Marcus Welby Medicine?????

[LvmyPug2]

Is anyone else amused by this new discription of primary care in TV? Ummmm ......Dr Welby was a fictional character who didn't worry about getting paid for his services. I doubt that is what they mean. :a20:

[ilovetv]

I think they're aiming for having primary care doctors that actually know their patients by having the time with each one to actually converse and learn about the patient's whole health and lifestyle picture.

A worthy goal, but from what I've seen I think feeding the computer or iPad the information "it" demands, and clicking the right check-boxes to have canned, scripted text fill in that has excess info in it that doesn't even apply to this particular person, for the electronic medical record (EMR), is going to suck up most of the clinicians' time and attention.

I've seen it in visits and hospital stays up north and here, and the nurses and drs. I know have to wrestle The Thing at the expense of interacting with and caring for the patient. But that's what the feds and laws are mandating. It's driving seasoned, skilled clinicians to seek other work right when they're needed the most in clinical practice.

[gomoho]

Your explanation was spot on as to my experience at the Colony Plaza Center. Very discouraging. Then when I called to arrange a meeting with the Chief Medical Office at Colony Plaza (Dr. Hildner who said in the article he wanted to hear what we liked and didnn't like) I was advised I couldn't schedule a meeting, only an appointment. I didn't want to see him for medical care, but to give him feedback on my experience. They are talking the talk, but not walking the walk from my experience.

[NotGolfer]

Up north and here also, paper-less is how the medical field is functioning. I for one think the "Marcus Welby" concept is a good one. You won't be filling out those small books of information everytime you see a new physician...they can go into the computer to get it all. From what I understand your info will also transcend to TVHospital as well, in the event you are admitted.

The care I've gotten here in FL (so far--with the exception of one un-named physician) has been excellent. I have several auto-immune diseases so need to be monitored on a regular basis. My experience with Belleview Family Practice/The Villages has been excellent.

[Quixote]

The care I've gotten here in FL (so far--with the exception of one un-named physician) has been excellent.

I also deal with a variety of health issues, at least one potentially life-threatening, and I would have to agree about having received excellent AND compassionate care (and also about one unnamed physician who goofed big-time...)!

Yes, I agree that the "Marcus Welby" thing sounds like a marketing gimmick....

[ijusluvit]

My most fervent hope is that people will suspend their skepticism and crushing disappointment that things are never perfect.

My suggestion is that the Developer's voluntary sponsorship of a primary health care system available to TV'rs only a "10 minute golf cart ride away", deserves a chance to succeed.

Let's give it a chance.

[Bogie Shooter]

My most fervent hope is that people will suspend their skepticism and crushing disappointment that things are never perfect.

My suggestion is that the Developer's voluntary sponsorship of a primary health care system available to TV'rs only a "10 minute golf cart ride away", deserves a chance to succeed.

Let's give it a chance.

The other 99% are doing just that.

[perrjojo]

My most fervent hope is that people will suspend their skepticism and crushing disappointment that things are never perfect.

My suggestion is that the Developer's voluntary sponsorship of a primary health care system available to TV'rs only a "10 minute golf cart ride away", deserves a chance to succeed.

Let's give it a chance.

I:agree:
We previously lived in Georgia and had Kaiser Insurance. It is a big organization, sorta one stop does all: X-rays, MRI, blood, RXs, specialist, Etc. the doctors really rarely looked at you and sat at a computer asking questions and ticking off boxes. At first we hated it but after awhile it was a great system that we loved. No constant filling out forms at different doctors. Test results were available within a few hours on our home computer. RXs could be ordered online and could be mailed to our home. No matter which doctor we saw, they had ALL of our health information. We could ALWAYS see a doctor the same day and and if you emailed a question to your doctor it would be answered in a few hours. This is the modern day Marcus Welby. We were VERY happy with the Kaiser Health Care System. It seems to me that this is the type of Health network they are trying to build.

[NotGolfer]

I:agree:
We previously lived in Georgia and had Kaiser Insurance. It is a big organization, sorta one stop does all: X-rays, MRI, blood, RXs, specialist, Etc. the doctors really rarely looked at you and sat at a computer asking questions and ticking off boxes. At first we hated it but after awhile it was a great system that we loved. No constant filling out forms at different doctors. Test results were available within a few hours on our home computer. RXs could be ordered online and could be mailed to our home. No matter which doctor we saw, they had ALL of our health information. We could ALWAYS see a doctor the same day and and if you emailed a question to your doctor it would be answered in a few hours. This is the modern day Marcus Welby. We were VERY happy with the Kaiser Health Care System. It seems to me that this is the type of Health network they are trying to build.

This is EXACTLY right. I LOVED the electronic component as you say here---could e-mail my provider with questions, could request RX's, could also see test results and also info from prior dr. visits. It was a step backward (or two) when we arrived here 4 years ago to have to fill out what seemed like volumes of paperwork each time we went to a new location. I see nothing but positive re: this new system and we're happy to be a part of it!

[rubicon]

Marcus Welby label does leave one with the impression that is is a marketing gimmick. The Health Care Industry in general is moving toward a paperless system. I have to commend them but many corporations they have done the same thing but really never got rid of the paper.
The cocnern for this electronic health history on patient's is that it will be easy to secure leaving the patient""s privacy at risk.

I made a conscious choice to use my cardiologist as my primary care doc primarily because he he will spend as much time as a patient needs ...Now that is what I dwfinw as Marcus Welby

[LittleDog]

I heard Morse's speech at the Savannah Center and I'm not quite sure what all this means. I have a very good gp and I would hate to leave him for one of these centers. I believe that most people who like their gp will want to stick with him or her. I don't think there will be a big rush to change doctors.

John

[NJblue]

I think they're aiming for having primary care doctors that actually know their patients by having the time with each one to actually converse and learn about the patient's whole health and lifestyle picture.

A worthy goal, but from what I've seen I think feeding the computer or iPad the information "it" demands, and clicking the right check-boxes to have canned, scripted text fill in that has excess info in it that doesn't even apply to this particular person, for the electronic medical record (EMR), is going to suck up most of the clinicians' time and attention.

I've seen it in visits and hospital stays up north and here, and the nurses and drs. I know have to wrestle The Thing at the expense of interacting with and caring for the patient. But that's what the feds and laws are mandating. It's driving seasoned, skilled clinicians to seek other work right when they're needed the most in clinical practice.

I'm not sure I agree with this observation - at least not in theory. Nothing drives me more nuts than when I see my doctor and he asks ME when the last time I had a colonoscopy or whether I had such and such shot or what drugs I am on. It is unconscionable that he doesn't have that information at the tip of his fingers in digital form. In fact, I would expect his iPad or whatever, to start flashing in big red characters that I am due for a certain test or inoculation as soon as he pulls up my records. It should also flash a warning that the drug he is about to prescribe is dangerous in combination with one that another specialist already has me on.

The notion that doctors have to rifle through reams of paper to find any information is mind numbing in today's hi tech world. In a 21st century world of medical technology, we are literally killing ourselves with 19th century record keeping.

[gomoho]

My most fervent hope is that people will suspend their skepticism and crushing disappointment that things are never perfect.

My suggestion is that the Developer's voluntary sponsorship of a primary health care system available to TV'rs only a "10 minute golf cart ride away", deserves a chance to succeed.

Let's give it a chance.

I give 2nd chances to hairdressers and restaurants and the like - not my primary doctor. Actually I wanted to give Dr. Hildner the information about my experience in the hopes of improving the system. Unfortunately he is about as unaccessible as Mr. Morse.

I arrived in June of 2012 and waited to sign up with a primary because I was so excited about The Village Health Care and what is was promising. Maybe that is why I was sooooo disappointed. Expected them to deliver what they promised and didn't even come close.

[graciegirl]

I am not unrealistic in my hopes. I want a well trained physician.I don't care if he is mean as a snake.

Marketing ploys are NOT bad. They just are.

[ilovetv]

I'm not sure I agree with this observation - at least not in theory. Nothing drives me more nuts than when I see my doctor and he asks ME when the last time I had a colonoscopy or whether I had such and such shot or what drugs I am on. It is unconscionable that he doesn't have that information at the tip of his fingers in digital form. In fact, I would expect his iPad or whatever, to start flashing in big red characters that I am due for a certain test or inoculation as soon as he pulls up my records. It should also flash a warning that the drug he is about to prescribe is dangerous in combination with one that another specialist already has me on.

The notion that doctors have to rifle through reams of paper to find any information is mind numbing in today's hi tech world. In a 21st century world of medical technology, we are literally killing ourselves with 19th century record keeping.

I'm all for digitized records if they are designed to work the way the people who actually USE them think and work....in putting patient care first and foremost. But sadly, programmers and IT people often want nothing to do with the dr. or nurse on the front lines and the critical tasks they need to accomplish quickly and efficiently, under pressure.

Instead of rifling thru reams of paper, they now rifle thru 15 menu and submenu screens that choke, stall and take too long to load in light of the person in the bed needing something done promptly and correctly.....and in light of the captive souls in the waiting area who've waited 12 hours to be seen in the ER.

This is a case of "be careful what you wish for".

[Advogado]

My most fervent hope is that people will suspend their skepticism and crushing disappointment that things are never perfect.

My suggestion is that the Developer's voluntary sponsorship of a primary health care system available to TV'rs only a "10 minute golf cart ride away", deserves a chance to succeed.

Let's give it a chance.

I just watched the televised version of the Mr, Morse's speech. Keep in mind that the new health system is apparently a for-profit business venture of the Developer, not a "voluntary sponsorship". However, I have no problem with that. The present health-care system in this country is broken. It would appear that the Developer's approach is a possible solution, or at least a reasonable approach to a possible solution.

[CFrance]

I'm all for digitized records if they are designed to work the way the people who actually USE them think and work....in putting patient care first and foremost. But sadly, programmers and IT people often want nothing to do with the dr. or nurse on the front lines and the critical tasks they need to accomplish quickly and efficiently, under pressure.

Instead of rifling thru reams of paper, they now rifle thru 15 menu and submenu screens that choke, stall and take too long to load in light of the person in the bed needing something done promptly and correctly.....and in light of the captive souls in the waiting area who've waited 12 hours to be seen in the ER.

This is a case of "be careful what you wish for".

I disagree. All they have to do is enter what they're looking for into the search box and click.

[getdul981]

From what I have heard, you have to go to whatever clinic is assigned to your particular village. That is very discriminatory. You should be able to choose what doctor you want to go see. If you are not happy with the Dr.s at the clinic you are assigned, you can't go to another clinic to find one that you will be happy with.

In response to NJBlue about the Dr. asking what meds you are taking. It's quite possible that the Dr. is trying to see if you really know what your meds are. There are many people that don't know what their meds are. They just know that they take 2 little white ones, a big red one and occationally a orange one. These are just examples. I used to be on a Rescue Squad and know for a fact that many people don't know what their meds are.

[champion6]

From what I have heard, you have to go to whatever clinic is assigned to your particular village. That is very discriminatory. <snip> If you are not happy with the Dr.s at the clinic you are assigned, you can't go to another clinic to find one that you will be happy with.This is a false rumor. During his presentation Mark Morse said we will be able to choose by location or by doctor.

[getdul981]

This is a false rumor. During his presentation Mark Morse said we will be able to choose by location or by doctor.

I hope you are right.

[CFrance]

This is a false rumor. During his presentation Mark Morse said we will be able to choose by location or by doctor.

But will you be able to use doctors at all locations? For instance, if you love the internist at one and the cardiologist at another, can you see both?

[champion6]

But will you be able to use doctors at all locations? For instance, if you love the internist at one and the cardiologist at another, can you see both?Well, time will tell.

My opinion is this... The context of Morse's comment was about the primary care facilities that are being built. I believe he was referring to selecting your primary care physician (PCP, a.k.a. Marcus Welby). You can pick the one you want.

If your PCP wants you to see a specialist, such as a cardiologist, you are able to use whomever you wish. My understanding is that specialists will not be located in the primary care facilities. As is obvious in this area, specialists have their own small group in an office - cardiologists, orthopedic specialists, etc.

[Advogado]

But will you be able to use doctors at all locations? For instance, if you love the internist at one and the cardiologist at another, can you see both?
Apparently (I say "apparently" because, thanks to superficial reporting by The Daily Sun, other than the notion that doctors will be like Marcus Welby, few details are available), we are talking about a Medicare advantage system. That is, it will be an HMO, owned and operated by the Developer on a for-profit basis. Participating doctors, according to Morse's speech, will be paid a flat fee per patient, thus removing the economic incentive to run a lot of unnecessary tests. On the other hand, there will be a disincentive to running tests in borderline situations if the doctor thinks he can dodge a malpractice suit if things go wrong.

I don't know how all this will work out, but I prefer traditional Medicare, where I can choose my own doctors-- not just doctors who participate in the advantage plan and are disincentivated from running tests since the doctors are paid on a per-patient basis. On the other hand, I have many friends who are happy with a Medicare advantage plan, and from an economic-policy standpoint, the advantage plans seem to be more efficient and cost effective.

In any event, this new business venture by the Developer will bring more doctors (we will see about their quality) and medical facilities to The Villages, which are needed for our growing population. Participation is voluntary. Nobody has to sign up for it if it doesn't seem appealing, and, apparently, from what we have been told so far, it should be a win-win situation for the Developer and Villagers.

[Jim 9922]

This plan appears to be a PPO (Preferred Provider Plan) with a "neighborhood" marketing twist. I assume that the insurance risk and benefits coverage is actually covered by a national health insurer hidden in the background. With any health plan you need deep pockets ready to step in in case the actuarial assumptions come up short. I am sure the Developer is not going to risk his personal fortune on "insuring" the ongoing health of a bunch of aging retirees.
As for switching doctors: if you don't like yours or the system, you can always drop the plan and enroll in another "outside" of TV, just like now as in any other city.
I, for one, hope this plan works, that it is priced fairly, that good doctors are recruited and that they don't keep pushing the patient loads until the system becomes overloaded and we are back to where we are today.

[champion6]

Apparently (I say "apparently" because, thanks to superficial reporting by The Daily Sun, other than the notion that doctors will be like Marcus Welby, few details are available), we are talking about a Medicare advantage system. That is, it will be an HMO, owned and operated by the Developer on a for-profit basis. Participating doctors, according to Morse's speech, will be paid a flat fee per patient, thus removing the economic incentive to run a lot of unnecessary tests. On the other hand, there will be a disincentive to running tests in borderline situations if the doctor thinks he can dodge a malpractice suit if things go wrong.

I don't know how all this will work out, but I prefer traditional Medicare, where I can choose my own doctors-- not just doctors who participate in the advantage plan and are disincentivated from running tests since the doctors are paid on a per-patient basis. On the other hand, I have many friends who are happy with a Medicare advantage plan, and from an economic-policy standpoint, the advantage plans seem to be more efficient and cost effective.

In any event, this new business venture by the Developer will bring more doctors (we will see about their quality) and medical facilities to The Villages, which are needed for our growing population. Participation is voluntary. Nobody has to sign up for it if it doesn't seem appealing, and, apparently, from what we have been told so far, it should be a win-win situation for the Developer and Villagers.I believe it is simply a multi-location clinic, staffed with doctors and staff who focus on primary care. They will prefer (require?) that your insurance be the Medicare Advantage plan offered by United Healthcare, which is called MedicareComplete Choice Plan 2. This insurance plan is a PPO, not an HMO. Therefore, yuou can choose your own doctors.

This plan appears to be a PPO (Preferred Provider Plan) with a "neighborhood" marketing twist. I assume that the insurance risk and benefits coverage is actually covered by a national health insurer hidden in the background. With any health plan you need deep pockets ready to step in in case the actuarial assumptions come up short. I am sure the Developer is not going to risk his personal fortune on "insuring" the ongoing health of a bunch of aging retirees.
As for switching doctors: if you don't like yours or the system, you can always drop the plan and enroll in another "outside" of TV, just like now as in any other city.
I, for one, hope this plan works, that it is priced fairly, that good doctors are recruited and that they don't keep pushing the patient loads until the system becomes overloaded and we are back to where we are today.I don't think the national health insurer is hidden in the background. Morse specifically mentioned the United Healthcare Medicare Advantage plan.

I am no expert in this field by any stretch of the imagination. But in my opinion both of the above posts seem to confuse and incorrectly tie together two completely separate businesses: A) the business of owning a medical practice (aka clinic) which provides primary care services to patients, and B) the business of selling insurance which pays for medical services.

The developer has announced that he is going to offer "A" and he is willing to take the financial risk. After all, we are not obligated to use the doctors in these new clinics.

The developer is not going to get into offering "B." That will be done by existing insurance companies.

[Advogado]

I believe it is simply a multi-location clinic, staffed with doctors and staff who focus on primary care. They will prefer (require?) that your insurance be the Medicare Advantage plan offered by United Healthcare, which is called MedicareComplete Choice Plan 2. This insurance plan is a PPO, not an HMO. Therefore, yuou can choose your own doctors.

I don't think the national health insurer is hidden in the background. Morse specifically mentioned the United Healthcare Medicare Advantage plan.

I am no expert in this field by any stretch of the imagination. But in my opinion both of the above posts seem to confuse and incorrectly tie together two completely separate businesses: A) the business of owning a medical practice (aka clinic) which provides primary care services to patients, and B) the business of selling insurance which pays for medical services.

The developer has announced that he is going to offer "A" and he is willing to take the financial risk. After all, we are not obligated to use the doctors in these new clinics.

The developer is not going to get into offering "B." That will be done by existing insurance companies.
There is an article about the subject on page A8 of today's (Sunday) Daily Sun. It is not particularly informative about how the system will work, but we are again assured that it will be just like Marcus Welby.

If you are interested in ownership of the new health system, go to: Detail by Entity Name (http://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail/EntityName/flal-l12000066182-ce38d734-2e39-467a-a7df-6210d683963b/villages%20health%20care/Page1)
Then, look up the members (owners) of the Villages Health Holding Company at Detail by Entity Name (http://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail/EntityName/flal-l12000058533-4de78beb-58b4-40c1-b729-2f3cbf3a1e4b/villages%20health%20holding%20company/Page1)

As I have said in an earlier post, I think that the new health facilities are probably a good thing for Villagers and, if the Developer can earn another fortune from setting them up and running them, good for him. He has done a terrific job with his other endeavors here. I just wish that the Daily Sun would give us the facts of the matter (pros and cons) and not run Developer "Marcus Welby" press releases as news.

[Bonny]

My PA went with Family Drs. of Bellview. They are part of the new Health Care program & I love it there. They are in the Sharon Morse building.

[Jim 9922]

I don't think the national health insurer is hidden in the background. Morse specifically mentioned the United Healthcare Medicare Advantage plan.

I am no expert in this field by any stretch of the imagination. But in my opinion both of the above posts seem to confuse and incorrectly tie together two completely separate businesses: A) the business of owning a medical practice (aka clinic) which provides primary care services to patients, and B) the business of selling insurance which pays for medical services.

The developer has announced that he is going to offer "A" and he is willing to take the financial risk. .

The developer is not going to get into offering "B." That will be done by existing insurance companies.


Sorry if I was not clear in my statement, but I did not state that THE national health insurer was going to be involved. I stated that A national health insurer will be involved, which apparently is United Healthcare, as announced.
Overall your comments sum up the situation well; the developer is establishing a Villages-wide healthcare group practice with certain ways of doing business. The costs to Villagers will be whatever rates the insurance carrier charges in addition to the government portion of Medicare premiums.

[dgammon6]

gomoho, why don't you go into your portal and send Dr. Hildner an email?

[gomoho]

Thank you for that recommendation - didn't realize it was an option.

[skyguy79]

But will you be able to use doctors at all locations? For instance, if you love the internist at one and the cardiologist at another, can you see both?
This is a false rumor. During his presentation Mark Morse said we will be able to choose by location or by doctor.To expand on this a little, "will be" are the key words mentioned above. Mark Morse did explain why not everyone could enroll when Colony opened.

In a nut shell it's because they could not hire all doctors and open all centers at the same time. So because of such a large population here in TV, they needed to limit Colony to just 7 of the closest villages as well as making exceptions for those whose doctors were moving into the system, thereby allowing their patients to have continuity with them.

IMHO this all sounds more than reasonable. It also sounds like from what MM said, that they will be removing this restriction in time - once they feel that open enrollment has become feasible or manageable.

[jrandall]

I have had very positive experiences at Colony With Dr. Hawley! I am happy so far. I have seen her three times.

[johndamelio]

What I dislike about this is the "Marcus Welby " label. Seems like a deceptive marketing trick.
We"ll see how this all shakes out.

[simpkinp]

many of our new Villagers my not even be able to relate to the term "dr. welby". Even I barely remember that series on television when I was a kid, and I am not that young.

[johndamelio]

Marcus Welby aired from the late 60's to mid 70's.

[Bavarian]

Not all of us want to give up our current Health Insurance. We will stick with FEHP Blue Cross/Blue Shield. Probably will have to go to Orlando or Tampa for Doctors.

Certainly don't want any insurance AARP backs.

[cquick]

If The Villages Healthcare is anything like our Sterling Clinic in Sterling,Illinois, I am FOR it!

We could go to the clinic to our gp, orthopedist, gynecologist, cardiologist, ...you name it. Also a full laboratory in house, X rays, radiologists.
One stop shop. We loved it.

[NotGolfer]

Not all of us want to give up our current Health Insurance. We will stick with FEHP Blue Cross/Blue Shield. Probably will have to go to Orlando or Tampa for Doctors.

Certainly don't want any insurance AARP backs.

Have you checked?? I've heard they take several insurances...I really can't see them being limited!

[Villages PL]

I heard Morse's speech at the Savannah Center and I'm not quite sure what all this means. I have a very good gp and I would hate to leave him for one of these centers. I believe that most people who like their gp will want to stick with him or her. I don't think there will be a big rush to change doctors.

John

That's exactly right. I like my GP too and plan to stay with him. There is no rush to change doctors, that's why they only have 1,400 patients signed up so far. These are all the people who were on a waiting list, waiting for the clinic to open. From here on in, it's going to be more difficult. Especially due to the fact that other doctors are beginning to fight back.

In today's Daily Sun there were a couple of adds that seemed to be responding to the Marcus Welby claim. One ad by Premier Medical Associates said, "the staff makes house calls...." (They have 5 Marcus Welbys.)

Then there was an ad by Dr. Paiano: It said, "This is a physicians office where the patient comes first.....Dr. Paiano spends a lot of time with each patient....With every new patient, he spends ample time to discuss your medical issues."

The fight for patients is on!

[dgammon6]

The following link list the Insurance they accept.

Accepted Insurance by The Villages Health (http://www.thevillageshealth.com/insurance.php)

[dgammon6]

Sorry didn't get that correct.

http://www.thevillageshealth.com/insurance.php

[Bizdoc]

The clinics take Fed Blue (they are a preferred provider)

[gomoho]

Well most of you have put up with my bitching and moaning about my experience at
"the Dr. Welby" facility and I am the first to criticize, but also the first to compliment.
Went with my husband today to the Family Physicians Group and saw their newest doc,
Dr. Saxon, and was so happy to see a competent doctor who could talk to you while entering the information into that hateful electronic system. Without either my husband or I giving any indication of the problems with the Dr. at Colony he confirmed our suspisions about health issues that were either missed or misdiagnosed. So he has now had 2 physicals in 3 months, with additional blood work that she missed to be done in a few days, but at least we both feel confident he knows what he is doing.

As we were leaving Dr. Saxon came out another door and I told him how grateful and relieved we were to find him and he actually gave me a hug and said "I like what I do".
He shared some personal information with us that he had retired 4 years ago and came back to practice 'cause he likes helping and working with people. He is former military and you can tell by his incredible efficiency.

So anyone looking for an "outstanding" primary care physician I can't praise Dr. Saxon enough. He is one of the few good guys left in medicine! This was a true "Dr. Welby"
experience. He actually asked if we had any questions or concerns he didn't cover.

P.S. My husband and I are both early 60's and only dealing with high blood pressure and cholesterol for him and hypothyroid for me. We are not ailing and in need of continuous care or monitoring. We are very aware of our health and keep diligent records or past lab work. What worries me is we are very tuned into this and fortunately caught the issue with Colony early on - what about a senior not so tuned in getting poor care - who will advocate for them?

[Bavarian]

Marcus Welby aired from the late 60's to mid 70's.

The clinics take Fed Blue (they are a preferred provider)

Thanks for the info. I found some doctors listed in the villages on FEPBLUE site.

[Finallyfree]

We have been using Premier Medical for the last year. We live one mile from the new clinic and will NOT switch. Dr. Gegaj is like the Dr. Welby from the old show, talks as long as needed, listens and believes we should take responsibility for our health issues not just take meds and keep bad habits.

From what I have heard it takes several appts. to actually see the Dr. at colony the first time, why?

[Quixote]

Certainly don't want any insurance AARP backs.

Can't imagine what the issue would be with, for example, the United HealthCare Medicare Supplement that I have. A friend who had done extensive research into these plans pointed out that every single Medicare Supplement plan of the same designation MUST be identical to conform to federal Medicare guidelines. Incredibly their premiums varied--and in some cases considerably--for identical coverage! And that's how I chose United HealthCare, as it had the absolute lowest premium, which made the choice a no-brainer. My friend even mentioned that if both husband and wife enroll in the same supplement, they offer a small discount on the monthly premiums. What could be wrong with this program?

[Shimpy]

Before moving way up north to The Villages I read of doctors that were limiting their practices to only 2000 or so patients. To be a customer or patient it cost about $1500 per year. Is this similar to Dr Welby? What are they charging?

[Hancle704]

Good question. Since the doctors are salaried, who pays the salary? Is there an upfront fee, an annual fee and does Medicare cover any of the fees?

Also been wondering if one of their patients is admitted to any of the area hospitals, will these doctors treat the patient in hospital for non surgical follow up or will routine care be handled by a hospitalist?

[gomoho]

There is no "up-front" fee and since this is Morse's baby I assume he is paying the salaries until they get up and running and Medicare covers the costs. Knowing how savvy the developer is this will be a profitable venture, but curious how Obamacare may affect his plan since it seems weekly new things are unveiled how Obamacare will really work.

[champion6]

Good question. Since the doctors are salaried, who pays the salary? Is there an upfront fee, an annual fee and does Medicare cover any of the fees?

Also been wondering if one of their patients is admitted to any of the area hospitals, will these doctors treat the patient in hospital for non surgical follow up or will routine care be handled by a hospitalist?In msg. #40, dgammon6 posted a link the The Villages Health website. The FAQs have most of the answers -- Frequently Asked Questions | The Villages Health (http://www.thevillageshealth.com/faqs.php)

Is there an upfront fee? No
An annual fee? No
Does Medicare cover any of the fees? Yes, since the fees are the normal and customary fees
Will these doctors treat the patient in hospital for non surgical follow up Yes or will routine care be handled by a hospitalist? and Yes

[Bavarian]

Can't imagine what the issue would be with, for example, the United HealthCare Medicare Supplement that I have. A friend who had done extensive research into these plans pointed out that every single Medicare Supplement plan of the same designation MUST be identical to conform to federal Medicare guidelines. Incredibly their premiums varied--and in some cases considerably--for identical coverage! And that's how I chose United HealthCare, as it had the absolute lowest premium, which made the choice a no-brainer. My friend even mentioned that if both husband and wife enroll in the same supplement, they offer a small discount on the monthly premiums. What could be wrong with this program?

I do not like AARP! Had been a member years ago, when Bush 43 wanted to reform SS, they were all upset, wrote them to fight for Federal Employees getting less SS if we qualified for SS also when had jobs in private sector. Many people retired at 55 then went to work for a contractor to complete their necessary quarters for SS. The said they did not care about Feds and we got "too much money" I stick to NARFE and AMAC now.

[sharonga]

My husband and I just started with Colony Health Care. We are very impressed. They are trying very hard to be the kind of medical center we all want.

[blueash]

I'm not sure I agree with this observation - at least not in theory. Nothing drives me more nuts than when I see my doctor and he asks ME when the last time I had a colonoscopy or whether I had such and such shot or what drugs I am on. It is unconscionable that he doesn't have that information at the tip of his fingers in digital form. In fact, I would expect his iPad or whatever, to start flashing in big red characters that I am due for a certain test or inoculation as soon as he pulls up my records. It should also flash a warning that the drug he is about to prescribe is dangerous in combination with one that another specialist already has me on.

The notion that doctors have to rifle through reams of paper to find any information is mind numbing in today's hi tech world. In a 21st century world of medical technology, we are literally killing ourselves with 19th century record keeping.


Oh don't I wish. In fact most electronic health records have their primary purpose to be sure that the office visit gets coded at as high a level as possible to increase insurance reimbursement. That is how they are sold to practices. That means checking the box that says "reviewed family history" and the one that says "asked if patient smokes or uses alcohol" etc. And to actually find the last colonoscopy requires reading thru all the electronic documents scanned into the file that is labeled "documents" just like on your own home computer. Instead of opening each document to read it, it is much easier to ask the patient. A well organized and legible paper record is much easier to review than an electronic record just as a paper document is easier to read than an online letter. No need to scroll down, click there, move the cursor... just read it.

[blueash]

I disagree. All they have to do is enter what they're looking for into the search box and click.

I am now on my third electronic health system and you could not be more wrong about the ones I have seen. You have to know where every item is supposed to be stored and go thru a series of menus and submenus to get there. No such thing as a search box for data other than patient name in any of them.

[CFrance]

I am now on my third electronic health system and you could not be more wrong about the ones I have seen. You have to know where every item is supposed to be stored and go thru a series of menus and submenus to get there. No such thing as a search box for data other than patient name in any of them.

Then you haven't been associated with the University of Michigan health system, because I have personal knowledge of their search system. Our doctor pulls up anything she wants to know about us, using the search function, and I see it as I'm sitting beside her. It can (and should) be done right. U of M has been doing this since before it became a standard requirement.

[Quixote]

I do not like AARP! Had been a member years ago, when Bush 43 wanted to reform SS, they were all upset, wrote them to fight for Federal Employees getting less SS if we qualified for SS also when had jobs in private sector. Many people retired at 55 then went to work for a contractor to complete their necessary quarters for SS. The said they did not care about Feds and we got "too much money" I stick to NARFE and AMAC now.

Now I�m even more baffled. This thread is about the �Marcus Welby� HMO program (a Medicare Advantage plan) being created in TV versus staying with conventional Medicare coupled with a Medicare Supplement. What I said was that all Medicare Supplement plans of the same designation (for example, I have Plan F; each has different benefits) are identical, yet the administrators of these identical plans all set different premiums. Does this make sense? I chose United HealthCare as it has the lowest premium, that is, making it the least profitable to its shareholders (which in itself is amazing when you think about it). What does this have to do with whether or not I like AARP?

Speaking of those other organizations mentioned in the quote, there�s a post in the thread having to do with choosing the right plan where someone tried to get info about the plan offerings of one of these groups and was rebuffed, never being given the literature needed to make an intelligent choice. Anyone would question the covertness and secrecy. At least United HealthCare, Mutual of Omaha (which I used to have but got awfully expensive), and others make their program info readily accessible. These are, after all, Medicare Supplement plans, structured in accordance with their contracts with Medicare central; who their administrators are has nothing to do with the operation of the plans! I see no reason for me to "cut off my nose to spite my face"....

[Villages PL]

Went with my husband today to the Family Physicians Group and saw their newest doc, Dr. Saxon, and was so happy to see a competent doctor who could talk to you while entering the information into that hateful electronic system.

P.S. My husband and I are both early 60's and only dealing with high blood pressure and cholesterol for him and hypothyroid for me. We are not ailing and in need of continuous care or monitoring. We are very aware of our health and keep diligent records or past lab work. What worries me is we are very tuned into this and fortunately caught the issue with Colony early on - what about a senior not so tuned in getting poor care - who will advocate for them?

Whether or not he's a good doctor depends on the treatment he recommends for high blood pressure, high cholesterol and hypothyroidism. What did he do or suggest other than write prescriptions?

[Number 6]

Oh don't I wish. In fact most electronic health records have their primary purpose to be sure that the office visit gets coded at as high a level as possible to increase insurance reimbursement. That is how they are sold to practices. That means checking the box that says "reviewed family history" and the one that says "asked if patient smokes or uses alcohol" etc. And to actually find the last colonoscopy requires reading thru all the electronic documents scanned into the file that is labeled "documents" just like on your own home computer. Instead of opening each document to read it, it is much easier to ask the patient. A well organized and legible paper record is much easier to review than an electronic record just as a paper document is easier to read than an online letter. No need to scroll down, click there, move the cursor... just read it.

That has not been my experience at all, and I am a retired Practice Administrator. Most physicians code too low in fear f an audit. The EMR (and this is specifically true for eClinical Works, which Colony uses) says that it will help the provider "Correct" code. Now is this higher than the provider currently codes? Probably, but it is in no way incorrect, and it will survive an audit.
I was happy to see eClinical Works, because I know the company and how they sell their product. To be honest, it would not be my first choice, but it is up there.

[gomoho]

Whether or not he's a good doctor depends on the treatment he recommends for high blood pressure, high cholesterol and hypothyroidism. What did he do or suggest other than write prescriptions?

Lifestyle was discussed for cholesterol and blood pressure. Hypothyroidism is successfully treated with synthroid - not much you can do to make a thyroid produce on its own when it's shot!

I can at least for the time being eliminate my concern about the doctor that rendered such poor care at Colony Health Center - I understand she is no longer there.

[gerryann]

Can anyone tell me if a referral to a specialist is needed with United Health Care and/or Preferred Care Partners?

[champion6]

Can anyone tell me if a referral to a specialist is needed with United Health Care and/or Preferred Care Partners?This is my understanding...

MedicareComplete Choice Plan 2 is a PPO plan offered by United HealthCare, and it DOES NOT require a referral to see a specialist.

Preferred Secure Option is a HMO plan offered by Preferred Care Partners, and it DOES require a referral to see a specialist.

Note that I am not an expert in this area. Please consult their websites, or contact an expert or an educated volunteer with SHINE in TV.

[Mack184]

Looking for Marcus Welby, Hawkeye Pierce, Trapper John MacIntyre or even Dr. House is a fool's errand. None of the stories spun on these TV shows should ever be used as a definition for REAL healthcare.

[Villages PL]

Lifestyle was discussed for cholesterol and blood pressure. Hypothyroidism is successfully treated with synthroid - not much you can do to make a thyroid produce on its own when it's shot!

I can at least for the time being eliminate my concern about the doctor that rendered such poor care at Colony Health Center - I understand she is no longer there.

Glad to hear that lifestyle was disscused for cholesterol and blood pressure. If I keep getting this kind of feedback, I won't have anything to complain about. Darn! :)

[Villages PL]

I read the articles in last Sunday's Daily Sun and again today. The reporter keeps saying that the problem with health care today is that doctors have to have 2,000 or more patients just to keep the doors open. And because they have so many patients they have to rush, so they don't spent enough time with their patients.

With The Villages Clinics, each doctor's patient load is capped at 1,250 so they can spend 30 minutes with each patient instead of 15. But the reporter never explains how they will be able to afford keeping their doors open while other doctors need 2,000+ patients in order to do so.

Don't tell me they get a salary (unless the salary comes from the Tooth-Fairy) because that doesn't explain how the bills get paid long term. Money coming in from patient care must equal money going out to pay bills and salary. So where is the money going to come from with so many fewer patients?

[gomoho]

The Morse Family??? parternship with University of South Florida??? partnership with United Health Care??? I believe there are enough high rollers involved with this to support getting it off the ground. Hopefully, once things are up and running is will be self sustaining. Don't forget those docs with the 2000 patients have ridiculous malpractice insurance and it is very possible The Village Health System has a group malpractice policy in place that is more reasonable.

[Sanbo]

My husband, Bobby and I arrived at TV a week ago Saturday. We are momentarily living in Mallory Square, but building in Fernandina. I have a minor health problem that needs to be addressed. Can anyone recommend a physician around 466A. We don't mine a short ride to get there.

[graciegirl]

Looking for Marcus Welby, Hawkeye Pierce, Trapper John MacIntyre or even Dr. House is a fool's errand. None of the stories spun on these TV shows should ever be used as a definition for REAL healthcare.

Where ya been?

Well said...as usual.

[Mack184]

Where ya been?

Well said...as usual.

G-Person...I've been practicing my own kind of healthcare. Keeping my blood pressure in check by NOT reading TOTV. :laugh:

[graciegirl]

G-Person...I've been practicing my own kind of healthcare. Keeping my blood pressure in check by NOT reading TOTV. :laugh:

I completely understand.

[Quixote]

Looking for Marcus Welby, Hawkeye Pierce, Trapper John MacIntyre or even Dr. House is a fool's errand. None of the stories spun on these TV shows should ever be used as a definition for REAL healthcare.

Agreed! Sounds more like a marketing gimmick than reality. It's a pleasant sounding gimmick, but I can't rely on gimmicks for my health care!

[ilovetv]

I think we all knew from the first article in the Daily Sun that Marcus Welby was a fictional character who portrayed the reality of doctors who do care and do spend time talking with patients to know more about them.

I have doctors and know others who do care and want to spend time with patients....but the cost of doing business in light of low insurance/medicare/medicaid reimbursement does not always permit that. And if you think private insurers pay a lot more than medicare does, think again. What private insurers often call "reasonable and customary" charges are often what Medicare pays...which is below cost to the clinicians.

"Marcus Welby" isn't what we're looking for. It's the concept, Stupid.

And the ad slogan "Marcus Welby" was chosen to remind us of the concept to keep in front of the discussion....when talk of healthcare financing sucks up all the public attention and the concept gets lost in the wrangling about "who pays?".

[graciegirl]

Where's the beef? Just Do It! See the USA in your Chevrolet. A little dab'l do ya. Pepsi Cola hits the spot, eight ounce bottle, that's a lot. This Bud's for YOU. Wouldn't you really rather drive a Buick? The weiner the world awaited.

Burma Shave. I LIKE marketing gimmicks. They are very American.

[teamC]

Electronic records are a government mandate:
The American Recovery and Reinvestment Act also includes financial incentives for healthcare providers who prove meaningful use of electronic health records (EHR). EHR is not only a more comprehensive patient history than EMR, the latter of which contains a patient�s medical history from just one practice, but also the end-goal of the federal mandate. �Meaningful use� of EHR, as defined by HealthIT.gov, consists of using digital medical and health records to achieve the following:

Improve quality, safety, efficiency, and reduce health disparities
Engage patients and family
Improve care coordination, and population and public health
Maintain privacy and security of patient health information
Penalties also exist for non-compliance. EP�s who haven�t implemented EMR/EHR systems and demonstrated their meaningful use by 2015 will experience a 1% reduction in Medicare reimbursements, and rates of reduction will likely rise annually thereafter.

[ilovetv]

E‐Health Records (EHRs) – 10 Things to Know

Advocates claim federally‐certified electronic health records (EHRs) will transform health care delivery in America. However, concerns include:

1. Computerized medical records give government health officials easy access to private details of the confidential patient-doctor relationship. Electronic health records (EHRs) record everything. Requiring EHRs to be interoperable across the United States (able to work together and link together) gives outsiders and strangers easy access. Outside access is authorized under federal law. Specifically, because of the federal HIPAA2 “privacy rule,” have access to private health records without patient consent and often 2.2 million entities, including state and federal government, [U]without patient knowledge.

2. The federal government is paying $20 billion to doctors and hospitals to buy expensive government‐certified online EHR systems.
Federal incentive payments under the 2009 HITECH Act only cover about a third of the EHR system costs—and none of the hidden administrative, training and other costs.......

...6. EHRs are part of a larger research agenda to statistically analyze everyone’s patient information and use the “findings” to rationalize health care rationing.

The HITECH modifications to HIPAA provide 2.2 million entities with patient data
for study and predictive analysis. Proponents claim algorithms can be created to theoretically “see” things in the data that people cannot see and this will lead to “cures” for cancer. Failure to do so would be blamed on insufficient data, and data withholding—including refusal to share genetic data—would be a crime.

7. When EHR research finds “cures,” doctors may be required to provide certain treatments or face financial penalties and prosecution. “Decision Support” (DS), standardized treatment protocols based on data and algorithms embedded in a physician’s computer, will push doctors to prescribe one‐size‐fits‐all treatments rather than customized care. Not using the standards could be considered fraud, waste or abuse. Doctors using DS are less trusted.

8. EHRs have captured the interest of investors.
Private equity firms (the kind that only acquire companies with at least $100 million in revenue) are bidding on EHR companies to expand their portfolios......

See full report to consumers:

http://www.cchfreedom.org/files/files/EHR%20Top%2010%20FINAL%20TEXT.pdf

[Russ_Boston]

As a nurse I think #7 is actually a positive. Too often I see docs who prescribe 'custom care' and in the long run it didn't work. (I think they actually just missed what the care should be from a standards point of view in the first place.). Let the data say what to try first and if THAT doesn't work then let's go custom.

[Bavarian]

As a nurse I think #7 is actually a positive. Too often I see docs who prescribe 'custom care' and in the long run it didn't work. (I think they actually just missed what the care should be from a standards point of view in the first place.). Let the data say what to try first and if THAT doesn't work then let's go custom.

I am concerned with this mandatory sharing of medical information and that it is mandatory for me, a patient, to allow all my medical history to be known. Then insurance companies will have access to this info and use it to deny coverage, employers will check this database before making job offers, etc. And that is just the tip of the iceberg.

[travelguy]

marcus welby was a made up character and as such had his 'life' planned out via a tv script. reality is unscripted. i am sure that the ladies would enjoy it if our 'marcus welby's' had a young assistant like james brolin!

[mrsyarbie]

Well most of you have put up with my bitching and moaning about my experience at
"the Dr. Welby" facility and I am the first to criticize, but also the first to compliment.
Went with my husband today to the Family Physicians Group and saw their newest doc,
Dr. Saxon, and was so happy to see a competent doctor who could talk to you while entering the information into that hateful electronic system. Without either my husband or I giving any indication of the problems with the Dr. at Colony he confirmed our suspisions about health issues that were either missed or misdiagnosed. So he has now had 2 physicals in 3 months, with additional blood work that she missed to be done in a few days, but at least we both feel confident he knows what he is doing.

As we were leaving Dr. Saxon came out another door and I told him how grateful and relieved we were to find him and he actually gave me a hug and said "I like what I do".
He shared some personal information with us that he had retired 4 years ago and came back to practice 'cause he likes helping and working with people. He is former military and you can tell by his incredible efficiency.

So anyone looking for an "outstanding" primary care physician I can't praise Dr. Saxon enough. He is one of the few good guys left in medicine! This was a true "Dr. Welby"
experience. He actually asked if we had any questions or concerns he didn't cover.

P.S. My husband and I are both early 60's and only dealing with high blood pressure and cholesterol for him and hypothyroid for me. We are not ailing and in need of continuous care or monitoring. We are very aware of our health and keep diligent records or past lab work. What worries me is we are very tuned into this and fortunately caught the issue with Colony early on - what about a senior not so tuned in getting poor care - who will advocate for them?

Not everyone will have a good experiance and not every system is best for everyone. THIS is a brand new venture. Glad you found a system that works for you. I have been a RN for over 30 years, love the new Colony Clinic and for the first time in years feel I have a intelligant primary MD Karla Noel who actually cares, knows what she is talking about and listens to me. ALso I retired from USF Health in 2010 and never as a pt. had to wait for less than 30 minutes for any MD even worse for most pts. and found that to be the normal in most offices over the years.It has been very difficlut fo rmost of the older MD's to switch over to the paperless system. It takes a lot of time to avoid errors in the pts charts.The younger the MD the easiest it is. Beleive Ihave worked with some brilliant docs who we had to help with e-mail.:wave: There is not a perfect sytem.... expect maybe in our imaginations. By the way I am also only 61. Best wishes to you both...

[gomoho]

Not everyone will have a good experiance and not every system is best for everyone. THIS is a brand new venture. Glad you found a system that works for you. I have been a RN for over 30 years, love the new Colony Clinic and for the first time in years feel I have a intelligant primary MD Karla Noel who actually cares, knows what she is talking about and listens to me. ALso I retired from USF Health in 2010 and never as a pt. had to wait for less than 30 minutes for any MD even worse for most pts. and found that to be the normal in most offices over the years.It has been very difficlut fo rmost of the older MD's to switch over to the paperless system. It takes a lot of time to avoid errors in the pts charts.The younger the MD the easiest it is. Beleive Ihave worked with some brilliant docs who we had to help with e-mail.:wave: There is not a perfect sytem.... expect maybe in our imaginations. By the way I am also only 61. Best wishes to you both...

The good news is the offending Doctor is no longer at Colony Health so that problem has been eliminated.

[champion6]

I am concerned with this mandatory sharing of medical information and that it is mandatory for me, a patient, to allow all my medical history to be known. Then insurance companies will have access to this info and use it to deny coverage, employers will check this database before making job offers, etc. And that is just the tip of the iceberg.This is completely untrue. Please don't worry. As has always been true, your personal medical information is released only after YOU authorize it, and only to the person/business/agency that YOU specify. This is true regardless of whether your records are stored electronically or on paper.

[gomoho]

This is completely untrue. Please don't worry. As has always been true, your personal medical information is released only after YOU authorize it, and only to the person/business/agency that YOU specify. This is true regardless of whether your records are stored electronically or on paper.

You have to be kidding - do you know how valuable this information will be to a cyber hacker that could obtain information and sell it or a government that wishes to look into your history. This is a can of worms that has been opened and we have very little control of the security of this system. :mad:

[laceylady]

Goodness! Our medical records in WA state have been electronic for at least five years. I worked for Social Security Disability for 30 years. In 2005 ALL their medical files became electronic. Many people in the Villages are on this program. SSA, the granddaddy of all bureaucracies, worked with doctors, hospitals and clinics nationwide to convert their records to electronic form. This is not 'new' in 2013. It is the 21st century and computers rule! There are far more benefits to electronic records than there are problems with them. The complaining about so many issues on this forum sure gets tiring. We sound like a bunch of 'crotchety old people'!

[gomoho]

I am sure anyone who has experienced identity theft doesn't share your opinion. We have enough fraud with medicare without making all that information available to those that wish to make a fast buck. Can't hardly compare the state of Washington having some people on electronic records with the entire country having to be electronic by 2015. Whole different ball game.

So far I have only experienced inconvenience to me the patient as far as medical records. Have yet to see a benefit, but hoping for the best in the future.

[Quixote]

.... And if you think private insurers pay a lot more than medicare does, think again. What private insurers often call "reasonable and customary" charges are often what Medicare pays...which is below cost to the clinicians....

I've been told time and again by providers of various medical services (not just MDs, that is) that Medicare is one of the best, if not THE best, payer. Possibly private insurers are more focused on their bottom line than they are on the health needs of their insureds....

[Russ_Boston]

I am concerned with this mandatory sharing of medical information and that it is mandatory for me, a patient, to allow all my medical history to be known. Then insurance companies will have access to this info and use it to deny coverage, employers will check this database before making job offers, etc. And that is just the tip of the iceberg.

Don't fear. I worked at the Medical Information Bureau (look it up) for 27 years and they are, and will be, under the strictest guidelines for release of information. This will not change as long as HIPAA standards exist. Even as a nurse at the hospital I can't look up your information unless I'm actively on the case.

[ilovetv]

Don't fear. I worked at the Medical Information Bureau (look it up) for 27 years and they are, and will be, under the strictest guidelines for release of information. This will not change as long as HIPAA standards exist. Even as a nurse at the hospital I can't look up your information unless I'm actively on the case.

I respect your experience and opinion based on it, but I used to think the IRS was "under the strictest guidelines" to prevent misuse/abuse of our private tax information.

It's the IRS involvement in our medical records that has me concerned. It's not the electronic medical record. It's the misuse of it by politicians using it as a political football to get votes in any way possible under the sun.

[CFrance]

Goodness! Our medical records in WA state have been electronic for at least five years. I worked for Social Security Disability for 30 years. In 2005 ALL their medical files became electronic. Many people in the Villages are on this program. SSA, the granddaddy of all bureaucracies, worked with doctors, hospitals and clinics nationwide to convert their records to electronic form. This is not 'new' in 2013. It is the 21st century and computers rule! There are far more benefits to electronic records than there are problems with them. The complaining about so many issues on this forum sure gets tiring. We sound like a bunch of 'crotchety old people'!

:agree::agree: Finally all of my doctors have seen what each other have done, right there on the screen. My in-laws had several doctors each, in the same hospital system, none of whom communicated. it landed my mil in the hospital with a serious blood infection due to being over prescribed very heavy steroids. She almost lost her eyesight, and was on the way to losing her life, all from doctors who never communicated with each other--some out of ego arrogance, some out of ignornce, some out of laziness to look up and read the records. My sil and husband had to nail these doctors to the wall and demand they effect some kind of records communications.

That is inexcusable, and that is what this new system is supposed to prevent. And now we have computers to facilitate that process, and yet people are complaining, making up all sorts of scenarios where this will abort our identity protection, etc.... You may like the old system, but times have changed; there are fewer doctors for more people, and they have to come up with a safe way to transmit patient information internally.

It'll be no satisfaction to you, if the irs can't get a hold of your medical information, if you happen to be dead due to lack of timely record sharing by your doctors.

[gomoho]

CFrance - I don't think anyone is arguing if done correctly electronic medical records can save lives. We are concerned about the misuse of the information and I believe it is a legitimate concern. None of our personal information is safe anymore in this electronic age.

Russ_Boston - I respect your position and knowledge; however, I don't believe you are a computer hacker and would therefore not have the ability or inclination to obtain that information.

[14thMed]

CFrance - I don't think anyone is arguing if done correctly electronic medical records can save lives. We are concerned about the misuse of the information and I believe it is a legitimate concern. None of our personal information is safe anymore in this electronic age.

Russ_Boston - I respect your position and knowledge; however, I don't believe you are a computer hacker and would therefore not have the ability or inclination to obtain that information.

OUR Mega-Medical Center was hacked.All information was compromised.SSAN's everything including medical info.
I don't know which will be worse that or the Government having access.

[looneycat]

I also deal with a variety of health issues, at least one potentially life-threatening, and I would have to agree about having received excellent AND compassionate care (and also about one unnamed physician who goofed big-time...)!

Yes, I agree that the "Marcus Welby" thing sounds like a marketing gimmick....

I deal with a number of life threatening conditions and have found a lot of incompetent nincompoops who have caused me additional treatments and surgery tro fix their screw ups. I am in the process of suing a dermatology practice here that allows PAs to be in charge of your care. No thanks quack Welby I'd rather see good doctors rather than those whose practices were so bad that they were willing to leave them to start over here!
:eek:

[looneycat]

OUR Mega-Medical Center was hacked.All information was compromised.SSAN's everything including medical info.
I don't know which will be worse that or the Government having access.

I spent many years programming everything from cash registers to main frame computer systems, your info is not totally safe anywhere...not the motor vehicle system, not the IRS, not retail stores, no one can guarantee your datas' security these days so why obsess on the medical records system which can help you more than financial systems that get hacked every day? You give just as much 'dangerous' info when you open a store credit card.

[gomoho]

I spent many years programming everything from cash registers to main frame computer systems, your info is not totally safe anywhere...not the motor vehicle system, not the IRS, not retail stores, no one can guarantee your datas' security these days so why obsess on the medical records system which can help you more than financial systems that get hacked every day? You give just as much 'dangerous' info when you open a store credit card.

I am not paranoid by nature, but if I had a condition that could affect future employment or the government would be interested in tracking for whatever reason I would prefer it not be so readily available. My social security, number, address, phone, buying habits are public information - I prefer something as personal as my health record not be.

[twinklesweep]

Where's the beef? Just Do It! See the USA in your Chevrolet. A little dab'l do ya. Pepsi Cola hits the spot, eight ounce bottle, that's a lot. This Bud's for YOU. Wouldn't you really rather drive a Buick? The weiner the world awaited.

Burma Shave. I LIKE marketing gimmicks. They are very American.

You really want your health care, which can be life and death stuff, represented by a marketing gimmick?! Well, you're entitled, but I sure don't!

[Carla B]

I've been told time and again by providers of various medical services (not just MDs, that is) that Medicare is one of the best, if not THE best, payer. Possibly private insurers are more focused on their bottom line than they are on the health needs of their insureds....

Exactly. Following surgery and after Medicare and the secondary insurance had paid I still owed a balance to the surgeon. His office said that the secondary insurance co. didn't think that particular surgery was worth as much as Medicare allowed, so they only paid a partial amount of their 20% and I was responsible for the remainder. That's one reason we stick with original Medicare and not a Medicare Advantage program run by an insurance co.

[graciegirl]

You really want your health care, which can be life and death stuff, represented by a marketing gimmick?! Well, you're entitled, but I sure don't!


Whoops. You responded to me thinking I responded to the issue of records being made available on the internet and I was referring to someone who said Marcus Welby was a marketing gimmick.

Actually, I am for records being available through the computer. We have some very unusual health conditions in our collective family that are not seen often, so having them available on line in an emergency would be to our benefit.

I can understand people wanting privacy but when you have some unusual genetic stuff like we have...folks who aren't up on it need to see the records...STAT.

I would want it for us. It outweighs someone acting on a job. It is a life and death issue.

Everyone should be able to decide for themselves.

[queasy27]

For me, the cost/benefit ratio of electronic records is worth it. I've had a spate of bad medical luck in the last couple months and ended up at the hospital in Leesburg and in The Villages, plus ER visits and multiple doctors in both cities, and all of them were able to pull up my charts and test results. For me, the continuity of care is more important and the chance of privacy violations less so.

Admittedly, since I'm still working and covered by group medical, the possibility of being turned down by insurance companies or by a potential employer don't apply to me, but I agree those are legitimate concerns about the system.

In general, I care about my SSN and financial records but don't shred prescription bottles or scrape the labels off before recycling because it doesn't worry me if some random stranger at the sorting plant can see that some random person with the same name as me takes omeprazole.

Tugging the privacy topic sideways a bit -- I do very much wonder how all the online tracking and monitoring is going to come back and bite us. I was trying to set up a free Android phone app recently and never could get it to work so uninstalled it. I then noticed a charge from Google Voice for $25 on my credit card. On my active credit card (I only keep one), which I had not given the app people. I suppose at some point I used Google checkout for online shopping and boy, they saved that info.

[Russ_Boston]

I am in the process of suing a dermatology practice here that allows PAs to be in charge of your care.
:eek:

That raises a big red flag to me. Anyone else see it?

IF you cared that much about the dermatologist using PA's then WHY did you allow it to happen in the first place? Did you know he/she was a PA? If you knew and allowed it then how can you sue? What happened?

[queasy27]

That raises a big red flag to me. Anyone else see it?

IF you cared that much about the dermatologist using PA's then WHY did you allow it to happen in the first place? Did you know he/she was a PA? If you knew and allowed it then how can you sue? What happened?

Curious, and this is said in a very mild tone in my head -- why is that a red flag? My inclination as a patient is to trust and put my faith in the training and experience of all medical staff until I have a reason not to. I've seen wonderful PAs before and one that wasn't. But I don't know that going in.

[Russ_Boston]

Curious, and this is said in a very mild tone in my head -- why is that a red flag? My inclination as a patient is to trust and put my faith in the training and experience of all medical staff until I have a reason not to. I've seen wonderful PAs before and one that wasn't. But I don't know that going in.

They said that they're sueing them BECAUSE they USE PA's. Not because of the care received. Their words not mine.

Yes, I agree completly about PAs. Many are great.

[Bonny]

I deal with a number of life threatening conditions and have found a lot of incompetent nincompoops who have caused me additional treatments and surgery tro fix their screw ups. I am in the process of suing a dermatology practice here that allows PAs to be in charge of your care. No thanks quack Welby I'd rather see good doctors rather than those whose practices were so bad that they were willing to leave them to start over here!
:eek:
Why would you sue a Dr. that uses PAs ? What did they do to you ? You had to know it wasn't the Dr. If you didn't want a PA you could have just left.

[looneycat]

Why would you sue a Dr. that uses PAs ? What did they do to you ? You had to know it wasn't the Dr. If you didn't want a PA you could have just left.

the 'Dr.' took the biopsy, the lab said it was negative, the PA that I saw the next 2 visits insisted it was OK since the biopsy was negative, however, I showed him that it continued to grow, it was circular with raised edges and a scaly surface. He wouldn't freeze it off since it was 'negative'. It started to ulcerate so I immediately made an appointment elsewhere and wound up in the hospital having surgery that should not have been necessary and complicated by the fact that I am a transplant patient with APS as well.....so what do you think Russ? Oh and on each occasion the PA was accompanied by a female Dr. who stood in the background and never introduced herself.

[looneycat]

I am not paranoid by nature, but if I had a condition that could affect future employment or the government would be interested in tracking for whatever reason I would prefer it not be so readily available. My social security, number, address, phone, buying habits are public information - I prefer something as personal as my health record not be.

tell that to the people who don't think a perspective employer would look them up on facebook. and , by the way, if you have a serious health issue and discussed it on any forum anywhere any perspective employer can find that out when they google you!

[Russ_Boston]

the 'Dr.' took the biopsy, the lab said it was negative, the PA that I saw the next 2 visits insisted it was OK since the biopsy was negative, however, I showed him that it continued to grow, it was circular with raised edges and a scaly surface. He wouldn't freeze it off since it was 'negative'. It started to ulcerate so I immediately made an appointment elsewhere and wound up in the hospital having surgery that should not have been necessary and complicated by the fact that I am a transplant patient with APS as well.....so what do you think Russ? Oh and on each occasion the PA was accompanied by a female Dr. who stood in the background and never introduced herself.

As I said and I'll say it again. Why sue the practice for using PA's? Why not sue the lab for saying it was negative? All PA's pass all their cases and care onto the doctor for approval and treatment options. If your mole was positive for cancer then sue the lab and doctor - PA had nothing to do with it IMHO.

And of course I wish you well but lawsuits are not the way to better health.

I see at least 20% of my patients who 'chase' cures when there is none to be had. They spend their last years on earth going from doc to doc since they didn't like the most recent prognosis. "There's always a better doctor" is what I hear. But sometimes even that 'better' doc has the same opinion.

[Bonny]

the 'Dr.' took the biopsy, the lab said it was negative, the PA that I saw the next 2 visits insisted it was OK since the biopsy was negative, however, I showed him that it continued to grow, it was circular with raised edges and a scaly surface. He wouldn't freeze it off since it was 'negative'. It started to ulcerate so I immediately made an appointment elsewhere and wound up in the hospital having surgery that should not have been necessary and complicated by the fact that I am a transplant patient with APS as well.....so what do you think Russ? Oh and on each occasion the PA was accompanied by a female Dr. who stood in the background and never introduced herself.
That's a shame, but what does that have to do with the PA ? I would think that's the lab's fault.

[Russ_Boston]

My guess is that the mole was pre-cancerous and thus negative from the lab. I have seen dermatologists (I worked for two of them up north) who take a 'cautious waiting' treatment option. In other words, keep and eye on it every few months and then treat if necessary. They certainly didn't remove every irregular mole they saw.

[LvmyPug2]

PAs and Nurse Practitioners are fully licensed medical providers and using them is standard practice in most primary care settings. Given the shortage of family practice physicians, you will see more and more care delivered by these "mid level" medical providers. The good news is there have been many studies publish in medical journals including JAMA that have shown Nurse Practioners deliver equal and often superior quality of care when compared to physicians and their patients have better health outcomes than physicians, especially when it comes to treating chronic diseases like diabetes, heart disease and asthma.

While one can sue any provider, mid-level or physician for malpractice, I seriously doubt anyone would be successful in suing simply because a licensed mid-level provided care, unless of course the mid-level misrepresented themselves as a physician.

[graciegirl]

PAs and Nurse Practitioners are fully licensed medical providers and using them is standard practice in most primary care settings. Given the shortage of family practice physicians, you will see more and more care delivered by these "mid level" medical providers. The good news is there have been many studies publish in medical journals including JAMA that have shown Nurse Practicioners deliver equal and often superior quality of care when compared to physicians and their patients have better health outcomes than physicians, especially when it comes to treating chronic diseases like diabetes, heart disease and asthma.

While one can sue any provider, mid-level or physician for malpractice, I seriously doubt anyone would be successful in suing simply because a licensed mid-level provided care, unless of course the mid-level misrepresented themselves as a physician.

I think some of the confusion may be that Physicians Assistants are not licensed or used or seen in all states. In Ohio we have a completely different category called Nurse Practitioners and they do NOT have the powers that PA's have. It is something like a doctor's degree in nursing..but not exactly..being a Nurse Practitioner , they cannot practice unless under the direction of an MD in Ohio.

I had not heard of PA's until I moved here and I still am not clear what they can or cannot do. Our dermatologist always looked us over himself in Ohio.

AND no reputable MD of any kind sold " product" in their office as many dermatologists do here. It really puts me off.

[Villages Kahuna]

This is a false rumor. During his presentation Mark Morse said we will be able to choose by location or by doctor.
That's NOT what I was told when I visited the Colony Cottage office. The "greeter" asked what village I lived in and told me that when a VHC facility was built serving my village, I would get a letter inviting me to visit and become a patient.

[ilovetv]

I googled "Florida physician scope of practice", but most results were written/published by the P.A. lobbying groups that want state-by-state restrictions lifted on what they can and cannot do. Other results were the legalese of state laws regulating/licensing them.

This article helps a bit:

Battles Erupt Over Filling Doctors' Shoes - WSJ.com (http://online.wsj.com/article/SB10001424127887323644904578271872578661246.html)

[Mack184]

PAs and Nurse Practitioners are fully licensed medical providers and using them is standard practice in most primary care settings. Given the shortage of family practice physicians, you will see more and more care delivered by these "mid level" medical providers. The good news is there have been many studies publish in medical journals including JAMA that have shown Nurse Practioners deliver equal and often superior quality of care when compared to physicians and their patients have better health outcomes than physicians, especially when it comes to treating chronic diseases like diabetes, heart disease and asthma.

While one can sue any provider, mid-level or physician for malpractice, I seriously doubt anyone would be successful in suing simply because a licensed mid-level provided care, unless of course the mid-level misrepresented themselves as a physician.
My wife is an NP and I will put her skills and talent up against many doctors.

[Mack184]

I think some of the confusion may be that Physicians Assistants are not licensed or used or seen in all states. In Ohio we have a completely different category called Nurse Practitioners and they do NOT have the powers that PA's have. It is something like a doctor's degree in nursing..but not exactly..being a Nurse Practitioner , they cannot practice unless under the direction of an MD in Ohio.

I had not heard of PA's until I moved here and I still am not clear what they can or cannot do. Our dermatologist always looked us over himself in Ohio.

AND no reputable MD of any kind sold " product" in their office as many dermatologists do here. It really puts me off.
G-Person...State rules vary all over the country about NPs & PAs. However they ALL are under the supervision of an MD and they have ALL had very comprehensive schooling. Most of them have Master's degrees plus. A lot of the difference between PAs & NPs is merely semantics. And.. most of these people are doing the vast majority of "hands-on" care in today's brave new world of health care. I'm lucky enough to have my very own personal one at home!! :D

[ilovetv]

Nurse practitioners and physician assistants have a definite place in clinical healthcare. But I think it goes out of bounds to say they are good to take the place of physicians. The education and training are not the same in each profession or para-profession.

It's like saying a paralegal is equal to a lawyer. Would you want a paralegal as your legal defense if prosecuted for a crime? I wouldn't. It would be fine if the paralegal researches and does filings and communicates with me for the lawyer, but not for making my case in trial. There's a reason why state bar exams are strident and difficult to pass.

It's also like saying a medical school graduate or first-year intern can take the place of the board-certified physician. After all, the medical school graduate with new diploma in hand has done 2 solid years of clinical experience in the hospital in addition to the classroom courses in the first couple of years. But there are state and national board exams for licensure, and there are strident board-certification exams for each specialty and subspecialty....for good reason.

I wouldn't want a med school graduate being in charge of my care.....unless an attending physician were right there observing and available for immediate, in-person consult. That is how P.A.'s are licensed and authorized to work, and I hope it stays that way....under the supervision and malpractice insurance of a physician.

I think there's so much wishful thinking about lowering costs of healthcare (and I wish that too), that people are giving in and concluding, "Let's save all that money and get rid of medical school and residency requirements." But I think, as always: You get what you pay for.

[looneycat]

As I said and I'll say it again. Why sue the practice for using PA's? Why not sue the lab for saying it was negative? All PA's pass all their cases and care onto the doctor for approval and treatment options. If your mole was positive for cancer then sue the lab and doctor - PA had nothing to do with it IMHO.

And of course I wish you well but lawsuits are not the way to better health.

I see at least 20% of my patients who 'chase' cures when there is none to be had. They spend their last years on earth going from doc to doc since they didn't like the most recent prognosis. "There's always a better doctor" is what I hear. But sometimes even that 'better' doc has the same opinion.

the clinical evidence was obvious and contrary and over a period of 10 months showing continued growth....sorry, he was incompetent and the 'overseeing physician' was irresponsible. Doctors aren't special the are just people with specialized education, some are good, some are excellent and some are just plain terrible. I am an informed patient and don't chase cures, I have an incurable condition that has caused me more troubles than I would wish on any five people. One would have to be a moron to stick with a bad doctor, what happens when that 'better' doctor shows how your life was put at risk by the prior one? As for lawsuits, every professional is subject to suit when their service results in damage to their client or his business, over time it helps to weed out the incompetents!

[looneycat]

That's a shame, but what does that have to do with the PA ? I would think that's the lab's fault.

first off, was the sample supplied from the appropriate spot, next they are the clinicians, they kept falling back to the old sample rather than submitting a new one when their eyes and measurements showed it was expanding, and finally, as soon as the next dermatologist saw it...before I pointed it out..immediately said "that's a cancer, we need to remove it immediately". Biopsy was positive and the original report was obtained and it was noted that it had been a 'meager' sample. I would have expected more from such an 'advanced' practice.

[Russ_Boston]

first off, was the sample supplied from the appropriate spot, next they are the clinicians, they kept falling back to the old sample rather than submitting a new one

Wow, Having worked for a Derm for 2 years that is really hard to believe. But I will if you say it's true. Not sure what you mean by the appropriate spot. We used to take off the entire area all the way to clean margins (I think that is the standard of care even in areas that are not suspected cancer - just to be sure). Was it that large that they only took an area within?

[looneycat]

Wow, Having worked for a Derm for 2 years that is really hard to believe. But I will if you say it's true. Not sure what you mean by the appropriate spot. We used to take off the entire area all the way to clean margins (I think that is the standard of care even in areas that are not suspected cancer - just to be sure). Was it that large that they only took an area within?

from what I saw along with the new Dr was an image of a small sliver of the raised rim of the circular edge. we both saw the 'meager sample' comment and he agreed as did the plastic surgeon who wound up removing it.

[Quixote]

My guess is that the mole was pre-cancerous and thus negative from the lab. I have seen dermatologists (I worked for two of them up north) who take a 'cautious waiting' treatment option. In other words, keep and eye on it every few months and then treat if necessary. They certainly didn't remove every irregular mole they saw.

As a Clark's Level 3 melanoma survivor, I had been in the care of a dermatologist up north for forever. When I moved here, I began using a dermatologist whose practice structure is to allow the PA to determine what to biopsy, and when it comes back positive and not with clean margins, then the MD operates. I swear by the PA I use; half to three quarters of the questionable moles come back as what used to be termed as "early evolving melanoma." My body just seems to form these with gusto! IMHO, based on what I've learned from the both dermatologists and the PA, something that is "pre-cancerous" should not be described as "negative"....

I have records sent to the dermatologist up north, who during one of my rare visits there (I live in FL most of the year) he commented that some of what was biopsied may never actually become melanomas and that removing them that early was (pardon the expression) overkill, in his opinion. When I brought this up the PA, the response--which seemed pretty sensible to me--is that in FL we have to be that much more cautious than up north because of sun exposure so much more and so much stronger. And frankly, I'd rather err on the side of caution: "Take it off!"

[Russ_Boston]

Thanks for the info.

Now back to the topic:)

[twinklesweep]

Wow, Having worked for a Derm for 2 years that is really hard to believe. But I will if you say it's true. Not sure what you mean by the appropriate spot. We used to take off the entire area all the way to clean margins (I think that is the standard of care even in areas that are not suspected cancer - just to be sure). Was it that large that they only took an area within?

Thanks for the info.

Now back to the topic:)

Yes, good idea: Back to the topic!

[Advogado]

My most fervent hope is that people will suspend their skepticism and crushing disappointment that things are never perfect.

My suggestion is that the Developer's voluntary sponsorship of a primary health care system available to TV'rs only a "10 minute golf cart ride away", deserves a chance to succeed.

Let's give it a chance.

As I understand it, although the propaganda in the Daily Sun obfuscates about structure and ownership, the new health-care system is a for-profit operation of the Developer-- not a "voluntary sponsorship". This is not a criticism. If the Developer can run health-care delivery as well as he runs his other operations, this is a good thing, and he deserves to make a profit. However, to call it a "voluntary sponsorship" implies that the Developer's motives are altruistic.

[graciegirl]

As I understand it, although the propaganda in the Daily Sun obfuscates about structure and ownership, the new health-care system is a for-profit operation of the Developer-- not a "voluntary sponsorship". This is not a criticism. If the Developer can run health-care delivery as well as he runs his other operations, this is a good thing, and he deserves to make a profit. However, to call it a "voluntary sponsorship" implies that the Developer's motives are altruistic.


Some people think that he might be. One should keep an open mind.


So far in seven years I haven't met a soul who knows him well. So he may be altruistic in many ways. Some rich people are very nice.