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<blockquote data-quote="tRidiot" data-source="post: 1751543" data-attributes="member: 9374"><p>There is no alternative. You either ask the questions and CYA, or you don't, and let it hang in the breeze. It's a personal choice.</p><p></p><p>it's not about doing what admin says. It's about doing what you have to do to protect yourself from liability. What you are advocating is essentially saying, "Damn the torpedoes, full speed ahead." I somehow think you just don't understand the basic nature of how the medical system works. Not that I expect you would. I don't fault you for that, but many people aren't interested in educating themselves or learning about it, either. </p><p></p><p>As a physician, you have a medical license which says you can practice medicine the way you want to. For the most part, you're free to do this. But the bottom line is, if you do things which are considered to be "outside the standard of care," then you are increasing your liability and opening yourself to additional complaints. If you happen to be an employed physician (i.e., by a larger group or a hospital system, etc.), then you're also at risk of losing your job due to an increase in "perceived" liability. Not to mention losing your insurance coverage. And good luck practicing anywhere in any capacity without insurance.</p><p></p><p></p><p>Blame the customers for poor rapport? I dunno... not sure how to respond to that, actually. I think too many "customers" take little to no responsibility for their own health. They want a pill to fix everything, or they want xrays, lab tests and even surgeries when there is no need for them. There is no consequence for people who abuse the system and the practitioners. Medicaid/Soonercare has little or no copay or consequences for overuse. You can go to the ER a dozen times a month for every little tickle in your throat or ache and pain in your back, and if you don't get the antibiotics or narcotic pain medicine you want, you just call up and complain to the administration, who then has to come down on the doctor for not keeping "the customer" happy.</p><p></p><p>I work in the Emergency Room nowadays, because I grew too fed up with the BS involved in running a practice. It's not worth it, in my opinion. Too many upfront costs, too many regulations, too much hassle and time spent in paperwork that is not directly related to patient care, but is otherwise necessary and you get paid nothing for. In many of my day-to-day situations, there is no possible way to both practice medicine appropriately and keep people happy due to a number of factors. The fact that people are already pissed off because they've had to wait hours. Everybody feels they need a prescription for antibiotics or pain medicine. Tylenol, ibuprofen and non-narcotic pain medicines "never work for me". Abusing the system with dozens of unnecessary visits for minor or imagined complaints. Thorw in the fact that we have to run thousands of dollars worth of unnecessary tests, just again to CYA. I could go on for hours on end, but I also know that no one <strong>really </strong>cares, and nothing will ever change, either. Except to get worse. It's more of the entitlement mentality pervading our society today. Unrealistic expectations from all sides. </p><p></p><p></p><p></p><p>Sounds good. </p><p></p><p>I will tell you that when I had my practice, my patients adored me. I was tactful and handled things as well as I could, and kept things in line for the most part. But again, government restriction and intervention drove me away from it. And now I work in the ER. Where you get sucked into the vortex of BS and learn to insulate yourself even further by overtesting (which administration WANTS you to do anyways), CYAing, and dealing with the abusers of the system one of two ways - you either give them all the drugs they want and they love you and abuse the system even more, or you put your foot down and try to practice good medicine and you get complaints. I am one who gets complaints... 90+% of which are from the people who abuse the system the most, yet still have "a voice."</p><p></p><p>You can hold whatever opinion of me you like. I practice medicine in a way that I feel is most appropriate, yet try to protect myself and my family, and I do my best not to encourage the abusers.</p><p></p><p>I can't wait to pay off my debts and walk away from this crap. I honestly wish I'd never gone to medical school, and I tell everyone who asks me not to go. Maybe I'm one of the bad ones, one of the problem people who should be weeded out of the system. I dunno. I am, however, tired of being told what I greedy bastard I am, who just profits off of other people's misery. This, by the .gov, of course.</p></blockquote><p></p>
[QUOTE="tRidiot, post: 1751543, member: 9374"] There is no alternative. You either ask the questions and CYA, or you don't, and let it hang in the breeze. It's a personal choice. it's not about doing what admin says. It's about doing what you have to do to protect yourself from liability. What you are advocating is essentially saying, "Damn the torpedoes, full speed ahead." I somehow think you just don't understand the basic nature of how the medical system works. Not that I expect you would. I don't fault you for that, but many people aren't interested in educating themselves or learning about it, either. As a physician, you have a medical license which says you can practice medicine the way you want to. For the most part, you're free to do this. But the bottom line is, if you do things which are considered to be "outside the standard of care," then you are increasing your liability and opening yourself to additional complaints. If you happen to be an employed physician (i.e., by a larger group or a hospital system, etc.), then you're also at risk of losing your job due to an increase in "perceived" liability. Not to mention losing your insurance coverage. And good luck practicing anywhere in any capacity without insurance. Blame the customers for poor rapport? I dunno... not sure how to respond to that, actually. I think too many "customers" take little to no responsibility for their own health. They want a pill to fix everything, or they want xrays, lab tests and even surgeries when there is no need for them. There is no consequence for people who abuse the system and the practitioners. Medicaid/Soonercare has little or no copay or consequences for overuse. You can go to the ER a dozen times a month for every little tickle in your throat or ache and pain in your back, and if you don't get the antibiotics or narcotic pain medicine you want, you just call up and complain to the administration, who then has to come down on the doctor for not keeping "the customer" happy. I work in the Emergency Room nowadays, because I grew too fed up with the BS involved in running a practice. It's not worth it, in my opinion. Too many upfront costs, too many regulations, too much hassle and time spent in paperwork that is not directly related to patient care, but is otherwise necessary and you get paid nothing for. In many of my day-to-day situations, there is no possible way to both practice medicine appropriately and keep people happy due to a number of factors. The fact that people are already pissed off because they've had to wait hours. Everybody feels they need a prescription for antibiotics or pain medicine. Tylenol, ibuprofen and non-narcotic pain medicines "never work for me". Abusing the system with dozens of unnecessary visits for minor or imagined complaints. Thorw in the fact that we have to run thousands of dollars worth of unnecessary tests, just again to CYA. I could go on for hours on end, but I also know that no one [B]really [/B]cares, and nothing will ever change, either. Except to get worse. It's more of the entitlement mentality pervading our society today. Unrealistic expectations from all sides. Sounds good. I will tell you that when I had my practice, my patients adored me. I was tactful and handled things as well as I could, and kept things in line for the most part. But again, government restriction and intervention drove me away from it. And now I work in the ER. Where you get sucked into the vortex of BS and learn to insulate yourself even further by overtesting (which administration WANTS you to do anyways), CYAing, and dealing with the abusers of the system one of two ways - you either give them all the drugs they want and they love you and abuse the system even more, or you put your foot down and try to practice good medicine and you get complaints. I am one who gets complaints... 90+% of which are from the people who abuse the system the most, yet still have "a voice." You can hold whatever opinion of me you like. I practice medicine in a way that I feel is most appropriate, yet try to protect myself and my family, and I do my best not to encourage the abusers. I can't wait to pay off my debts and walk away from this crap. I honestly wish I'd never gone to medical school, and I tell everyone who asks me not to go. Maybe I'm one of the bad ones, one of the problem people who should be weeded out of the system. I dunno. I am, however, tired of being told what I greedy bastard I am, who just profits off of other people's misery. This, by the .gov, of course. [/QUOTE]
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