Call From Home
My phone is on, and I am available. At the moment, I’m back in my house. I worked five cases today. Everyone, all the patients and their families, were very kind. I had good surgeons and nurses too. It was a pleasure.
Last night I went to the craft store. I actually went to a Hobby Shop first, where there was no needle projects, it was more building racecars and airplanes and models and stuff.
But I manifested something. The other day I was thinking about the horror movie monster models I built when I was nine. I had the whole set–Dracula, Frankenstein, Mummy and my favorite, The Creature From The Black Lagoon. In our family, we cheered FOR the monsters on Saturday afternoon TV–because they were the underdog and the whole town was against them!
There are the shelf was the very exact model of the Creature From The Black Lagoon–the kit!
I bought it. And also a Bigfoot one for my boy, who really likes that TV show too.
Where Is Decency?
- A woman had to have a c-section type incision for a surgery instead of the robot because her insurance company didn’t authorize it. The hospital wouldn’t allow it. So she cried on the phone with her surgeon for a half-hour the night before, and ended up having to stay IN the hospital for two days instead of go home. Someone said this way the hospital makes more money…
- United Behavioral Health just cut all reimbursements for counseling in half across the board, with no warning. It went from sixty dollars to thirty. And even at that, the counselor has to do an ‘interview’ on the phone to make sure the client is eligible for coverage with their treatment and diagnosis…
- A local hospital has established a ‘pay your copayment and deductible FIRST’ policy for all elective cases. Because insurance has changed to higher deductibles, hospitals are losing money. So–the question is, if you have insurance, but your deductible is sky high, IS it REALLY ‘insurance?’
- A surgeon had a colleague coming from his native country to observe surgery. It took much longer than usual, and it was a straightforward procedure. Immediately following, was a different surgeon, with no guest, for the same condition, on a totally different patient. It took half the time that the first one did! I listened to the surgical technicians talk amongst themselves, as one was training the other. The FIRST surgeon did ‘all the steps’ , even though he usually doesn’t, because of the observer. The SECOND surgeon skips even MORE steps–five out of ten. The reason I bring this up is because like ‘piecework’, surgeons are paid by the procedure–not by the outcome–and MANY orthopedic surgeons pride themselves on ‘being fast’. This creates a situation which is called ‘production pressure’–people need to do fast turnovers, and push themselves to the limits of safety to meet the demands of the surgeon…to do as many cases as possible in a given day, to make the most compensation that is possible for a given day. Although studies have shown that ‘high volume’ surgery places have ‘better outcomes’, and it makes sense that repetition and efficiency are good, I raise the question about motivation behind the ‘volume’ and just how many corners will be cut in the future?
- A ‘good hospital’ is all about the payor mix–the types of insurance that the patients bring to the hospital. For pretty much all specialties. For anesthesia for example, the local competitor ‘by the beach’ hospital pays twice the amount per unit as ours does. And at the ‘not so great part of town and trauma center’ hospital? The payor mix is so poor the hospital gives a ‘boost’ payment to bring the unit value–we get paid by the unit–UP to the local competitive rate.
- I have worked both at academic medical centers (salary or per-diem) and private practice. In every private practice setting, the person who assigns the cases–typically the one who has the contract with the hospital or facility–always takes the best cases for themselves. This is called ‘berry picking’. Some skim a cut off the top of all the pooled income too. You will not know when you meet your anesthesiologist before surgery where they are on the ‘totem pole’–but you can be sure that if your case has the most units, a senior member of the team will be assigned it to scoop those units up. What cases have good reimbursement? Spine. Bariatric. Neurosurgery. Cardiac surgery. and Lung Surgery. What cases have terrible reimbursement? anything Medicare. Also pediatrics and women’s medicine services often do not pay well.
- A woman obstetrician who graduated when I did, found work with another Ob-Gyn in private practice. They held partnership for at least five years. Another woman left her group where she was junior to join in their office, the three. Well, now the women are joining forces with another group–they cover call for each other–and now that the male who established the practice isn’t taking OB call or patients–they are kicking him out of his own practice. The women are going to offer aesthetic treatments combined with the OB-Gyn practice. This kind of politics goes on ALL the time! There have been people who break partnerships or even SUE one another working at the same place! And the patient will never know.
- Someone who hasn’t passed their boards yet, is due to be leaving the group. For some, this takes several attempts at both the written and the oral examinations. They are tough. The norm is to be ‘board eligible’ for four years. After this, returning to a mini-residency is required to ‘reset’ the clock. You can’t tell if someone is board certified by looking. Some hospitals get letters from the state for being ‘too lenient’ in their credentialing requirements. One person I know took nine years to pass their boards! In our specialty, we recertify every ten!
Everything else is simply Illusion.
Just for today, we are going to direct our healing focus towards this effort–to strengthen and support those who are apart because of restriction, duty, and work, the law, and everything else that comes between people who are in the same support group and family.
(A Hummingbird just landed on the fountain, right now as I type this, as confirmation of Gaia’s insistence on our joy be made present to our hearts…)
Please listen and if permitted, DANCE, while you send Reiki –to this tune…I’ve sent the first part. Now it’s your turn heart emoticon Namaste.
Then, tonight She sent out a similar call for this:
Please listen to the song, and ‘like’ if you agree that all of Gaia’s children deserve to have shelter, regardless of everything that prevents many people from ever reaching home ownership.
Gaia believes it is a right to inhabit something affordable which meets the basic needs–everywhere on Her planet.