 PM > Subject: RE: Bad week everywhere? > > > > yes it's here > check the website > will be great when all the kinks are worked out! > I am using it for billing now. > It's always a shock when things have been working well for some time > and suddenly a jillion moving parts need to be adjusted. > > ________________________________ > > To: mailto:%40yahoogroups.com<mailto:%2540ya\ hoogroups.com> > > CC: mailto:nellegreen%40earthlink.net<mailto:nellegreen%2540earthlink.net> > > From: mailto:nellegreen%40earthlink.net<mailto:nellegreen%2540earthlink.net> > > Date: Fri, 10 Aug 2012 17:10:39 -0700 > > Subject: RE: Bad week everywhere? > > > > > > > > Did you mention AC PM--as in Amazing Charts Patient Management? They've > > been promising PM for a long time?!? > > > > > > > > > > ------------------------------------ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 12, 2012 Report Share Posted August 12, 2012 Part of meaningful use?To notify us? Details?No other choice They mean well Well mostly The hopsitlaists here are not warm and fussy. they cannot remember to manually say " cc to " everytime that is how it could work They forget .Human itis their stupid electronics that should make it automatically go to the PCP on record. They just yell a t me for being a witch to not get the printer thing. God has just punished me anyway I wen to t he garden where the greenhouse door stuck yanked it and a yellow jacket showed up got under my glasses and got upset and stung me in the face Nice:) We had this problem with the hospitals, and I sent a couple nasty grams and talked to the head of the hospitalist group, and it is mostly resolved. We are notified on admission, and are receiving a full D C summary. Our hospitals are 80 miles away. It is now part of the Meaningful use, standard of care that any patient transition is suppose to be seamless. If they are not providing you with what you need, tell them to or change groups if you can. ________________________________________ From: [ ] On Behalf Of [jnantonucci@...] Sent: Sunday, August 12, 2012 8:27 AM To: Subject: Re: Bad week everywhere? I think the fact that you have been practicing so long in difficult NJ is a tribute Kath and I sure mean not offense just the opposite It was that I think that I am entitled to be told when someone is in the hospital.This is where I could be wrong. The nonsystem here is that I would have to install a hospital printer and go look every day at a report that would tell me a list of names that would be everything from Suzie Q needing 3 stiches on her hand to JOhn admitted for MI Maybe some of you think that is great. I contend not. This ain;t a third world country. They cannot send me something paperless to tel l me who was admitted or in the ER and for what ,without some other machine/ some other place to go look .Think of the errors we make when overloaded with interruptions to adjust to some other institutions work systems. It is possible I should be grateful to have a machine available this is the suck it up part, and go get the paper off it and get up and go look at it and open the hospital data base and go see what happened to who but I don;t think so A local office invovled in the PCMH pilot has this printer but the doc still had no idea he could tell who was admitted Nonsytems that demand more work and more nonsense flurrying around to attend to the computer. are nuts! However if I am trying to do care coordination I should rightly KNOW if a patietn is admitted and discharged eh? In some offices I know that the nurses check this thing and print out reams of reports and put them on the docs desk I am not sure that improves care or follow up And it don;t do much for expenses. I just cannot do one more fragmetned thing to get my work done You were saying oh suck it up get the printer installed This maybe why you stay in practice Kath some things should be sucked up SOme things infuriate me when I have to do MORE work and disrupt my work flow to get my work done well Jeez i coudl do alot if no real people ever came in.I could chase faxes and attach them to charts and copy and paste etc. Some offices just get stuff done- but I am sure leaving other stuff by the wayside i complain becasue it is stupid and I want to make change PCPs have been lying down like rugs for yrs.. You want me to keep people from being readmitied? Well tell me when they are, so I can follow up , Needy patients get needy. we do our best to be helpful Yes Ihad a woman who owed me 57.00 for a year HAs horrbile conflicts about fear of her htn vs fear of meds and could use more of a therapist than I can be for her. Cries fearful , angry AND then lost her job. Through the resp co. last year I was asked who would like a free holiday dinner and I sent her one But then she sneds nasty nasty emails when I snet her a third personal from me letter to please for the last time see if she could call my biller just call and answer the bills and pay 5.00? Just talk to us is all I ever ask of patietns Sent me emails that my letters are threatening and that if she had been told she could pay a little at a time she would; how dare i threaten her. And you guys want to talk NCBF?? Dream on . She has now paid her bill 5.00 by 5.00 and lives in an angry conflicted world- and sees a hosp clinic where she sees docs who are paid handsomely see her for 5.00 Sigh. Ah lets see the guy whose wife I saw through incredible stuff had a visit to quit tobacco which he did Owed me 80 for a yr Got insuracne Came in Was told the copay was 20 and there was an old bill of 80 as well. 1 yr later He said- this is almost funny -- " but you siad I could pay it when I could " well uh yess.... He stormed out saying I hate men Trouble is that in a rural area one person likes this tells 20 and it is hard to fill a schedule when you actually cannot see them for 5.00 and there is bad shit all over town. about you the job is really really hard the visits are busy with many demands and the pay and respect and nonsystems suck right now Even if the pay were good the systems superb and the specialist and resepct better it is just a hard job and gets to us. Will get off email and stop bothering you guys HAppy sunday On Sat, Aug 11, 2012 at 11:25 PM, Kathy Saradarian > wrote: Oh. I thought I told you to go out in your garden or take a vacation; not suck it up and stop whining. I’ve recently fired a couple of patients who I just got sick of abusing me. It was very uplifting. And then, I get mad at the patient who sends an e-mail that she went to another doctor after I refused to call in an ABT for her usual sinusitis and bronchitis as I tried to explain that they are viral and don’t need antibiotics. The other doctor told her she has bronchitis and sinusitis and gave her an antibiotic. Of course she saw the other doctor too. I get pissed. But when patients just start getting me mad, I know it’s past time for a vacation. Saradarian From: <mailto: > [mailto: <mailto: >] On Behalf Of Sent: Saturday, August 11, 2012 9:35 PM To: <mailto: > Cc: < <mailto: >> Subject: Re: Bad week everywhere? Like you Are tougher stuff than me Sent from my iPod On Aug 11, 2012, at 8:43 PM, " Kathy Saradarian " > wrote: Why did you call me a suck up? What did I miss? Saradarian From: <mailto: > [mailto: ]<mailto:[mailto: ]> On Behalf Of Sent: Saturday, August 11, 2012 8:11 PM To: <mailto: > Subject: Re: Bad week everywhere? Egads. I find no humor in the irony that is spending hrs trying to get out of medicare while spends the same to get in, while its' recent administrator decries waste and lack of cooperation I do remain crabby I am not burnt out I am very sorry to hear people closing their doors! Sharon, the residents may be inspired by IMP but they rarely practice They become ER docs and hospitalists The increase in PCPs here is that some have left the hospital to open privately and the hospital replaces them AND three have left then returned! One closed her practice, sold it to the hospital and took some position somewhere- and is back. One left with his NP honey for allegedly better place - and is back 1 yr later Which may tell me what it is like Out There. Saradarian -you are a better sucker upper( survivor?) than I . A personality fault o f mine to tilt at a world that SHOUld be better but isn;t ,still I just took a call from a Mom becasue ortho here is a Neanderthal ; I was frustrated at the calls and endless endless faxes of the day I wrote when I WAS on vacation and someone went to the er because she couldn't get me The call dropped at the garage and I called he r back within 4 minutes and while she is old and worried and I understand , I just go under at the " I couldn't get you " stuff. ,sorry about the typing. I really struggle ; I struggle at work becasue I tend to listen not type/manage the MU questions etc Dragon is really slow I cannot get it to go fast,I just cannot sit here waiting and waiitn g for it t o type. I realize it annoys people. It annoys me! I do not encourage anyone anymore to do this work and stand my ground. I will not Noone should take this job Maybe that will make change I get up every day and resolve to do better .I plan to reinvent and slog on for a while I am glad I got a nurse despite the payroll crap to learn I think that my practice needs a little staff to be better to patietns. Wish I could afford a nurse every day Patients here need to schmooze and I cannot, they exhaust me . I think the practice would be better for patients with staff .Gordon(moore) was disagreeing with me about this recently but he is wrong .I do not have high functioning educated people here .And when they a re with me I need to do work.This is very hard for them I think that is an error in how I set this practice up but not sure I can do much about it... When some practices succeed and have nothing replicable they can share for those that fail we are doing somethign dreadfuly wrong in this country Marrying well /concierge / charging/firing patients/ the happy md are fine but are but tiny plugs in the huge rent in the fabric of health care in this country. I suppose it will even get worse before it gets better I wish it would get worse fast Let s get it over with For anyone interested, this week in JAma ,an article for by Goroll about the vested interests that slow down change for pcps Also a good read really well done last week a essay also in JAMA by someone ,about the crap in emr notes the nonlinealrity / cut and paste garbage with endless repetition of lists of useless data that is what now constitutes a note DEpressing but well done Jean On Sat, Aug 11, 2012 at 5:51 PM, Sharon McCoy > wrote: So, what will it do? Sharon On Sat, Aug 11, 2012 at 12:30 PM, Lynn Ho > wrote: good idea I would say don't do it yet ________________________________ > To: <mailto: > > > Date: Sat, 11 Aug 2012 12:04:38 -0700 > Subject: Re: Bad week everywhere? > > > > I've done some beta testing but I wasn't brave enough to do that one. > I'll wait. You are a brave soul. > > > > To: " practiceimprovement1 <mailto:practiceimprovement1 > " > <practiceimprovement1 <mailto:practiceimprovement1 >> > Sent: Saturday, August 11, 2012 12:01 PM > Subject: RE: Bad week everywhere? > > > > yes it's here > check the website > will be great when all the kinks are worked out! > I am using it for billing now. > It's always a shock when things have been working well for some time > and suddenly a jillion moving parts need to be adjusted. > > ________________________________ > > To: mailto:%40yahoogroups.com<mailto:%2540yahoogroups.com> > > CC: mailto:nellegreen%40earthlink.net<mailto:nellegreen%2540earthlink.net> > > From: mailto:nellegreen%40earthlink.net<mailto:nellegreen%2540earthlink.net> > > Date: Fri, 10 Aug 2012 17:10:39 -0700 > > Subject: RE: Bad week everywhere? > > > > > > > > Did you mention AC PM--as in Amazing Charts Patient Management? They've > > been promising PM for a long time?!? > > > > > > > > > > ------------------------------------ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 12, 2012 Report Share Posted August 12, 2012 I am surviving by working 24 hours a week as a hospitalist. A physician who is moving back here mid career is joining with me to lease a more functional office. I am doing Suboxone treatment for continuous opioid dependency in addicted mainly young people. So my practice has become a much younger age than it was in 2003 when I retired from my solo practice with 3 employees. I have practiced mainly in 1 county but had salaried positions in an adjacent county. I find it necessary to be open to areas I did not think would fit me and while some did not work out, I learned from them all. Things are very tough for us now, but we are the foot soldiers in a time when they are still needed. Fair pay could make a difference and insurance and coding could facilitate that. I do take insurance and more than my share of indigents. Things are improving slowly, but I stlll worry that the rug might be pulled out from under. I am working with other independent providers in the same office. Doing okay with substance abuse counsellor who is after 8 months of struggling just beginning to get payments in and hopes to help with office rent soon. Physician coming and I are each paying half rent in new office to be occupied Sept 1. Will post again later to update progress. Carolyn B. McCormick MD FAAFP Sent from my iPad Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 12, 2012 Report Share Posted August 12, 2012 Re yellow jacket I reincarnated disatisfied pt? :-) I'll miss u at camp no time/money to go this year Wash DC was driving distance 4 me M in Western Pa now sweating in Houston Tx balmy 91 heat index 100 RE: Bad week everywhere? > > > > > > > > > > > > Did you mention AC PM--as in Amazing Charts Patient Management? > They've > > > been promising PM for a long time?!? > > > > > > > > > > > > > > > > > > > > ------------------------------------ > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 12, 2012 Report Share Posted August 12, 2012 Aww That’s just adding insult to injury. I was not implying you should “suck it up” if that’s how it came out. I was just saying you might have to bend a little. I am on the HER implementation committee for my hospital. My little hospital only has a few doctors but we are part of a bigger system with hundreds of doctors. And for as many doctors, there were demands on how it should work. Communication with hospitalist (which I don’t have to deal with yet) is one of them. Someone needs to be responsible for notifying the primary of the admission. Our hospitalists supposedly send a fax. I often do not get anything. Installing printers in everyone’s office is costly and 1990’s technology. And stupid. What if you have more than one office and the reports are sitting in your “other” office. They should be able to do better than that. What I was saying is that you have an issue, other doctors probably do too. I receive ER summaries by fax. The fax is electronic so I can save or delete. The ER sum tells me if one of my patients was admitted. I can also log into the hospital and see any of my patients that have registered in past 2 weeks ( a list). We had many issues setting this up. Many doctors didn’t want any sumarries. If you were on ER call, you got an ER sum of every patient that did not have a doctor that went to the ER. Most of these patients you would never hear from. Specialists didn’t want any summary. PCPs wanted detailed summaries. Our hospital IT department worked with us and they were able to create a variety of provider categories so that most doctors got what they wanted. Can’t they fax you the report? (I can access the electronically faxed reports remotely or from any computer in the office. PS: Sounds like the hospitalists are indeed “fussy” and not “fuzzy”. Maybe Carolyn can shed some light on the hospitalist side of the equation. Saradarian From: [mailto: ] On Behalf Of Sent: Sunday, August 12, 2012 12:02 PMTo: Subject: Re: Bad week everywhere? Part of meaningful use?To notify us? Details?No other choice They mean well Well mostly The hopsitlaists here are not warm and fussy. they cannot remember to manually say " cc to " everytime that is how it could work They forget .Human itis their stupid electronics that should make it automatically go to the PCP on record. They just yell a t me for being a witch to not get the printer thing.God has just punished me anyway I wen to t he garden where the greenhouse door stuck yanked it and a yellow jacket showed up got under my glasses and got upset and stung me in the face Nice:)We had this problem with the hospitals, and I sent a couple nasty grams and talked to the head of the hospitalist group, and it is mostly resolved. We are notified on admission, and are receiving a full D C summary. Our hospitals are 80 miles away. It is now part of the Meaningful use, standard of care that any patient transition is suppose to be seamless. If they are not providing you with what you need, tell them to or change groups if you can.________________________________________From: [ ] On Behalf Of [jnantonucci@...]Sent: Sunday, August 12, 2012 8:27 AMTo: Subject: Re: Bad week everywhere?I think the fact that you have been practicing so long in difficult NJ is a tribute Kath and I sure mean not offense just the oppositeIt was that I think that I am entitled to be told when someone is in the hospital.This is where I could be wrong.The nonsystem here is that I would have to install a hospital printer and go look every day at a report that would tell me a list of names that would be everything from Suzie Q needing 3 stiches on her hand to JOhn admitted for MI Maybe some of you think that is great. I contend not. This ain;t a third world country. They cannot send me something paperless to tel l me who was admitted or in the ER and for what ,without some other machine/ some other place to go look .Think of the errors we make when overloaded with interruptions to adjust to some other institutions work systems. It is possible I should be grateful to have a machine available this is the suck it up part, and go get the paper off it and get up and go look at it and open the hospital data base and go see what happened to who butI don;t think so A local office invovled in the PCMH pilot has this printer but the doc still had no idea he could tell who was admittedNonsytems that demand more work and more nonsense flurrying around to attend to the computer.are nuts! However if I am trying to do care coordination I should rightly KNOW if a patietn is admitted and discharged eh?In some offices I know that the nurses check this thing and print out reams of reports and put them on the docs deskI am not sure that improves care or follow up And it don;t do much for expenses.I just cannot do one more fragmetned thing to get my work done You were saying oh suck it up get the printer installedThis maybe why you stay in practice Kath some things should be sucked upSOme things infuriate me when I have to do MORE work and disrupt my work flow to get my work done well Jeez i coudl do alot if no real people ever came in.I could chase faxes and attach them to charts and copy and paste etc.Some offices just get stuff done- but I am sure leaving other stuff by the wayside i complain becasue it is stupid and I want to make change PCPs have been lying down like rugs for yrs.. You want me to keep people from being readmitied? Well tell me when they are, so I can follow up, Needy patients get needy. we do our best to be helpful Yes Ihad a woman who owed me 57.00 for a year HAs horrbile conflicts about fear of her htn vs fear of meds and could use more of a therapist than I can be for her. Cries fearful , angry AND then lost her job. Through the resp co. last year I was asked who would like a free holiday dinner and I sent her one But then she sneds nasty nasty emails when I snet her a third personal from me letter to please for the last time see if she could call my biller just call and answer the bills and pay 5.00? Just talk to us is all I ever ask of patietns Sent me emails that my letters are threatening and that if she had been told she could pay a little at a time she would; how dare i threaten her. And you guys want to talk NCBF?? Dream on . She has now paid her bill 5.00 by 5.00 and lives in an angry conflicted world- and sees a hosp clinic where she sees docs who are paid handsomely see her for 5.00 Sigh.Ah lets see the guy whose wife I saw through incredible stuff had a visit to quit tobacco which he did Owed me 80 for a yr Got insuracne Came in Was told the copay was 20 and there was an old bill of 80 as well. 1 yr later He said- this is almost funny -- " but you siad I could pay it when I could " well uh yess.... He stormed out saying I hate men :)Trouble is that in a rural area one person likes this tells 20 and it is hard to fill a schedule when you actually cannot see them for 5.00 and there is bad shit all over town. about you the job is really really hard the visits are busy with many demands and the pay and respect and nonsystems suck right now Even if the pay were good the systems superb and the specialist and resepct better it is just a hard job and gets to us.Will get off email and stop bothering you guys HAppy sundayOn Sat, Aug 11, 2012 at 11:25 PM, Kathy Saradarian > wrote:Oh. I thought I told you to go out in your garden or take a vacation; not suck it up and stop whining.I’ve recently fired a couple of patients who I just got sick of abusing me. It was very uplifting. And then, I get mad at the patient who sends an e-mail that she went to another doctor after I refused to call in an ABT for her usual sinusitis and bronchitis as I tried to explain that they are viral and don’t need antibiotics. The other doctor told her she has bronchitis and sinusitis and gave her an antibiotic. Of course she saw the other doctor too. I get pissed. But when patients just start getting me mad, I know it’s past time for a vacation.SaradarianFrom: <mailto: > [mailto: <mailto: >] On Behalf Of Sent: Saturday, August 11, 2012 9:35 PMTo: <mailto: >Cc: < <mailto: >>Subject: Re: Bad week everywhere?Like you Are tougher stuff than meSent from my iPodOn Aug 11, 2012, at 8:43 PM, " Kathy Saradarian " > wrote:Why did you call me a suck up? What did I miss?SaradarianFrom: <mailto: > [mailto: ]<mailto:[mailto: ]> On Behalf Of Sent: Saturday, August 11, 2012 8:11 PMTo: <mailto: >Subject: Re: Bad week everywhere?Egads. I find no humor in the irony that is spending hrs trying to get out of medicare while spends the same to get in, while its' recent administrator decries waste and lack of cooperation I do remain crabby I am not burnt outI am very sorry to hear people closing their doors!Sharon, the residents may be inspired by IMP but they rarely practice They become ER docs and hospitalistsThe increase in PCPs here is that some have left the hospital to open privately and the hospital replaces them AND three have left then returned! One closed her practice, sold it to the hospital and took some position somewhere- and is back. One left with his NP honey for allegedly better place - and is back 1 yr laterWhich may tell me what it is like Out There.Saradarian -you are a better sucker upper( survivor?) than I . A personality fault o f mine to tilt at a world that SHOUld be better but isn;t ,still I just took a call from a Mom becasue ortho here is a Neanderthal ; I was frustrated at the calls and endless endless faxes of the day I wrote when I WAS on vacation and someone went to the er because she couldn't get me The call dropped at the garage and I called he r back within 4 minutes and while she is old and worried and I understand , I just go under at the " I couldn't get you " stuff. ,sorry about the typing. I really struggle ; I struggle at work becasue I tend to listen not type/manage the MU questions etc Dragon is really slow I cannot get it to go fast,I just cannot sit here waiting and waiitn g for it t o type. I realize it annoys people. It annoys me! I do not encourage anyone anymore to do this work and stand my ground. I will not Noone should take this job Maybe that will make changeI get up every day and resolve to do better .I plan to reinvent and slog on for a whileI am glad I got a nurse despite the payroll crap to learnI think that my practice needs a little staff to be better to patietns. Wish I could afford a nurse every day Patients here need to schmooze and I cannot, they exhaust me . I think the practice would be better for patients with staff .Gordon(moore) was disagreeing with me about this recently but he is wrong .I do not have high functioning educated people here .And when they a re with me I need to do work.This is very hard for themI think that is an error in how I set this practice up but not sure I can do much about it...When some practices succeed and have nothing replicable they can share for those that fail we are doing somethign dreadfuly wrong in this countryMarrying well /concierge / charging/firing patients/ the happy md are fine but are but tiny plugs in the huge rent in the fabric of health care in this country. I suppose it will even get worse before it gets betterI wish it would get worse fast Let s get it over withFor anyone interested, this week in JAma ,an article for by Goroll about the vested interests that slow down change for pcps Also a good read really well done last week a essay also in JAMA by someone ,about the crap in emr notes the nonlinealrity / cut and paste garbage with endless repetition of lists of useless data that is what now constitutes a note DEpressing but well doneJeanOn Sat, Aug 11, 2012 at 5:51 PM, Sharon McCoy > wrote:So, what will it do?SharonOn Sat, Aug 11, 2012 at 12:30 PM, Lynn Ho > wrote:good idea I would say don't do it yet________________________________> To: <mailto: >> > Date: Sat, 11 Aug 2012 12:04:38 -0700> Subject: Re: Bad week everywhere?>>>> I've done some beta testing but I wasn't brave enough to do that one.> I'll wait. You are a brave soul.>> >> To: " practiceimprovement1 <mailto:practiceimprovement1 > " > <practiceimprovement1 <mailto:practiceimprovement1 >>> Sent: Saturday, August 11, 2012 12:01 PM> Subject: RE: Bad week everywhere?>>>> yes it's here> check the website> will be great when all the kinks are worked out!> I am using it for billing now.> It's always a shock when things have been working well for some time> and suddenly a jillion moving parts need to be adjusted.>> ________________________________> > To: mailto:%40yahoogroups.com<mailto:%2540yahoogroups.com>> > CC: mailto:nellegreen%40earthlink.net<mailto:nellegreen%2540earthlink.net>> > From: mailto:nellegreen%40earthlink.net<mailto:nellegreen%2540earthlink.net>> > Date: Fri, 10 Aug 2012 17:10:39 -0700> > Subject: RE: Bad week everywhere?> >> >> >> > Did you mention AC PM--as in Amazing Charts Patient Management? They've> > been promising PM for a long time?!?> >> >> >>>>>------------------------------------ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 12, 2012 Report Share Posted August 12, 2012 The first patient you describe who now goes to the hospital clinic, likely cost you more money to collect on her account than you actually collected. Not smart business but of course, there is a principle to uphold... but at what cost both financially and emotionally on both ends? I am learning where to cut my losses.Do you not have a FHQC in your area at all? I am learning that I need to value my service and time. Its been said before but we all have to learn it in different ways and some, like me, have to try it on a little at a time. If I don't value these, then my patients won't. Even the "good" ones. As I learn more about marketing, I understand more about perceived value. The more you give away and the lower the price you have, the lower the perceived value typically is in general. This does not mean that you should not pack your service with as many benefits as you can, but you should hold firm on the price. I think we need to use marketing strategies in our practices. We need to show patients that we are the boat they need to get from their island of pain and frustration to "pleasure island" as one marketing guru says. Though, technically we are the boat ride, we aren't selling the boat ride, we are selling "pleasure island" which is what they get by using our service. Many of my patients want the extra time/attention and education I provide. Some don't. Those that do, value the relationship and the superior health care delivered in that relationship (pleasure island). Those that don't, are never going to get superior health care- they will fragment their care by going to urgent care and doctor-hopping and looking for the lowest cost boat ride- but that boat ride keeps missing the ultimate destination and delivering them just a little off course. I know that doctors and other HCPs hate "selling" and marketing, but there is a LOT to learn from those marketers that can be applied to our practices. Personally, I will continue to provide service (within the standard of care) to those who are certain they only want to go from point A to point B at the lowest cost (ie get their UTI treated without looking at their whole health picture). But I will make it clear that there is a different option that is a greater value.Membership practices, NCBFs and such are probably using this type of marketing concept. These providers are valuing their own service and putting a price on that service. Patients are perceiving that the "extras" are valuable to them and they are worth paying for. Many of us keep saying that our patients would not go for that. I wonder how true that is. How many IMPs who have gone that route have failed? you have posted previously about always saying "yes" to patients as a way of dealing with challenging conversations - I've always liked that but still struggle with figuring out exactly how to do it. I would love a thread on this topic alone. Here is what I come up with for your first patient and what I will be using in the future (thanks for the opportunity to think about this): "I understand you are financially strapped and payment on your account is difficult. Here is what I can do for you: I can discount your remaining balance by 30% if you agree to send a check on a monthly basis, for x amount until the balance is paid off. This alleviates my cost in sending expensive statements to you and it helps to nurture and maintain our mutual trust." Then have them sign a contract that includes a clause that states they will be discharged if payment is late- or get their credit card and charge it monthly. If they don't agree then: "I believe it will be in both our best interests, for me to forward your records to the provider of your choice so you can establish with someone who can meet your primary care needs. I will continue to provide services to you for the next 30 days. I will be happy to send your records to your next provider within those 30 days absolutely free of the usual record copying charges. After those 30 days, the charge will be x amount to send your records and I will no longer be available to provide primary care services for you." I might offer that they contact me for discussion if they feel I've misinterpreted the situation or some such thing... I would put it in their court to consider what is fair to both of us. The few people I've offered the discount with monthly payments to, have mostly paid up on their own. And when needed: "The office financial policies, which you signed, are followed strictly. These policies allow me to remain financially afloat so that I am available to provide the best care possible to you and my other patients. Veering from these policies is not fair to the practice or to the other patients in the practice." I like the broken record technique and removing yourself from the equation (use 'the practice' rather than 'me'). And if they don't give up? Ask them what they think is fair. If you agree, then accept it. If not, simply say you will have to agree to disagree about what's fair and you will do all you can to help facilitate their moving to a new PCP.Notice the short term offer of sending their records free- that is a marketing technique- plus, you are offering them something for free- they perceive that as a value and it can help them get out of your hair sooner and more definitively! And you also offered them something of value if they paid their bill on their own. How much better could you feel about yourself? You have not begged, you have not harassed and yet you hold your ground. And even though you used a "marketing" technique, it isn't "slimy".Patients who don't pay, and who abuse us, should be divorced or the game should be changed- and we are the only one who can change it. Maybe on the new website we can start a collection of letters like Kathy's devalued patient letter and other's who have come up with the right words for the challenging situations.Carla To: Sent: Sunday, August 12, 2012 8:27 AM Subject: Re: Bad week everywhere? I think the fact that you have been practicing so long in difficult NJ is a tribute Kath and I sure mean not offense just the opposite It was that I think that I am entitled to be told when someone is in the hospital.This is where I could be wrong. The nonsystem here is that I would have to install a hospital printer and go look every day at a report that would tell me a list of names that would be everything from Suzie Q needing 3 stiches on her hand to JOhn admitted for MI Maybe some of you think that is great. I contend not. This ain;t a third world country. They cannot send me something paperless to tel l me who was admitted or in the ER and for what ,without some other machine/ some other place to go look .Think of the errors we make when overloaded with interruptions to adjust to some other institutions work systems. It is possible I should be grateful to have a machine available this is the suck it up part, and go get the paper off it and get up and go look at it and open the hospital data base and go see what happened to who but I don;t think so A local office invovled in the PCMH pilot has this printer but the doc still had no idea he could tell who was admittedNonsytems that demand more work and more nonsense flurrying around to attend to the computer. are nuts! However if I am trying to do care coordination I should rightly KNOW if a patietn is admitted and discharged eh?In some offices I know that the nurses check this thing and print out reams of reports and put them on the docs desk I am not sure that improves care or follow up And it don;t do much for expenses.I just cannot do one more fragmetned thing to get my work done You were saying oh suck it up get the printer installed This maybe why you stay in practice Kath some things should be sucked upSOme things infuriate me when I have to do MORE work and disrupt my work flow to get my work done well Jeez i coudl do alot if no real people ever came in.I could chase faxes and attach them to charts and copy and paste etc. Some offices just get stuff done- but I am sure leaving other stuff by the wayside i complain becasue it is stupid and I want to make change PCPs have been lying down like rugs for yrs.. You want me to keep people from being readmitied? Well tell me when they are, so I can follow up , Needy patients get needy. we do our best to be helpful Yes Ihad a woman who owed me 57.00 for a year HAs horrbile conflicts about fear of her htn vs fear of meds and could use more of a therapist than I can be for her. Cries fearful , angry AND then lost her job. Through the resp co. last year I was asked who would like a free holiday dinner and I sent her one But then she sneds nasty nasty emails when I snet her a third personal from me letter to please for the last time see if she could call my biller just call and answer the bills and pay 5.00? Just talk to us is all I ever ask of patietns Sent me emails that my letters are threatening and that if she had been told she could pay a little at a time she would; how dare i threaten her. And you guys want to talk NCBF?? Dream on . She has now paid her bill 5.00 by 5.00 and lives in an angry conflicted world- and sees a hosp clinic where she sees docs who are paid handsomely see her for 5.00 Sigh.Ah lets see the guy whose wife I saw through incredible stuff had a visit to quit tobacco which he did Owed me 80 for a yr Got insuracne Came in Was told the copay was 20 and there was an old bill of 80 as well. 1 yr later He said- this is almost funny --"but you siad I could pay it when I could" well uh yess.... He stormed out saying I hate men Trouble is that in a rural area one person likes this tells 20 and it is hard to fill a schedule when you actually cannot see them for 5.00 and there is bad shit all over town. about you the job is really really hard the visits are busy with many demands and the pay and respect and nonsystems suck right now Even if the pay were good the systems superb and the specialist and resepct better it is just a hard job and gets to us. Will get off email and stop bothering you guys HAppy sunday Oh. I thought I told you to go out in your garden or take a vacation; not suck it up and stop whining. I’ve recently fired a couple of patients who I just got sick of abusing me. It was very uplifting. And then, I get mad at the patient who sends an e-mail that she went to another doctor after I refused to call in an ABT for her usual sinusitis and bronchitis as I tried to explain that they are viral and don’t need antibiotics. The other doctor told her she has bronchitis and sinusitis and gave her an antibiotic. Of course she saw the other doctor too. I get pissed. But when patients just start getting me mad, I know it’s past time for a vacation. Saradarian From: [mailto: ] On Behalf Of Sent: Saturday, August 11, 2012 9:35 PMTo: Cc: < > Subject: Re: Bad week everywhere? Like you Are tougher stuff than me Sent from my iPod Why did you call me a suck up? What did I miss? Saradarian From: [mailto: ] On Behalf Of Sent: Saturday, August 11, 2012 8:11 PMTo: Subject: Re: Bad week everywhere? Egads. I find no humor in the irony that is spending hrs trying to get out of medicare while spends the same to get in, while its' recent administrator decries waste and lack of cooperation I do remain crabby I am not burnt outI am very sorry to hear people closing their doors!Sharon, the residents may be inspired by IMP but they rarely practice They become ER docs and hospitalists The increase in PCPs here is that some have left the hospital to open privately and the hospital replaces them AND three have left then returned! One closed her practice, sold it to the hospital and took some position somewhere- and is back. One left with his NP honey for allegedly better place - and is back 1 yr later Which may tell me what it is like Out There.Saradarian -you are a better sucker upper( survivor?) than I . A personality fault o f mine to tilt at a world that SHOUld be better but isn;t ,still I just took a call from a Mom becasue ortho here is a Neanderthal ; I was frustrated at the calls and endless endless faxes of the day I wrote when I WAS on vacation and someone went to the er because she couldn't get me The call dropped at the garage and I called he r back within 4 minutes and while she is old and worried and I understand , I just go under at the "I couldn't get you" stuff. ,sorry about the typing. I really struggle ; I struggle at work becasue I tend to listen not type/manage the MU questions etc Dragon is really slow I cannot get it to go fast,I just cannot sit here waiting and waiitn g for it t o type. I realize it annoys people. It annoys me! I do not encourage anyone anymore to do this work and stand my ground. I will not Noone should take this job Maybe that will make changeI get up every day and resolve to do better .I plan to reinvent and slog on for a while I am glad I got a nurse despite the payroll crap to learnI think that my practice needs a little staff to be better to patietns. Wish I could afford a nurse every day Patients here need to schmooze and I cannot, they exhaust me . I think the practice would be better for patients with staff .Gordon(moore) was disagreeing with me about this recently but he is wrong .I do not have high functioning educated people here .And when they a re with me I need to do work.This is very hard for them I think that is an error in how I set this practice up but not sure I can do much about it... When some practices succeed and have nothing replicable they can share for those that fail we are doing somethign dreadfuly wrong in this country Marrying well /concierge / charging/firing patients/ the happy md are fine but are but tiny plugs in the huge rent in the fabric of health care in this country. I suppose it will even get worse before it gets better I wish it would get worse fast Let s get it over withFor anyone interested, this week in JAma ,an article for by Goroll about the vested interests that slow down change for pcps Also a good read really well done last week a essay also in JAMA by someone ,about the crap in emr notes the nonlinealrity / cut and paste garbage with endless repetition of lists of useless data that is what now constitutes a note DEpressing but well done Jean So, what will it do?Sharon good idea I would say don't do it yet ________________________________> To: > From: myriaemeny@... > Date: Sat, 11 Aug 2012 12:04:38 -0700> Subject: Re: Bad week everywhere?>>> > I've done some beta testing but I wasn't brave enough to do that one.> I'll wait. You are a brave soul.>> > To: "practiceimprovement1 "> <practiceimprovement1 > > Sent: Saturday, August 11, 2012 12:01 PM> Subject: RE: Bad week everywhere?>>>> yes it's here> check the website> will be great when all the kinks are worked out! > I am using it for billing now.> It's always a shock when things have been working well for some time> and suddenly a jillion moving parts need to be adjusted.>> ________________________________ > > To: mailto:%40yahoogroups.com> > CC: mailto:nellegreen%40earthlink.net > > From: mailto:nellegreen%40earthlink.net> > Date: Fri, 10 Aug 2012 17:10:39 -0700> > Subject: RE: Bad week everywhere? > >> >> >> > Did you mention AC PM--as in Amazing Charts Patient Management? They've> > been promising PM for a long time?!?> >> >> > >>>>------------------------------------ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 13, 2012 Report Share Posted August 13, 2012 God isn't punishing you, he is trying to get your attention. The yellow jacket is saying, see how upset this is making you, things have to change, NOT "serves you right". To: Sent: Sunday, August 12, 2012 11:06:32 AMSubject: Re: Bad week everywhere? Re yellow jacketI reincarnated disatisfied pt? :-)I'll miss u at camp no time/money to go this year Wash DC was driving distance 4 meM in Western Panow sweating in Houston Txbalmy 91 heat index 100 RE: Bad week everywhere?> > >> > >> > >> > > Did you mention AC PM--as in Amazing Charts Patient Management?> They've> > > been promising PM for a long time?!?> > >> > >> > >> >> >> >> >>>> ------------------------------------>> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 13, 2012 Report Share Posted August 13, 2012 I love the island analogy. I have had to learn a fair amount of marketing for the beauty business, but yet, persist in not carrying it over to my medical clients. When you give them a deadline, it's called a "call to action", in other words, do this now, before you forget and loose the benefit. My oldest sister has a GED rather than a highschool diploma, she has innate business and marketing sense, and has run successful business' without any college degree. She calls your analogy, "selling the blue sky" IN other words, we sell hope!. Hope is a very powerful emotion, and can compell us to do all kinds of things good or bad. I once called her and complained about a patietn who told me they were seeing a local Naturopath in a conceirge clinic for hormone replacement, and "wellness", ie vitamins, and paying 1500/yr, plus the cost of all the supplements. I of course, do bioidentical hormone replacement, and have supplements to sell. But this place was selling her "the hope of feeling better" or Pleasure island. For alot of money, that I'm not getting. All I had to do was tweak how I express that I do this also, and bang, she is back with me. We can do this, we just need to value ourselves more, and stand our ground. I like your verbage and solution for both of the scenarios. Cote To: Sent: Sunday, August 12, 2012 12:45:21 PMSubject: Re: Bad week everywhere? The first patient you describe who now goes to the hospital clinic, likely cost you more money to collect on her account than you actually collected. Not smart business but of course, there is a principle to uphold... but at what cost both financially and emotionally on both ends? I am learning where to cut my losses.Do you not have a FHQC in your area at all? I am learning that I need to value my service and time. Its been said before but we all have to learn it in different ways and some, like me, have to try it on a little at a time. If I don't value these, then my patients won't. Even the "good" ones. As I learn more about marketing, I understand more about perceived value. The more you give away and the lower the price you have, the lower the perceived value typically is in general. This does not mean that you should not pack your service with as many benefits as you can, but you should hold firm on the price. I think we need to use marketing strategies in our practices. We need to show patients that we are the boat they need to get from their island of pain and frustration to "pleasure island" as one marketing guru says. Though, technically we are the boat ride, we aren't selling the boat ride, we are selling "pleasure island" which is what they get by using our service. Many of my patients want the extra time/attention and education I provide. Some don't. Those that do, value the relationship and the superior health care delivered in that relationship (pleasure island). Those that don't, are never going to get superior health care- they will fragment their care by going to urgent care and doctor-hopping and looking for the lowest cost boat ride- but that boat ride keeps missing the ultimate destination and delivering them just a little off course. I know that doctors and other HCPs hate "selling" and marketing, but there is a LOT to learn from those marketers that can be applied to our practices. Personally, I will continue to provide service (within the standard of care) to those who are certain they only want to go from point A to point B at the lowest cost (ie get their UTI treated without looking at their whole health picture). But I will make it clear that there is a different option that is a greater value.Membership practices, NCBFs and such are probably using this type of marketing concept. These providers are valuing their own service and putting a price on that service. Patients are perceiving that the "extras" are valuable to them and they are worth paying for. Many of us keep saying that our patients would not go for that. I wonder how true that is. How many IMPs who have gone that route have failed? you have posted previously about always saying "yes" to patients as a way of dealing with challenging conversations - I've always liked that but still struggle with figuring out exactly how to do it. I would love a thread on this topic alone. Here is what I come up with for your first patient and what I will be using in the future (thanks for the opportunity to think about this): "I understand you are financially strapped and payment on your account is difficult. Here is what I can do for you: I can discount your remaining balance by 30% if you agree to send a check on a monthly basis, for x amount until the balance is paid off. This alleviates my cost in sending expensive statements to you and it helps to nurture and maintain our mutual trust." Then have them sign a contract that includes a clause that states they will be discharged if payment is late- or get their credit card and charge it monthly. If they don't agree then: "I believe it will be in both our best interests, for me to forward your records to the provider of your choice so you can establish with someone who can meet your primary care needs. I will continue to provide services to you for the next 30 days. I will be happy to send your records to your next provider within those 30 days absolutely free of the usual record copying charges. After those 30 days, the charge will be x amount to send your records and I will no longer be available to provide primary care services for you." I might offer that they contact me for discussion if they feel I've misinterpreted the situation or some such thing... I would put it in their court to consider what is fair to both of us. The few people I've offered the discount with monthly payments to, have mostly paid up on their own. And when needed: "The office financial policies, which you signed, are followed strictly. These policies allow me to remain financially afloat so that I am available to provide the best care possible to you and my other patients. Veering from these policies is not fair to the practice or to the other patients in the practice." I like the broken record technique and removing yourself from the equation (use 'the practice' rather than 'me'). And if they don't give up? Ask them what they think is fair. If you agree, then accept it. If not, simply say you will have to agree to disagree about what's fair and you will do all you can to help facilitate their moving to a new PCP.Notice the short term offer of sending their records free- that is a marketing technique- plus, you are offering them something for free- they perceive that as a value and it can help them get out of your hair sooner and more definitively! And you also offered them something of value if they paid their bill on their own. How much better could you feel about yourself? You have not begged, you have not harassed and yet you hold your ground. And even though you used a "marketing" technique, it isn't "slimy".Patients who don't pay, and who abuse us, should be divorced or the game should be changed- and we are the only one who can change it. Maybe on the new website we can start a collection of letters like Kathy's devalued patient letter and other's who have come up with the right words for the challenging situations.Carla To: Sent: Sunday, August 12, 2012 8:27 AMSubject: Re: Bad week everywhere? I think the fact that you have been practicing so long in difficult NJ is a tribute Kath and I sure mean not offense just the opposite It was that I think that I am entitled to be told when someone is in the hospital.This is where I could be wrong.The nonsystem here is that I would have to install a hospital printer and go look every day at a report that would tell me a list of names that would be everything from Suzie Q needing 3 stiches on her hand to JOhn admitted for MI Maybe some of you think that is great. I contend not. This ain;t a third world country. They cannot send me something paperless to tel l me who was admitted or in the ER and for what ,without some other machine/ some other place to go look .Think of the errors we make when overloaded with interruptions to adjust to some other institutions work systems. It is possible I should be grateful to have a machine available this is the suck it up part, and go get the paper off it and get up and go look at it and open the hospital data base and go see what happened to who butI don;t think so A local office invovled in the PCMH pilot has this printer but the doc still had no idea he could tell who was admittedNonsytems that demand more work and more nonsense flurrying around to attend to the computer.are nuts! However if I am trying to do care coordination I should rightly KNOW if a patietn is admitted and discharged eh?In some offices I know that the nurses check this thing and print out reams of reports and put them on the docs deskI am not sure that improves care or follow up And it don;t do much for expenses.I just cannot do one more fragmetned thing to get my work done You were saying oh suck it up get the printer installed This maybe why you stay in practice Kath some things should be sucked upSOme things infuriate me when I have to do MORE work and disrupt my work flow to get my work done well Jeez i coudl do alot if no real people ever came in.I could chase faxes and attach them to charts and copy and paste etc.Some offices just get stuff done- but I am sure leaving other stuff by the wayside i complain becasue it is stupid and I want to make change PCPs have been lying down like rugs for yrs.. You want me to keep people from being readmitied? Well tell me when they are, so I can follow up , Needy patients get needy. we do our best to be helpful Yes Ihad a woman who owed me 57.00 for a year HAs horrbile conflicts about fear of her htn vs fear of meds and could use more of a therapist than I can be for her. Cries fearful , angry AND then lost her job. Through the resp co. last year I was asked who would like a free holiday dinner and I sent her one But then she sneds nasty nasty emails when I snet her a third personal from me letter to please for the last time see if she could call my biller just call and answer the bills and pay 5.00? Just talk to us is all I ever ask of patietns Sent me emails that my letters are threatening and that if she had been told she could pay a little at a time she would; how dare i threaten her. And you guys want to talk NCBF?? Dream on . She has now paid her bill 5.00 by 5.00 and lives in an angry conflicted world- and sees a hosp clinic where she sees docs who are paid handsomely see her for 5.00 Sigh.Ah lets see the guy whose wife I saw through incredible stuff had a visit to quit tobacco which he did Owed me 80 for a yr Got insuracne Came in Was told the copay was 20 and there was an old bill of 80 as well. 1 yr later He said- this is almost funny --"but you siad I could pay it when I could"well uh yess.... He stormed out saying I hate men Trouble is that in a rural area one person likes this tells 20 and it is hard to fill a schedule when you actually cannot see them for 5.00 and there is bad shit all over town. about you the job is really really hard the visits are busy with many demands and the pay and respect and nonsystems suck right now Even if the pay were good the systems superb and the specialist and resepct better it is just a hard job and gets to us.Will get off email and stop bothering you guys HAppy sunday Oh. I thought I told you to go out in your garden or take a vacation; not suck it up and stop whining. I’ve recently fired a couple of patients who I just got sick of abusing me. It was very uplifting. And then, I get mad at the patient who sends an e-mail that she went to another doctor after I refused to call in an ABT for her usual sinusitis and bronchitis as I tried to explain that they are viral and don’t need antibiotics. The other doctor told her she has bronchitis and sinusitis and gave her an antibiotic. Of course she saw the other doctor too. I get pissed. But when patients just start getting me mad, I know it’s past time for a vacation. Saradarian From: [mailto: ] On Behalf Of Sent: Saturday, August 11, 2012 9:35 PMTo: Cc: < > Subject: Re: Bad week everywhere? Like you Are tougher stuff than me Sent from my iPod Why did you call me a suck up? What did I miss? Saradarian From: [mailto: ] On Behalf Of Sent: Saturday, August 11, 2012 8:11 PMTo: Subject: Re: Bad week everywhere? Egads. I find no humor in the irony that is spending hrs trying to get out of medicare while spends the same to get in, while its' recent administrator decries waste and lack of cooperation I do remain crabby I am not burnt outI am very sorry to hear people closing their doors!Sharon, the residents may be inspired by IMP but they rarely practice They become ER docs and hospitalists The increase in PCPs here is that some have left the hospital to open privately and the hospital replaces them AND three have left then returned! One closed her practice, sold it to the hospital and took some position somewhere- and is back. One left with his NP honey for allegedly better place - and is back 1 yr laterWhich may tell me what it is like Out There.Saradarian -you are a better sucker upper( survivor?) than I . A personality fault o f mine to tilt at a world that SHOUld be better but isn;t ,still I just took a call from a Mom becasue ortho here is a Neanderthal ; I was frustrated at the calls and endless endless faxes of the day I wrote when I WAS on vacation and someone went to the er because she couldn't get me The call dropped at the garage and I called he r back within 4 minutes and while she is old and worried and I understand , I just go under at the "I couldn't get you" stuff. ,sorry about the typing. I really struggle ; I struggle at work becasue I tend to listen not type/manage the MU questions etc Dragon is really slow I cannot get it to go fast,I just cannot sit here waiting and waiitn g for it t o type. I realize it annoys people. It annoys me! I do not encourage anyone anymore to do this work and stand my ground. I will not Noone should take this job Maybe that will make changeI get up every day and resolve to do better .I plan to reinvent and slog on for a whileI am glad I got a nurse despite the payroll crap to learnI think that my practice needs a little staff to be better to patietns. Wish I could afford a nurse every day Patients here need to schmooze and I cannot, they exhaust me . I think the practice would be better for patients with staff .Gordon(moore) was disagreeing with me about this recently but he is wrong .I do not have high functioning educated people here .And when they a re with me I need to do work.This is very hard for themI think that is an error in how I set this practice up but not sure I can do much about it... When some practices succeed and have nothing replicable they can share for those that fail we are doing somethign dreadfuly wrong in this countryMarrying well /concierge / charging/firing patients/ the happy md are fine but are but tiny plugs in the huge rent in the fabric of health care in this country. I suppose it will even get worse before it gets betterI wish it would get worse fast Let s get it over withFor anyone interested, this week in JAma ,an article for by Goroll about the vested interests that slow down change for pcps Also a good read really well done last week a essay also in JAMA by someone ,about the crap in emr notes the nonlinealrity / cut and paste garbage with endless repetition of lists of useless data that is what now constitutes a note DEpressing but well doneJean So, what will it do? Sharon good idea I would say don't do it yet________________________________> To: > Date: Sat, 11 Aug 2012 12:04:38 -0700 > Subject: Re: Bad week everywhere?>>> > I've done some beta testing but I wasn't brave enough to do that one.> I'll wait. You are a brave soul.>> > To: "practiceimprovement1 "> <practiceimprovement1 >> Sent: Saturday, August 11, 2012 12:01 PM> Subject: RE: Bad week everywhere?>>>> yes it's here> check the website> will be great when all the kinks are worked out!> I am using it for billing now.> It's always a shock when things have been working well for some time> and suddenly a jillion moving parts need to be adjusted.>> ________________________________> > To: mailto:%40yahoogroups.com> > CC: mailto:nellegreen%40earthlink.net> > From: mailto:nellegreen%40earthlink.net> > Date: Fri, 10 Aug 2012 17:10:39 -0700> > Subject: RE: Bad week everywhere?> >> >> >> > Did you mention AC PM--as in Amazing Charts Patient Management? They've> > been promising PM for a long time?!?> >> >> >>>>> ------------------------------------ Quote Link to comment Share on other sites More sharing options...
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