but the landscaper has a photo of the clean yard after they finished. They send it to you but you ( as the insurance company) say they need to call a specific time and speak to your 12y/o who is the yard representative of the house.
The 12 y/o say ‘no you stink’ and hangs up. Then you send the landscaper a letter saying ‘sorry your peer to peer was denied’
( I know this is exaggerating a bit and made to sound funny but it mostly works like that in healthcare )
sometimes, but extra hours dont get paid extra, so very little incentive to do so. there are many different models for compensation but you can think of it as a 'fixed salary with optional bonuses'.
EDIT to add:
Most places have a base + bonus structure. You get your base salary, and you see patients, for each patient seen you generate 'RVUs' which is how your group/practice generates income ( by billing insurance companies ). Once you generate enough RVUs to cover your base salary, you start accumulating 'bonus' and that gets paid out down the line using whatever formula your employer uses. There is some variation to this but for the most part groups follow a similar scheme.
EDIT #2: This is US centric, i dont know how other countries do it.
The pharmacies issue is a constant problem: patient lives out of town so prescription is sent to his home pharmacy at his request, on the day of discharge he realized his pharmacy is closed and wants them sent to a local pharmacy, of course this always happens at 5pm when you are driving in traffic, the patient is angry because they want to leave but there is not much you can do. This happens very frequently, doesnt matter if you ask ahead of time for the patient to confirm the pharmacy, something inevitably happens.
The other issue is peer to peers and prior authorizations, these take up a significant amount of time and are essentially ways the insurance companies put barriers to care and reduce their costs.
I think some of your ideas could work but good luck getting anything past the politicians, some of these things would be expensive and others would be unpopular to those that donate to the politicians.
The docs dont get paid per hour, they are salaried, so 2 docs is double the cost of 1 doc.
This is why they are overworked, why pay 2 docs if 1 can do the work, the burnout of the doc is irrelevant as there are more docs to hire after they burn-out.
Where I grew up the data for murders is curated in such a way that anybody that dies 24 after being attacked is not considered a ‘murder’. Tehy do this to reduce the statistical murder rate.
Slightly related, my uni id was a prefix for the campus + year
of admission + serial number
the serial number was sequential based on last name, you could essentially guess anyones student id if you had a couple of data points of last name : serial number
As far as I know no one used it for nefarious purposes, but it was a cool party trick to guess someone’s number.
In the end I don't know where the solution lies, sometimes I feel the best solution is to re-design everything from the ground up. Other times I feel like regulation would help, but it would have to come from someone who practices actual medicine, bureaucrat.
What would happen if doctors simply refused to do more then 60 hours a week? -> you can get sued for patient abandonment if you refuse to followup on a patient you are responsible for
Is there really enough supply of new doctors coming in that the hospital can just fire them all and replace them with doctors willing to burn themselves out? -> in part yes there are ( in some fields) but what would happen is that patients would be shifted to other facilities that have staff to see the patients, also when you have 400-500k of school debt its hard to refuse work
Or would it mean the hospital would have no choice but to hire additional doctors so that each one would only have to work a sustainable number of hours? -> this happens as well, they hire locum tenens docs to fill in gaps ( higher short term expense in exchange for not giving staff docs what they need)
I find the subscription model leaves a bad taste in my mouth. I’d rather pay up front or pay to add it later. I also firmly believe in voting with you wallet and it doesnt matter what their marketing says, they are backtracking because it did not generate the income they hoped.
Probably a good idea, I pretty much eliminated them from the list of possibilities when shopping for a car this year because of this. I’m just one data point but I’m pretty sure im not the only lost sale.
I guess the best explanation is that I liked engineering but it didnt 'fulfill' me. It's something tough to explain.
In any case make sure you know what you are getting yourself into ( speak to medical colleagues ) as medicine has changed a lot in the last 5-10 years. I suspect in 10 more years medicine will be completely corporate run, as things are going now, small practices are being absorbed and being merged into larger and larger groups.
Also I agree with the sibling comments by Arch and snakes.
So i did a masters in engineering(3yrs), worked for 2 years then went into med school (4yrs) and finished residency (3yrs) in the same time a friend of mine did a PHD in engineering…
I was shocked when i found out he had just finished the PHD when i was graduating residency.
We had 3 TVs hooked up, each with its own instance and a central recording instance with 3 capture cards. It worked great, you could record or playback from any of the TVs.
Main issue we had was getting the remotes to work correctly. I remember editing configs constantly to get correct behavior from the remotes.
So the configuration is a one time thing to set the card parameters, you shouldn’t need to touch it once its setup for your panels and layout. As far as I know it can only be done using their widows app.
The display is done by sending the card network frames ( someone did a reverse engineering of the protocol, i dont know the details ). You can send the display anything you want.
The 12 y/o say ‘no you stink’ and hangs up. Then you send the landscaper a letter saying ‘sorry your peer to peer was denied’
( I know this is exaggerating a bit and made to sound funny but it mostly works like that in healthcare )