The focus of this web site is medicine. In this blog, you’ll read about patient stories. The situations have been changed to be HIPAA compliant. Factual statements may or may not be true. I may change ages, gender or presenting complaints about patients. I may even entirely make up complete patient encounters from my fertile imagination. Trust me, if you think I’m writing about you, I’m not. There are billions of people in this world and readers send me stories about patients all the time. It isn’t you.
You’ll also read a lot about health care policy. I may throw in posts about life lessons, computers, and will even throw in family stories once in a while. If you’re looking for articles about politics, sports, or celebrities, you’re in the wrong place – unless the topics have some relationship to medicine.
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Some states are having difficulty finding enough physicians to provide needed specialty care to patients who come to the emergency department. If a patient needs neurosurgery or trauma surgery and there is no one on staff that is able (or willing) to perform the necessary services, then the patient must be transferred to another facility. Sometimes the waits involved in arranging and performing the transfers can lead to bad outcomes for the patients involved. In a recent Healthcare Update, I mentioned an article about Oklahoma legislation providing tax credits to physicians to provide on-call care. A friend forwarded me an e-mail from ACEP that listed several states which are contemplating tax credits for on-call care. Hawaii has a bill that would provide physicians who provide at least 576 hours of on-call services per year with a tax credit totaling 5 percent of the physician’s liability premiums. For a policy premium of $30,000 per year, the credit would be $1,500. Another bill in Hawaii would waive medical licensing fees (usually several hundred dollars) for physicians who treat more than 20 percent Medicaid patients. Missouri considered a bill that would exempt Medicaid payments from a physician’s state income tax (currently 6%). Keep in mind that Medicaid reimbursements are generally low, so the benefit isn’t as significant as the bill would make it seem. In a chart I have from 2006, Missouri paid a whole $15 for managing a high complexity (life threatening) patient in the emergency department – the same as it paid for treating a kid with a runny nose. In the entire country in 2006, Missouri reimbursed the least for providing high complexity care in the emergency department. By 2008, the rates it paid were up to $20.23 for low complexity and $60.01 for detailed complexity patients – a little more than half of what Medicare paid for the same patients. Oklahoma’s Senate Bill 1604 would provide a $100 state tax credit per day for on-call emergency coverage in rural areas – to a maximum credit of $5000 per year. So what do you think? [poll id=”4″]Read More »