tag:blogger.com,1999:blog-9143719926358099859.post8781603220046128512..comments2023-10-26T08:08:43.486-07:00Comments on Dr. Mintz' Blog: Factors Associated with Medical Students' Career Choice Regarding Internal Medicine: Pay is Not Really One of Them!Dr. Matthew Mintzhttp://www.blogger.com/profile/01058182168282244996noreply@blogger.comBlogger2125tag:blogger.com,1999:blog-9143719926358099859.post-60785213021553209752008-11-17T14:15:00.000-08:002008-11-17T14:15:00.000-08:00Internal Medicine and primary care used to be wher...Internal Medicine and primary care used to be where the thinkers went, imitating their "Chief of Medicine", hoping to diagnose and treat.<BR/>That is no longer true because the beaurocrtic regulations enforced by the payors have reduced all internists to clerical workers. The EMR deepens the insult, being in effect a way to prove that you did what you billed for. The generic templates and mindless query boxes ("what is the lot number of the vaccine?") insult my sense of pride in my work and waste much of my time with things I have no interest in whatever. <BR/><BR/>Money is a consideration. I never made near $100K in my 35 years as an Internist, having no procedures or tests to pump up my income. Clearly my thoughtful interactions with patients are not valued nearly as much as a "sleep study" or an MRI. In the end I was frustrated and turning bitter so I left. I conceptually miss the joy of patient care and diagnosis but it was a mirage for the last twenty years. In the future as my generation become elderly and designer drugs become more costly there is a terrible reckoning to occur. I am not optimistic for the profession but there is a lot more to life than a job and I intend to savor what is left of these small joys. I did devote 35 years to medicine and in retrospect it was a charitable contribution to my patients and to the science of medicine. Now the Chief of Medicine is a Jiffy Lube salesman. By the way your air filter looks a little dirty, it may be prudent to replace it before trouble occurs.podhttps://www.blogger.com/profile/05301855334853287127noreply@blogger.comtag:blogger.com,1999:blog-9143719926358099859.post-30998959493068540102008-09-14T14:43:00.000-07:002008-09-14T14:43:00.000-07:00Payment for services really is the primary issue h...Payment for services really is the primary issue here, I'm not sure why you're trying hard to say it isn't. <BR/><BR/>why do you think "hamster wheel" medicine is the norm? Because that's the only way to maintain incomes in primary care. <BR/><BR/>Pay more for primary care visits and physicians can start doing more coordination, backing off on volume, etc. <BR/><BR/>It's why concierge/retainer practices work so well. Pay more for services rendered, deliver the services adequately and rationally. It's fairly simple, really. <BR/><BR/>The "volume problem" is almost completely derived from the payment problem.Anonymousnoreply@blogger.com