Doctors Can't Own Hospitals... Why the Stark Law Is a Joke.

[@amishshark3549]

would you consider making a video about the impact of residency unions on the future of healthcare given how they have recently increased in number

[@ahealthcarez]

Thank you for sharing the video.

[@JoyInResidency]

Great suggestion !

[@fhd89234n8f43n7]

“Safety sounds wonderful. And a harbor sounds wonderful!” 😂

[@erica5098]

Thank you

[@ahealthcarez]

Thank you for watching.

[@christophermoriarty7843]

Great video as always. The only point of disagreement I have (and this may be unique to my hospital system) is that I do not get paid based on what I order, but instead based upon what I personally do. So for example, if I bill a level four or level five visit, I will get paid accordingly. If I perform some type of joint injection, I will get paid for that. However, I don’t get paid for ordering tests and procedures that I don’t personally perform such as an MRI or an endoscopy. Of course the hospital makes money performing those procedures, but I don’t get a cut of that. No complaints. I definitely think that’s for the best. The whole wRVU model is a joke though. It basically means the only way I can ever increase my salary (just to keep up with the pace of inflation) is if I continue to do more procedures and see more patients every year for the rest of my working life. It’s also incredibly demoralizing. I can spend two hours in clinic with an extremely complicated patient and get paid less than 1/4 of a surgeon would get paid to do a total knee arthroplasty in an hour and a half. The system, incentivizes “doing stuff” and disincentives actually thinking in making the most accurate diagnosis possible.

[@ahealthcarez]

All good points. Thank you for sharing.

[@donkiebals123]

This is true, but..... a surgeon doing a knee arthroplasty is taking on considerable risk, and requires a hell of a lot more actual skill than ordering an MRI and waiting for the report. I guess you could go one of two ways. 1) Learn to do procedures 2) buy shares in imaging centers, surgery centers, infusion centers in your area. That's what the big kids do.

[@robert-rv8lo]

I have learned that in American healthcare speak, overutilization just means the patient getting the care they need before their issue turns more serious. A lot of plans have a stop loss insurance policy, so it's more profitable for them to just deny routine care and dump the really expensive claims to stop loss insurance I guess.

[@ahealthcarez]

Thank you for sharing your thoughts.

[@KickSinclair]

I get what you're saying and it's often true but I've witnessed the harm of genuine over utilization with my dad. He was only 60 when he passed, was a triathlete, ex-olympian, healthiest guy I have ever known. But after a brain injury he was exploited by both his caretakers and the hospital to such an extreme he didn't even last a full year with the insane level of polypharmacy he was made to take. His grand total of imaging studies he had done within the last few months of his life was OVER 20! he died of an acute liver injury..

[@donkiebals123]

@@KickSinclair No offense. Something about that story doesn't make any sense. Sorry for your loss.

[@donkiebals123]

I worked at the Sisters of Merciless for years. Nuns were tough when it came to money. Nuns would come around the units and literally be looking in the trash cans for yellow stickers that weren't pulled off of supplies. If they saw them, they just went into the supply room and stuck them on whatever patient charge card was closest to the door.

[@ahealthcarez]

Thank you for sharing your thoughts.

[@unebonnevie]

Holy molly! Healthcare costs even affect nuns' behaviors!!!

[@richardcao6297]

helpful video, but there is a high pitched background noise in all of your videos just fyi

[@ahealthcarez]

Thank you for your feedback.

[@donkiebals123]

I love his videos but your right. Between the voice and the background noise, sometimes it's hard to watch the videos in my car. And, I think he has a bot that puts the same "thank you for your feedback" on every response to his video. But, you won't get better detailed explanation on how the financial side of healthcare works anywhere else.

[@liberoAquila]

Not only should doctors not be able to own hospitals, they shouldn't be able to bill public and private insurance. All doctors should be salaried a la NHS, VHA model.

[@ahealthcarez]

Thank you for sharing your thoughts.

[@chilipepper9938]

People should try and work and give free care for people who never put any into the system. It will quickly change their tune. Takes 15 years and average debt to be a doc is 275k, so good luck in getting the best doc two work salary. All patients should get care like the VA model, the VA is a joke. Its subsidized.

[@liberoAquila]

@chilipepper9938 So why not address the years and debt it takes to become a doctor? Make it illegal not to work salary by suspending physician licenses for those who attempt to work illegaly. I have been a patient and a clinician in public and private systems, I have seen "private" systems being a joke too. And of course the VA is a subsidized system, duh, it's socialized healthcare.

[@chilipepper9938]

@@liberoAquila I worked as public and private physician. I’ve been part of a lot of medical societies. It boils down to raiding Medicare dollars. The best run hospitals are run and managed by doctors. We are in the business of admitting diagnosis codes and not patients. Making it illegal to work for a salary means you’re not going to get the best and brightest people to become a doctor. Who in the right mind will sacrifice 15 years after highschool and work 70 plus hours before there is salary ceiling. Better to be a plumber or a tradesman. And imagine If they were told that it would be illegal not to work for salary. This is a capitalist country. So what the hospitals are doing is hiring NP, and PA, instead of doctors. That is the future. Because they have a salary position. What you have in the healthcare system is healthy people who worked hard and took care of themselves paying for people who did not take care of themselves and didn’t put anything into the system. They should get rid of Emtala law or at least put a burden on non-compliant patients. Which will never happen, so long as there is money coming in, and as a result Medicare part A is set to be insolvent in 2034. What you want is transparency of healthcare costs. Which hospitals are suppose to be sharing but they do not. What you want is consumers which are patients to be able to shop around for the healthcare they can afford. It’s not affordable because the laws force the non compliant and unhealthy to be subsidized by the healthy and compliant patients. What is ideal is decentralized medicine which involves technology to allow flow of data. Hospitals horde patient data and control physician Credentialing, exactly how they make money. They need to get rid of non-compete laws. Now that non-compete laws are going by the wayside, they are using credentialing.

[@liberoAquila]

@chilipepper9938 Physicians like you are part of the problem.