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06/22/2014

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Yeah, McCrory's little side show was a bit nauseating. I do not understand physicians who will put on a white coat and act as props for politicians - of either party.

And McCrory's proposal was knee-deep in red flags.

You are quite right about large blocks of physicians in this state (particularly those deeply entrenched with academic centers) being all about preserving/expanding the cash-cow that is Medicaid. This generation's children can wallow, the next generation can pay.

And the newbies are being indoctrinated into buying that kind of thinking hook-line-and-sinker.

Anything the NC Medical Society mostly endorses needs to be looked at very skeptically - for (1) they only "represent" a fraction of the working doctors in the state, and (2) their leadership is completely in the pockets of the big hospitals/insurance companies. Individual physicians - particularly of the whistle-blowing variety - looking/paying for representatives with moral compasses and backbones need to look elsewhere.

I'd like to see the Senate stick to its guns to - force some real debate.

But in the end, it's about buying votes. You know that, Joe. Reason goes out the window when it's all about the cash.

Yes, Mary, the NCMS has "gone AMA". Sometimes these organizations, in their zeal to protect revenue flows and reimbursements for physicians and hospitals, forget their role as CITIZENS.

We don't need any more vote buying.

Medicaid in NC is broken, Joe. No one's going to fix it. It IS all about the-powers-that-be buying votes.

Meanwhile, providers are retiring early (or just getting out) in small droves. The shortages of Medicaid providers will get much bigger.

The NCMS is USELESS. Absolutely useless. On Housecalls, I once told the story of being appointed to their "peer review tack force" back in 2002 (that post is archived).

As you will recall, I was fired for defying the threats of hospital executives reporting substandard Pediatric care to hospital peer review - and (later) the NC Medical Board (who buried it - no doubt under the "doctrine" of "harmless error").

The leaders of the society KNEW that every word of my story was true. But the best that they could do was put me on a committee in a room with a bunch of hospital executives JUST LIKE the greedy/amoral morons running Randolph that did me in.

That was "advocacy". And in the end, the committee's recommendations were dismissed/buried in deference to the objections of the NC Hospital Association.

It was a TOTAL wast of my time.

I've been to some of their open forums. The leadership long ago totally sold out the individual physician trying to compete with the corporate monsters. And they've spent YEARS pretending medical whistle-blowers do not exist. We're STILL "disruptive" and "disgruntled". Women physicians who stand up/speak out/do what's best for patients are "crazy" or "hateful bitches" (heard that one yesterday).

I am watching the VA scandal unfold with a huge sense of vindication. For the people coming forward now are just like I was in 1998. They're taking brave stands and HUGE risks with their lives.

The difference between me and them is that I was one public servant in a small town screaming for help - and the patient did not die because I was there. In contrast, the VA whistle-blowers are many - they have the media's attention (I'm not sure how), and . . .

. . . many people died.

Mary, I have also become increasingly disappointed with the NCMS. As you suggest, in many ways, it no longer represents the individual/independent physician.

Perhaps the VA scandal is opening up many eyes among the general public. But the inexorable trend still seems to be increased central planners' direction of the health care sector, increased interference with care, increased taxpayer-provided insurance, increased costs, and increased control of physician's activities. It's no wonder so many doc's want to get out. And the young one's going through medical school have no idea what they are getting themselves into.

I hope the VA scandal blows things wide open on what passes for government "oversight" of medicine. Enough people have apparently died to kick up some righteous lawsuits.

As for "the young", due to a myriad of factors, Pediatric training programs are now putting out residents who do either clinic OR hospital work, but not both.

It's fine for the big hospitals that will hire them and treat them like glorified residents (because Pediatrics doesn't make money - of course, I don't think I've ever seen an administrator bill a single service).

But the community and rural hospitals are screwed. Just ask any of the groups in some of these places trying to recruit. No one is coming out who wants to be the "old-fashioned" kind of Ped - who can do it all (including and especially NICU) by themselves.

The kind of Ped like me. Again, it was intervening in a NICU case being botched by a Cone-owned FP-who-had-no-idea-what-he-as-doing that got me fired.

You could not talk back to Cone. You had to "cooperate".

That night, the Neonatology attending at NCBH on the other end of the phone (one of the guys who trained me) told me to do what I thought best because he knew I knew what I was doing - and he would have my back.

But apart from correcting perceptions with the baby's parents (because, trying to cover his sorry ass, the Cone-owned FP told them the baby's near-death-experience was my fault), the Neonatologist did nothing.

He/NCBH watched me BURN.

I was told (by someone-in-the-know) that it was because NCBH didn't want to step on Cone's toes. It wouldn't look right.

He's a dean at the Medical Center now.

Like Ed Cone is a member of the Cone Board.

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