Erik Gulbrandsen, D.O.

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Erik Gulbrandsen, D.O.

CMS changes for 2010 on the table, includes increase payments to PCP

Tuesday, 03 November 2009 06:13 Erik Gulbrandsen, D.O. Blog - Medicine
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they are discussing a 5-8% increase in payments to PCPs. Also, there is a 2% increase for those that are already electronically prescribing. Also, there is talk of doing away with consultant note reimbursement.

I see this as good news bad news. First, the flawed SGR formula wasn't addressed. Who gives a rip about a 5-8% increase when we are all going to see a 21% decrease due to the SGR formula. With the soon-to-be-coming huge influx in patients, I don't see how senior citizens can like what is on the horizon for them.

This is good because it shows that some policy can get through that is favorable for primary care. I do think that we aren't going to solve our primary care problem until we start reimbursing better (and adding value to things like phone messages).

this is truly in the best interest of a successful healthcare system.
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Public Option

Tuesday, 27 October 2009 17:15 Erik Gulbrandsen, D.O. Blog - Medicine
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I'm all for health care reform. Our industry makes some weird decisions. We waste alot of money. I cannot, however, understand how the president can call the public option "competition".

I guess if you can call it competition if you consider having a football game where one side has eleven players and the other team has 7. That is competition, though it is entirely unfair.

Letting this football game start and expect the shorthanded team to be able to win is crazy. The goverment will continue to dump money into the public option as it makes dumb decisions that aren't based upon accurate market forces, but more based upon votes.

This is a total mistake.
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Monday Morning

Monday, 02 November 2009 05:02 Erik Gulbrandsen, D.O. Blog - Thoughts
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Waking up on a Monday morning after vacation is impossible. I hit the snooze button about ten times. It doesn't help that my schedule today isn't set in stone. I'm in the ER, which means make certain that you get 30 hours in, be it at 10 am or 2 am.

I wanna go back to bed. I guess my saving grace is that it feels like 7 am right now.
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I know people hate HMO's, but...

Monday, 02 November 2009 19:59 Erik Gulbrandsen, D.O. Blog - Medicine
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I think that public aid patients should be treated like an HMO. They need to go through the PCP and get their permission to go to the ER. Much of what we do in the ER cN be taken care of in clinic. Patients don't understand this, but we, as physicians do. Patients are notoriously bad at triage.

How do you punish a patient for going to the ER without consulting the PCP? That is a really difficult question. If you don't pay for the visit, the hospital gets hurt because they are required to evaluate all patients due to EMTALA. so, there has to be a change to the law. I'm not an attorney, so I don't know how this would all work. Maybe the hospital can refuse to see patients that have been denied access to the ER by their PCP.

Dealing with this issue can go a long way in reducing our healthcare costs. I doubt this would happen because our current vogue thing to do in politics is more strict democracy (we aren't living in a democracy, we are a constituitonal republic...big difference). Our current structure is to please the masses, which could be the exact opposite of what is best for the masses.
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Daylight Savings Rocks

Sunday, 01 November 2009 17:19 Erik Gulbrandsen, D.O. Blog - Thoughts
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It is 6:18 and the kids are in bed! Sure, they are gonna get up at 5:30, but I don't care, I'm up at 4:30 anyway.

If you do daylight savings properly you can go far.
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