[HSF] Paper Journals in an Internet age.

[Tea Acuff]

This is a good example of how pieces of the health care system work. One size probably will not fit all , although we could all learn a great deal from straying "off topic". Your father as in my mountain upbringing realized there is a "cost" in getting paid especially by those that control your life, eg the government but even insurance companies. Cost is one side of a "value" equation.  It is the primary focus of social governments and insurance companies  since they understand value even less than cost, and  cost is their only direct interest. I personally believe we, as doctors, will not move out off this cost conundrum until we turn the conversation to "value", which will change our leverage in the "right" to health care argument (the present social mythology).

Consider the spectrum of this thread on "cost" between Prasanna querying for "free" information to Dr. Novick offering free congential heart surgery to"all". Cost has lost most of its meaning. It is the order of knowledge behind both of these endeavors that bring "value" to the "market". Ordered knowledge, be it cognitive in the stupid RBRVS rules or in our experienced hands, is what people crave. Unordered information like a bag of DNA or photons from the sun is, relatively speaking, necessary but largely useless.
Tea


----- Original Message ----
From: "Rwmfglycar at aol.com" <Rwmfglycar at aol.com>
To: OpenHeart-L at lists.hsforum.com
Sent: Wednesday, January 3, 2007 12:23:41 AM
Subject: Re: [HSF] Paper Journals in an Internet age.


These discussions on fees and money and who looks after the poor are as  
always interesting. 
My father, a surgeon, died in 1950. I helped my mother go through his  
account books. I realised after a while that 25% of his patients had not paid  him. 
I asked my doctor mother why this was so and she said "Those are the  patients 
who could not afford the surgery. The others gave us a comfortable  living." 
These were patients in his private practice. He also saw patients in a  
government charity hospital and was very upset when the government  announced they 
were going to start paying the "voluntary" doctors for their  sessions; he 
thought that was the beginning of the end of his independence. 
In the course of going through his papers I came across a letter from an  
anesthesiologist complaining that my Dad was using his services too frequently  
for the nonpay patients!
Bob
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