This and That

THIS:

Monday and Tuesday- the 16th and 17th of March- St Patty's Day.

24 people the past few days, 3 new patients, 1 renewal of a wellness plan.
A medicare check brought the revenues to January levels.

Hired a massage therapist. Part-time independent contractor to work 2 days a week.
Will be sending out email marketing tomorrow.
Plan is to put together a full introductory wellness package for patient's to try, and maybe at a discounted rate. After the discount, patient's can work out their own deal , but hopefully they will find the services valuable.

THAT:

In between patients, I had 3 pharmaceutical reps sitting in my waiting room. 2 were together, the odd pairing of the rep with the manager. You know how it goes, the rep actually tries to show he knows how to sell the product, while the manager sits and daydreams about how nice it is to not be stuck behind a desk somewhere. Actually, they all should be thankful they still have jobs. With the economy going south, generic price wars, and a new presidential administration calling for changes in the healthcare system, the pharmaceutical industry should be really worried.

But back to the waiting room. The rep who represented medicine X, started to "teach" me about when would be an appropriate time to use medicine X. Usually I just ignore their speeches, but when he started telling me how medicine X now is a tier 2 drug on formulary with so and so insurance plan, instead of tier 3, I abruptly stopped his speech.

I told him the following;

"Nothing personal, but if your industry does not stop bowing to the government and insurance companies, you are digging your own grave. You have enough competition with generics being so cheap, a downward economy, and a new federal administration that will presumably make it even worse, but you continue to dig yourself deeper, by detailing physicians about how we should prescribe medicine X to people with this or that coverage.

What about people with different coverage?

What about people with no coverage?

Why the different pricing for insurers and individuals?

We all know the insurers profit from prescription plans. Their formularies are not based on efficacy, but more on cost and profit. Your industry has taken a huge public opinion drop because the public knows you are not looking out for them. The system needs to be fixed, but it will never happen as long as your industry is seen to be in bed with the insurers. You need to stop making deals with all insurers. This will put an end to formularies and the b.llsh.t preauth nonsense that goes with it. One price for everyone, and a reduced price at that. Get rid of the middlemen, and have a price-point that will be profitable, to keep research and development thriving, and people employed. If insurers want to pay for prescriptions, let them reimburse the patient separately, but keep them out of the doctor-patient-pharmacy loop. It only adds cost and wastes time."

So I finished my little speech, and the three reps looked up and at first were afraid to talk. Finally, the third rep, a woman, decided to try and argue about how much it costs to bring a drug to market, etc, etc. I agreed, but that argument has nothing to do with the insurance-government middleman. She then said how they "voluntarily" signed the pharma code about gifts to doctor's office. The new "code" was signed to hopefully deter the feds from passing laws that would have greater restrictions on gifts. Boo Hoo. My patent's now have to use bank pens instead of drug sponsored pens. What a shame!! As if a free pen makes me write for a drug. Give me a break. But I am sure that politicians never, ever, ever help their lobbyists by passing laws that help them with ......

So back to my speech:

"The more your industry continues down this path, the worse it will get, and you will all be looking for a new job soon. I just heard Pfizer laid off 10 of the 14 reps that were in my area. You don't think you will be next? Your industry leadership needs a new direction. Now have a nice rest of your day, and be sure to go sit in your car and write down everything I just said and pass it on to your higher ups! If they want some advice, have them call me. I'll be glad to talk to them, For $500 per hour! "

Well, that felt good, and now its time for lunch.

Can you believe I actually had to buy my own sandwich today.

No drug rep lunch today ;)

DoctorSH

The Day After The Snow

It is the day after a missed day at work due to snow.

The usual happened. 2 no shows in the morning. And then it hits. The phone starts ringing and we start filling up. All the afternoon slots were filled by lunchtime. Still could be no shows, but I can't worry about that.

Ended up with 13 patients today. 3 wellness renewals including the two I will mention soon. 1 patient returned after 2 years away, and when he found out I did not participate with his insurance, he didn't mind, he said it was worht it as I took almost 45 minutes with him for a short physical and talk session. I could not have done that 2 years ago. I would not have had the time.

A good feeling this morning. An 82 yo man, a patient in my practice for many years, renewed his and his wifes wellness plan for the year. They have a Medicare-HMO plan that would enable them to recieve care elsewhere, and at a much reduced cost. Instead , he paid today in full for the wellness plan on his credit card. His wife was only in my office twice last year, but he still wanted her on the plan, primarily to fix the costs for the year. This couple does not have a lotof money, and lives off of a fixed income. But they obviously value my services. They have trust that I am working solely for them.

On another note, I am looking to further the wellness part of the practice. I am in the process of hiring a massage therapist. I think this will add to the value that patient's receive from my office. The fee schedule has not been cemented yet, but patient's in my wellness plans will get a discount.

The goal of my practice is to be as third party free as possible, and be able to give truly valuable services to those who come to my office for care. The key to keeping patient's in this system is one word, trust!

DoctorSH