NYTimes article on Medicare testing
 

I can't find the original NYT article but it was reprinted in the Boston Globe. For some reason, it disappeared on TOTV but I found it online. Very interesting. Well worth the read.
http://www.bostonglobe.com/news/nati...RSO/story.html

Here's another version of the same story that I just found online from the New York Times. The map of the U.S. clearly shows central Florida, including The Villages, as a "hot spot" for excessive medical testing of seniors.
http://www.nytimes.com/2015/02/01/us...-in-south.html

I am surprised so few are interested. Or is it that everyone already knew?

And what Governor bossed a company that committed one of the largest Medicare frauds? :evil6:
Welcome to Florida.

Florida showed its clear willingness to vote for a candidate from your side in the 2012 presidential election.

Results of that choice are why Florida voted against your side in the 2014 governor's election.

It's always a choice of the lesser of two evils, and as the saying goes, "when you choose the lesser of two evils, you still have some evil".

Put up a decent candidate and people will vote for him/her.

Indeed abuse by Florida doctors will hurt seniors for many reasons. It appears from the articles posted here these docs are motivated by greed.

However the other side of the story could mean that perhaps some of these tests were indeed necessary? I am all for dealing with the fraud abuse

However, medicare fees have been continually reduced across the board. Now we have the government with a plan to refuse payment to medical providers based on quality of results that they (government) admits they can't define. All this means is that many hospitals and docs will forego necessary treatment regimes.

Many doctors are beginning to refuse medicare patients because they can't afford to meet the government demands and patients more and more are getting caught up in the middle of it

What I am trying to explain is that thee are two sides to the same story

excessive testing and procedures are evident when you see all the medical ads in the local paper, docs trawling for suckers. also earlier this week in the great NY times was an article about a fla. cardiologist specializing in stents who increased his income by also placing stents in the legs of seniors to "cure" blood vessel problems, a procedure not widely believed effective. So all you sicko's out there, beware.

I think we also need to look at the other side of the coin - folks that thrive on going to the doctor and having these tests done cause "it doesn't cost me anything". Let's not forget the personal responsibility side of each of us has to question the doctor and getting a second opinion when needed. We can stop a lot of the Medicare fraud ourselves by asking questions and understanding that each of us ultimately pays for these tests one way or the other. It's not free folks.

:agree::agree::agree:

"It doesn't cost me anything" really is the crux of the problem once the charlatan doctors are put out of business (which I doubt anybody is doing because of federal enforcement that seems to be weak or apathetic).

Knowing how people quibble about having to pay a $2 split dinner charge at a restaurant, or how they will not tip more than a dollar bill on a $60 meal (if even that amount), or they have fits about a $5 co-pay on a $200 prescription……...I think a lot of the over-use of "free" medical care would stop if people had to pay a small cash co-pay up front!

I am quite sure there are people that want lots of tests because they aren't paying for them but the crux of the article is that doctors order tests they may not need. It referred to the example of people who came to Florida for the winter and were told to get tests which they found were totally unnecessary when they spoke to their regular doctor. If you read the article, it speaks to the medicare providers get paid the more they do and there is a significant problem with regard to this.

You're right, and the problem of what Medicare incentivizes was rightly stated by TV developer Gary Morse, back in 2010 (below). While others only complained, he put his money where his mouth was and funded/built a different type of primary-care system.

“Medicare is a lifesaving program but it has been set up in such a way that doctors are no longer able to care for us senior citizens in the same manner that we grew up with,” said Villages developer Gary Morse. “Medicare pays a doctor for every patient he sees, not how much time he spends with that patient. If the doctor sees 100 patients a day, he or she makes twice as much as seeing 50 patients.”

The result of that volume-driven system has changed the way most doctors operate….."

What it did not mention is that many primary-care doctors cannot pay the bills having mostly Medicare patients and few with private insurance, and because they do NOT do unnecessary procedures because they have a conscience, their practice goes belly up and they have to close.

Morse articulated the problem and DID something about it, but how many in Washington have been willing to listen and ACT on it--somehow?

http://www.thevillageshealth.com/art...20Hometown.pdf

I understand the crux of the article is about doctors ordering unnecessary tests, but I still hold that we are personally responsible as well to ask questions and get second opinions. There are way too many people that like the attention and really believe this stuff is "free". Both the doctors need to check themselves and all of us that use the Medicare system.

Many people were brought up to listen to what the doctor says and do it. I am not one of them but there are many who just follow the doctor's instruction.

I'm not either - I would like to hear from some folks that are of that mind set. I think it's a generational thing - I question everything and always have, but I also grew up in the 60s.

Gracie - weigh in on this. I would like to hear your thoughts on when you go to the doctor if you are comfortable questioning the doctor's orders. My guess is you are.

Rully.

My Father taught each of us - "Remember...Doctors only practice medicine. So be careful who you let practice on you and be wary of what they intend to practice!"

Am also a child of the 60s. Married into a large enough family of Italian heritage who always [before seeking medical care for anything but the obvious] sought out the old, proven tonic or treatment that had been handed down for generations.

I am comfortable challenging them, although I never once questioned our two pivotal doctors in Ohio which we consulted for twenty years.

We saw a PCP here for a little over a year and he ordered a sonogram on my leg to be performed in his office and I had no symptoms, no pain. This was after having a test with electrodes performed by his office staff. I questioned the reason for it and the answer was the doctor wanted it done. They called twice to have me come in and I said no. We moved from him last year to a new PCP, and I like him well enough but he ordered a cardiac sonogram and wanted it performed in his office and I said I preferred to have it performed by Lake Imaging. And I did have it performed by Lake Imaging and the sonogram tech who had done them for over twenty years assured me almost immediately that my heart was fine. AND I am a little not sure if it was necessary.

I don't like being skeptical about a physicians opinion. I am not used to it. I felt my trust in both of my doctors in Cincinnati was warranted. They trained at a respected place and were used by many very savvy people. And their hospital associations were stellar.

Gracie - thank you for you honest answer, especially the part how you are skeptical of questioning, but still will do it. And I only singled you out because from what I have picked up from your posts and how you grew up I expected authority wasn't to be challenged. Again, thanks.

It's a really tough decision, as we age, about whether or not we should buy in to all the tests they suggest. Our physician wanted me to have the same sonogram on my leg as Gracie's. He said it was tight and shiny and my feet were cold (they weren't and aren't), and they could do a stent in my leg if the sonogram showed lack of circulation. I said no.

But then we went on a long plane trip, and my feet were swollen for a month afterword. First time ever, and we fly a lot, and I do all the on board exercises they advise you to do to keep up circulation.

So I went back to the doc. Now they will take bp in the leg and see what it says. I'm okay with that.

So who knows? We don't think our doctor over prescribes tests. But we're vigilant about watching for that. He does want an appointment every three months, but I have read that this is better than an annual physical because you are constantly monitored. So I'm okay with that too.

Patients listen to and trust not only the doctor, but the federal agency that pays him for what he orders, too.

The agency (Centers for Medicare and Medicaid Services - CMS) knows how much they are paying all doctors and these charlatans who suck money that could be used to help more patients. CMS knew how much this creep has been milking out of Medicare, but he has connections.

"April 9 (Bloomberg) -- A doctor who treats a degenerative eye disease in seniors was paid $21 million by Medicare in 2012, twice the amount received by the next ophthalmologist on a list of 880,000 medical providers released by the government.

The data on the payments was given to the public for the first time today by the Centers for Medicare and Medicaid Services. The list, a detailed account of how $77 billion in federal health-care funds were spent in 2012, showed a wide range in which some top earners were paid as much as 100 times the average for their respective fields….."

Top Medicare Doctor Paid $21 Million in 2012, Data Show - Bloomberg Business

People hate insurance companies for denying payment for claims or reducing claims, but the above is why they do it!

In your link it says that doctors at The Villages Health Clinics will be paid generous salaries so they won't have to rush. They can spend as much time as they need to help a patient. Where does the money come from to pay generous salaries? (And I believe at the time it was written, no one knew that there would be extensive use of Physician's Assistants.)

Also, no one knew that the clinics would end up serving mostly HMO patients. How does that figure into the equation? Are doctors getting generous salaries from an unknown source or are they getting money from Medicare and the HMO?

Anyway, If Medicare pays less and less for doctor-visits and procedures, and the HMO is not known to be generous with their payments, where are the generous salaries coming from?

I don't think you should suggest that The Villages Clinics have the solution to Florida's healthcare problems because the clinics represent an on-going experiment. The verdict isn't in yet.

If you question what the doctor orders, he/she will take it that you are questioning their competence. They don't like it and they will give you a quick/abrupt answer, at which time they will get up and walk to the exit. If you don't understand and you persist in questioning them, they will think of you as a trouble-maker. Many don't have time for questions and you would have to wrestle them to the ground as they run for the exit. When they start walking toward the door, that means the visit is over, period!!!

The only time it's different from what I described is when they have lots of time because they don't have enough patients. But in that case, I still don't think they welcome a lot of questions because it suggests you doubt their competence.

Prove it!

I don't know where you're getting this. I've never had a doctor like this. More blanket statements with no facts to back them up.

How in the world would you know that "the only time it's different... is when they have lots of time," yadda yadda. There is not one iota of fact behind any of these statements.

The whole post is over the top inflammatory.

I've never had a doctor who didn't like us asking questions, either. To the contrary, they like it because an informed and educated patient is more likely to do what they're supposed to do in the course of treatment or wellness maintenance.

But then, we've never told a doctor that all of his education/training in modern medicine is bunk and that veganism is the answer to all medical problems and is the fountain of youth, either. Not the way to have a productive conversation.

At this stage of my life, I DO NOT have to question my doctors. I know what I have and I know what tests must be done periodically. All this knowledge came from questioning my doctors and having them tell me. Of course I have checked many reliable medical websites for confirmation. If you don't trust your doctors, you have a choice, find another.

And went on and on and on and on and on.

Two ears and one mouth. Very old sage advice.

Without mentioning names, I actually did have a doctor here say to me: Are you going to listen to me or are you going to ask questions.

Prove it!!!!

Bump: I'm still wondering where the generous salaries are coming from, especially due to the fact that we have been told that the clinic doctors only take on about half as many patients as other doctors need to to make a living.

How do you know their salaries are generous? If you do know, what are they?

That's my line.

And you are conveniently ignoring answering the people who called your post out that stated doctors will walk out on you if you ask questions by trying to divert the conversation on to generous salaries for TV doctors.

I think enough of us have shown that doctors do not walk out on you for asking questions.

Some of them are pretty special to us. We call this one St. Randy at our house and bless him every time we look at Helene. Dr. David Randall Drosick M.D. Oncologist from Cincinnati.

http://www.ohcare.com/wp-content/upl...R-MD-PHOTO.jpg

He looks like a very compassionate man, Gracie. Maybe an angel as well as a saint!

My son has a private practice and was considering selling. He interviewed with TV and said there was no way the practice could be profitable unless someone was subsidizing the salaries. I guess that mean old greedy developer must be subsidizing the salaries.

I guess you didn't read my post very carefully and you didn't read the link provided by sunnyatlast. It was his link that stated "generous salaries".

My point is: Why should you ask me to prove my statements when you were the first to make an unproved statement?