Watcher's DMH-BS Ad of the Week 2-9-06
The DMH H&R has been strangely silent with ads. Maybe they made Smithmier mad and he's punishing them again.
This weeks BS Ad is the new series of billboards that the propaganda machine has put up all over town. Breast cancer, prostate cancer, etc. All good topics in general, however, none of these topics has anything to do with a hospital! They have to do with physicians! A cancer doctor sees these patients once a primary care physician has diagnosed them!
These topics have everything to do with a primary care physician, but DMH has nothing to do with primary care physicians! They've kicked them out of the hospital and have installed their "hospitalists." To make the assumed statement that DMH is somehow responsible for patients to survive their cancer is ridiculous! Physicians, and for the most part, primary care physicians are the ones who need to be congratulated for diagnosing these patients early. DMH, however, does not support primary care docs, so Smithmier just takes the credit instead. Absurd.
This weeks BS Ad is the new series of billboards that the propaganda machine has put up all over town. Breast cancer, prostate cancer, etc. All good topics in general, however, none of these topics has anything to do with a hospital! They have to do with physicians! A cancer doctor sees these patients once a primary care physician has diagnosed them!
These topics have everything to do with a primary care physician, but DMH has nothing to do with primary care physicians! They've kicked them out of the hospital and have installed their "hospitalists." To make the assumed statement that DMH is somehow responsible for patients to survive their cancer is ridiculous! Physicians, and for the most part, primary care physicians are the ones who need to be congratulated for diagnosing these patients early. DMH, however, does not support primary care docs, so Smithmier just takes the credit instead. Absurd.
posted by Watcher2300 at 2/09/2006 08:52:00 AM
2 Comments:
For some time I followed this blog while employed as an Investigator with the United States Attorney, Central District of Illinois. Having some time on my hands since retirement, I decided to see what has been said on the blog. After reading the last entry regarding Hospitalist, there may be something not yet talked about or thought of.
That being said...I'm certain that there are many GOOD reasons to use a hospitalist.
When a Medicare patient is seen by their doctor and the doctor determines they are sick enough to be admitted. There is an admitting diagnosis.
From there, the patient is treated appropriately and normally there are tests done to further diagnose the problem and then treat disease or illness causing the admission. A normal family practioner will go through that [or similar]process and once the patient is well enough to be discharged, the doctor will discharge the patient and at the time of discharge, the doctor will identify a final diagnosis.
That final diagnosis is the key element that triggers what Medicare [YOU and I] pay for that hospital stay.
Medicare is set up so that the hospital is paid what Medicare determines to be an appropiriate amount for the particular illness or disease. To do that Medicare came up with the DRG system. That is Diagnostic Related Groups. So each final diagnosis is assigned to a DRG. Each DRG pays a flat rate.
As example, here in Central Illinois [the cost varies throughout the United States] a hospital will be paid a flat rate of approximately $4,000 for what is termed a simple case of pneumonia.
That amount is suppose to cover the hospital's cost and yield a slight profit. Unfortunately for hospitals that is not always the case.
Goverment studies have shown that a patient with simple pneumonia will be in the hospital 3-5 [apx]. If the patient is discharged sooner, the hospital makes money, if they stay longer, the hospital loses money. It is expected to balance out, whether that is the case or not is another topic.
A small percentage ( about 5% )of "all" pneumonia patients are found to have complex types of pneumonia. Those are more difficult and expensive to treat and cause a longer hospital stay. Because of that, the Medicare system pays a higher rate of reimbursement to the hospital for a patient who has been discharged as having a complex pneumonia.
Goverment studies have shown that a complex pneumonia will cause a hospital stay of about 6-8 days, thus Medicare will pay the higher reimbursement, somewhere around $6,000 to $7,000 [apx].
Keep in mind that a hospital could make a larger profit by having a patient discharged after 1-2 days when they are diagnosed with simple pneumonia.
EVEN BETTER...
What if...a hospital administrator could get that primary care physician to change his final diagnosis to complex pneumonia.
Of course that does not happen too often because most physicians are honorable people. But there have been many cases where this very thing took place. NOT IN DECATUR!!
But you should understand it can be a bad thing for us taxpayers when a physician can be influenced or no longer can make independant judgement.
Most doctors that I know are honorable and would not allow a hospital's administration to pressure them to change their diagnosis, but the fact is that has happened in other cities and towns.
So while there are probably very good reasons and good arguements in support of hospitalist, there is a potential dark [ $$MONEY$$ ] side.
One thing is a fact...every Medicare patient has [cited in the social security act] the freedom to choose who provides their health care...end of story. If someone prevents that from happening, eventually we will all lose, if we have not already. Keep in mind that choice can be influenced by disparaging remarks.
Robert A. Pittenger
I have copied the above into a separate post so that all would see it clearly. Please see the comments section afterward for more information!
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