Re: The Sad Case of the Patient Protection and Affordable Care Act
Les: I saw the handwriting on the wall starting back about 1997. I had a few episodes where i could not practice the best medicine for patients because of interference by HMO's, insurance companies, and Medicare. I discussed this at length with my office manager (my nurse and wife). I told her after 30 years of practice, for the first time, I could no longer practice like i have to. I told her I was going to shut down the office rather than become part of this system. I am no expert on much in this world but when it comes to medicine-I refuse to compromise. I was not going to allow some 21 year old girl on the phone who was popping gum in my ear tell me that i could not biopsy a nuclear physicist sitting in my office because he was not referred to me properly by his gatekeeper. Because I am me-and Jenny is Jenny-We wanted to personally explain to each patient. It took me 3-4 years to tell each patient we saw and notify all the others by mail. I could not close down without making sure each and every patient was either totally stable or referred properly to someone who could care for them as well as possible. it was an incredibly tough decision. Neither Jenny or I had come from families with any resources. Our retirement would have to be funded by what we had saved or invested (and being a doctor i of course knew nothing of finance-doctors are the WORST businessmen even though they would never admit it). We are very fortunate to have planned our life the way we did. We do not have large overhead. We live within our means. And i have made a second career out of investing and have surprised myself with how well i have done.
Do we miss practicing? Gosh, do we ever!. But i continue to do consulting work and i keep current on CME and even do occassional teaching. Jenny is the one who misses practice the most-she is cut from the old school cloth. The old time nurse. White shoes, white uniform, white hat and stockings. I still refer to her as nurse Ratchet. But she lives for the profession and is as devoted to helping people today as ever. We do not consider ourselves anything special, and i am sure most of my generation of physicians feels exactly the same, but we are the medical personnel that has been driven out of the profession and we are losing more like us every day. I salute you for continuing to try to provide the best of care. I am just not sure for how much longer you will be able to do it.
Les: I saw the handwriting on the wall starting back about 1997. I had a few episodes where i could not practice the best medicine for patients because of interference by HMO's, insurance companies, and Medicare. I discussed this at length with my office manager (my nurse and wife). I told her after 30 years of practice, for the first time, I could no longer practice like i have to. I told her I was going to shut down the office rather than become part of this system. I am no expert on much in this world but when it comes to medicine-I refuse to compromise. I was not going to allow some 21 year old girl on the phone who was popping gum in my ear tell me that i could not biopsy a nuclear physicist sitting in my office because he was not referred to me properly by his gatekeeper. Because I am me-and Jenny is Jenny-We wanted to personally explain to each patient. It took me 3-4 years to tell each patient we saw and notify all the others by mail. I could not close down without making sure each and every patient was either totally stable or referred properly to someone who could care for them as well as possible. it was an incredibly tough decision. Neither Jenny or I had come from families with any resources. Our retirement would have to be funded by what we had saved or invested (and being a doctor i of course knew nothing of finance-doctors are the WORST businessmen even though they would never admit it). We are very fortunate to have planned our life the way we did. We do not have large overhead. We live within our means. And i have made a second career out of investing and have surprised myself with how well i have done.
Do we miss practicing? Gosh, do we ever!. But i continue to do consulting work and i keep current on CME and even do occassional teaching. Jenny is the one who misses practice the most-she is cut from the old school cloth. The old time nurse. White shoes, white uniform, white hat and stockings. I still refer to her as nurse Ratchet. But she lives for the profession and is as devoted to helping people today as ever. We do not consider ourselves anything special, and i am sure most of my generation of physicians feels exactly the same, but we are the medical personnel that has been driven out of the profession and we are losing more like us every day. I salute you for continuing to try to provide the best of care. I am just not sure for how much longer you will be able to do it.
