Gary- I believe the Obama administration started the MIPS program and the misvalued code initiative to get more doctors under one roof so that it would be one step closer to a one-payor health system. And it worked, as doctors migrated out of their offices to hospitals, health care systems, and corporate entities. I think if we change the incentives for doctors, more will go into private practice- even the younger physicians. Medical Savings accounts would be helpful, too. The more options patients have the better. The more options doctors have the better.
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Scopes of practice is not in reference to expansion for PAs and NPs who would be expanding the definition and pivoting to a different education focus of their chosen field with such an expansion. From bedside nursing and assitance to a Doctor who is trained differently throughout their entire education. That is a different topic which is being addressed in other policies.
I wish I knew more about the impact of these. It sounds good but Iâll wait for Scott to weigh in.
Scott I hope you personally invite people to vote on this (& attach your actual proposal for them to click on). Another topic , abortion did this with message requests for us to consider and vote. It got 'way more votes, maybe due to younger participants but since everyone knows parents grandparents etc who suffer under our insurance/healthcare system, I believe you can get more votes if you ask.
Fran
Thank you for your help. I will try to contact more people to vote on my policies.
Scott
Fran
I am not very tech savvy. How do I know who is âviewing â my policies and clicking âthe like buttonâ. Is there more efficient way for me to do this?
I tried an email response but not sure it went through. None of us can keep up when it comes to technology, but Iâll try. When you hover over the colored circles below the posts you see names beneath. It seems if you click, you can share a link. (I find that if I click the 3 dots, a blue box appears & I can reply to the topic.) There is also a link icon below each post which makes it shareable, probably if you were answering someone else discussing the topic. I also tried clicking the number up near âvotesâ and you can see who each one is who voted for your policy (and thus know to invite the others to consider voting for it, those who only liked it!)
Fran,
Thank you for explaining this to me. I appreciate it.
Scott
Scott,
Thank you for drawing attention to these issues that would help your private practice.
As a consumer researching different systems in place around the world, Iâm curious what your thoughts are about other systems.
One system in particular Iâve found myself studying is how Norway handles their patient record management. They have a national patient portal that assigns all patients a D-number. This number is ultimately attached to their insurance, their patient records, and can be integrated with health networks for doctors and medical teams to easily access their patient data.
From your comments, you mentioned you werenât tech savvy. However, I do see benefits to having the administration of patient records easily accessible to those who need it. This is especially true with how insurance denials for not having medical records have seemingly become the expectation of the US health care system.
What are your thoughts about a universal health record system like this integrating into your practice? Have you considered patient preferences for this in your private practice?
Side note, Norway has universal insurance. Iâm really referrencing the portal itself, not their insurance model. If you havenât had an opportunity to explore it yet, Iâd encourage you to visit the site and see how easy it is to schedule appointments, find family doctors, access billing (limited function for non-users, but you can see how the system works), etc. Itâs arguably more user friendly than this forum.
The link to their system is below. But, youâre welcome to look it up online yourself if youâre worried about the link.
John,
Believe it or not, I still dictate my notes and use paper charts. I feel as a neurologist, I need to send a referring doctor a thoughtful and comprehensive note. This is a note that must be dictated. There are good dictation systems out there such as dragon that do work well. I dictate my notes and have them transcribed and sent to the referring doctor via fax (if there is one) and a copy sent to my office.
In my opinion, doctors were forced to use EHRâs before the technology was ready. Most EHR notes are cookie cutter, very lengthy, and just try to read one- they are awful. The impression and recommendations are often poor. To ask doctors to sit and type was a huge error. Doctors donât spend much time with patients and donât even look at them, because they are too busy worrying about fulfilling Medicare criteria so they donât get penalized.
I believe in entrepreneurship and individualism, so I may not be the best to ask. That said, yes having records that all doctors, nurses, and office staff can access at any time is very important. That certainly is not the case today. Doctors were forced to use EHRâs before the technology was ready. There is no universal system and many different EHR companies. Medicare forced doctors to get EHRâs so they could fulfil MIPS criteria.
I looked at the record system in Norway. The organization looks good. I donât know what the doctors notes (especially consultant notes) look like. I hope this answers your questions. It really should be up to the office as to what EHR or record system they use and how to use it. We should let doctors be doctors and not clerks. Let doctors decide what is best for themselves.
Scott
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Scott,
Thanks for the time and thoughtful response!