Why Your Doctor Is Either Depressed or Retiring
Why Your Doctor Is Burned Out or Retiring
There is a growing litany of acronyms and alphabet soup organizations and algorithms that are designed to confuse, obfuscate and subordinate physician discretionary thinking. Funneling physician thinking into more pre-defined and standardized patterns. With the notion that these patterns are always superior, more efficient and accurate. More than traditional physician discretionary thought, observation and formulation of diagnosis and treatment plans.
This dizzying array is one of the many reasons why virtually every physician over the age of 65 is retiring. You are losing an entire generation of extremely well educated and experienced physicians. The ones who cared. Who were trained to observe. Who were taught to exhaust all testing means. To use deductive and inductive logic.
We have entered the era of economic zero sum medicine. Simple agents of health insurance reimbursement schemes. A world in which medicine becomes thoroughly and inexhaustibly politicized. That is what is being played out in Washington today.
Do you care?
- ACO = Accountable Care Organization
- MA = Medicare Advantage, original Medicare + choice
- ACA (aka PPACA, patient protection and affordable care act) – disastrously branded as ObamaCare
- MSSP = Medicare Shared Savings Programs (built into the ACA).
- MUHIT = Meaningful Use of health information technology
- GPRO = Group Practice Reporting Option (CMS provider value modifier, 2010 present
- MACRA = Medicare Access and CHIP Reauthorization (an acronym within an acronym)
- MIPS = Merit Incentive Payment Systems (has 4 components)
- ACI = Advancing care information (replaces MUA’s IT).
- CPI = Clinical practice improvement activities
- TCoC = Total cost of care (usually expressed as annual cost per beneficiary)
- Quality = replaces the PQRS (physician quality reporting system)
- APM = Alternative payment models
- MIPS = Merit Incentive Payment Systems (has 4 components)
- SGR = Sustained growth rate physician formula (1997 – 2016)
- RAF = Risk adjustment factor (adjustment used for and a payments)
- HCC = Hierarchical condition category (codes that derive the RAF)
- TIN = Taxpayer identification number
- CMS = Center for Medicare Services — formerly HCFA (Healthcare Financing Administration)
- CPC+ = Comprehensive primary care plus (a CMS driven Advance Primary Care Medical Home Model)
- CPT = Current procedural terminology (procedure or billing codes)
- ICD-10 = Diagnosis coding module currently used in the United States (supersedes the ICD-9)
- VM or PVBM = Value Modifier or physicians value-based modifier
- CAHPS = Consumer assessment of healthcare providers and systems (HCAHPS, CGCAHPS, HHCAHPS, OASCAPS, etc.)
- HiTECH = Health Information Technology for Economic and Clinical Health Act (HITECH Act)
Makes your head spin. Doesn’t it? My mission is and has been the development of a new HealthCare paradigm. Health and Well Being for the next twenty years. Enhancing your healthspan. Enhancing cognitive function (smarter brains). You are going to need it in these times.
Here is a very personal summary of the onerous regulations in the state of California that will contribute to a manifest decline in the number of compounding pharmacists. And further price increases because of the costs of preparation. This is a direct quote from my good friend, Dana Gordon of