Medical School Debt- Cost of Education Must be Subsidized

Medical students may no longer have the earning potential of the preceding few generations of physician graduates before them. Simply put, the cost of a medical school education may be too high to recoup given the changing landscape of health care. Between decreasing reimbursements, commoditization of physician practices, and increasing overhead, and the cost of debt service, medical students will find themselves struggling to get ahead.
On the medical school side, the costs of providing an education are increasing and schools are finding themselves in budgetary binds with faculty restrictions, layoffs, and salary stabilization.
What's the solution?
If the government wants to dictate to physicians what their reimbursement will be for services provided and simultaneously continually increase the overhead expense of a doctor by regulatory compliance burdens, then the government must subsidize medical school education.
I am all for less big government so the other alternative (which obviously is not happening), would be that government does not dictate fees and reimbursements nor regulatory expense burdens for doctors, natural free market forces do and then in that scenario medical school costs would not be the responsibility of government.

The Reasons to E prescribe

Medicare providers have a few good reasons to start E prescribing. Of all the initiatives relating to health care and technology , the one most likley to get adoption is e-prescribing. It is easier for the office than meeting all the EHR criteria and it makes sense for the patient. The hurdles for EHR adoption for more established older physicians seems less likely and more obtrusive but e-prescribing shouldnt be as intimidating.

Here are a few reasons to do it:
1. Avoidance of 1 percent penalty on claims if providers e-prescribe ten times in 2011.
2. Avoidance of 1.5% penalty on claims if providers e-prescribe at least 25 times in 2011.

Dont forget that to be eligible the physician would need to report the G code, G8553 along with a denominator code such as new and established patient visit codes.

Potential Impact of Medicare Payment Reductions on Staffing of a Medical Practice

Nice report in January 2011, Dermatology World, that graphically represents the impact of Medicare payment reductions as a function of practice staffing and EHR implementation. In general, a 5-7% cuts in payments to physicians will translate to 20% of doctors reducing staff and 56% freezing staff hiring. And, also, a 5-7% reduction to physician payments will result in 33% of docs delaying EHR implementation and 29% indefinitely postponing.

Bottom line is private practice is small business and as soon as government intervenes with further reductions in payments it results in the unintended consequence of delaying other government initiatives such as EHR implementation and employment. Physicians have taken too big of a hit already and employ significant amounts of the labor burden. You cannot continually increase practice expense burden with regulatory obligations, etc and then at the same time make reductions in income and expect no impact on "initiatives". Docs are too tired and beat up to help here.

Medical students, doctors and medical residents are not taught about the Human Resources component of their career

In medical school and in medical residency we, as doctors entering the business world, get no training on HR (Human resources). Doctors are not instructed one iota on how to evaluate, hire, and fire employees. This can be a daunting task and doctors and medical students should be given some expectation of what running a business, ie a private practice is really like. One important aspect of private practice in medicine is knowing when and how to hire staff and when and how to terminate bad staff. There are legal ramifications for both actions. Critical to hiring is defining the role and responsibilities with a job description for each position you fill. (You can find a typical job description for the employees you would need to hire in the book, The Medical Entrepreneur). Having the employees and staff understand their role, responsibilities and job description will help them understand where they need to be focusing their efforts, so they can be more productive. Your staff will appreciate that clarity. Also, whom the employee reports to...such as the office manager in most cases is very important to define from the first day of their job. Also, the job description itself will serve as a benchmark by which you can objectively evaluate their performance. This is particularly important when an employee is not meeting their expected roles and responsibilities. If an employees are not working out, you should understand the process to correct this or if not, to let that employees go as soon as possible.