free market medicine or…how to love being a doctor again

8/15/2019 FREE MARKET MEDICINE Or…How to love being a doctor again

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WHY I DON’T WANT TO BE AN INSURANCE DOCTOR


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WHAT PATIENTS HATE


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Being treated like a 7-digit code

Not being able to get a 2nd opinion if they want one

Getting an answering machine that tells them to call911 when they need medical advice

That an insurance clerk will refuse them treatment adoctor has ordered

Dying while waiting in line for treatment.


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Average wait time to see a doctor is over 18 days


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WHAT DOCTORS HATE


8/46PAPERWORK


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UNCERTAINTY IN HEALTHCARE


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BATTLINGINSURANCE

COMPANIES


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nonsense computer forms, prior authorizations,

explaining the need forexpensive testing toinsurance representatives

that are uneducated

THE HASSLEFACTOR:


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WASTING

TIME CODING

VISITS INORDER TO BE

REIMBURSEDunretouched photo ofObamaCare Law


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ICD-10 CODES

! W5922XA - Struck by Turtle,

initial encounter

! W5922XD - Struck by turtle,subsequent encounter

! W5922XS - Struck by turtle,

sequela


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WEEDING THROUGH RIDICULOUS CODES

TO GET TESTS ORDERED

• V9027XA Drowning and submersion due to

falling or jumping from burning water skis

• V9107XA Burn due to water skis on fire.

• (There is not one recorded case burnsinvolving water skis..I looked)


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NOT HAVING

ENOUGH TIME TO

SPEND WITH

PATIENTS


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INTERNS TRAINED TO SPEND LESS TIME WITH PATIENTS

! In a recent NY Times article

! Johns Hopkins University and the University of Maryland

researchers followed interns in internal medicine training

programs over their almost 900 hours of training.! 12% of interns’ time was spent with the patient(average of 8

mins per patient).

! Interns now spend much more time in front of a computer

screen than they do with patients. They spend half their

training away from patients since most documentation must

be done electronically.


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OPPORTUNITIES ABOUND


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REASONS TEXANS ARE UNINSURED

! Willfully uninsured- self employed- real estate agents,

beauticians, preachers, builders, rebels

! Not enrolled due to process confusion/di!culty

! Work for small employers

! Part-time, seasonal or contract employee

! Recent immigrants

! Denied individual coverage

! Unemployed/very low income


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HOW MUCH DOES IT COST TO SEE THE DOCTOR?

!

Lowest level of ObamaCare has a $6000 deductible! The Silver plan has a $3,453 deductible

! With co-insurance, Obamacare patients still pay 26% of the

charge to see a primary care physician

! Copay is for primary care is $60/45/30/20 with Obamacare

! The average co-pay for Urgent Care with insurance is $75

(range$120-40 with Obamacare)

! The average woman’s haircut cost $48 in the US…and most

woman go every 8-12 weeks…just saying


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THE BESTPRACTICE


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The old way!


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! Teachers & Preachers get a discount

! Free visits if you are a patient whogets cancer

! BOGO’s

! $5 off if you come in wearing spurs

! House calls

! Patients can call me at home

! No gouging

! Every patient is a VIP

WHAT I DO


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WHY THISWORKS

People choose where their heath care dollars

go

I see a billionaires and I see migrant workersand everyone gets the same care and treatment

There is not an outside organization that stands to make a profit or lose less if the patient getsless care

My incentive is to take care of the person whopays my bill, the patient!


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WHY THIS WAY IS THE BEST

! Less staff

! No wasted telephone time on pre-authorization/resubmission ofclaims/coding problems

! No accounts receivable! Much less paperwork

! All my time is spent on patientcare issues, not governmentpaperwork or fighting insurancecompanies


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THE SIMPLE MATH

• If I want to take home $250,000,• double that to $500,000 to cover overhead

•

500,000/50 weeks per year• I need to make $10,000 per week so divide by 5 days

per week, that’s $2,000 a day• I can see 16 patients a day (30 min/pt)• I need to charge an average of $125/patient.


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PLAN FOR EFFICIENCY

! Get a low-cost EMR

! Start low, go slow

! Build a practice that fits your personality andlife-style (work hard, play hard; easy going;consistent; diversified)

! Pay yourself first

! Charge what’s fair for you and your patients

! If you don’t like it, you can charge more… then maybe you will like it.

! Offer services others don’t (house calls, 2ndopinions, same day appointments, low-costlabs, procedures)

! Don’t be afraid to promote yourself


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OPT-OUT


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WHAT DOCTORS LOVE


33/46SPENDING TIME WITH PATIENTS


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Taking care of Generations

of Patients


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TAKING CARE OF THE “DIFFICULT”

PATIENTS


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AND THE NON-COMPLIANT ONES


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EMPOWERING THE PATIENTS

One has been to the doctor too

much when he can set up his lab

and pay when no-one isthere…..ba ha ha!

Jan 18 1:15 PM


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LOVING ON THEIR PATIENTS

LETTING THEIR PATIENTS


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LETTING THEIR PATIENTS

LOVE ON THEM


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HAVING A HAPPY WORK ENVIRONMENT

HAVING BABIES NAMED AFTER THEM


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HAVING BABIES NAMED AFTER THEM


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HELPINGWHEREVER

THEY ARE

NEEDED


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DOING CHARITY WORK

AROUND THE WORLD


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THEY DON'T EVEN MIND DRAGGING THEIRKIDS WITH THEM TO THE HOSPITAL

SEEING THE BEAUTY


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SEEING THE BEAUTYIN EVERY LIFE


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HAVING TIME TO LOVE LIFE

free market medicine or…how to love being a doctor again

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