Wednesday, January 9, 2013

"Is There Any Chance You Won't Close the Clinic?"

     It's a question I get every day.
     I feel sad, as I anticipate shutting down the clinic and dismantling all its apparatus.  I am especially sorry about losing connections with my patients, many of whom importune me to keep the clinic open.
     "Can't you just have a small clinic, a few days a week?  Can't you re-open in Hawthorne?  What am I going to do?  Where will I go?  How can I find someone like you?"
     Maybe it's this ego-boost that keeps doctors going--even as we watch medicine turn into another bureaucracy, and are under attack from many angles, and wrangle with insurance companies over getting paid.  Patients are wonderful:  they keep us from losing hope, they remind us why we invested eleven or more years in training, and they validate us by getting better.
     I would keep the clinic open, if a miracle occurred.
     The miracle would be that a doctor or two, with experience in Family Medicine, and a PA or NP would show up and say, "We'd like to work in your clinic."
     I'd hire them on the spot, if they had the proper credentials, and I wouldn't close the clinic. 
     I'd expand our hours of operation, hire more staff, continue the employee health insurance plan and other benefits, and be very happy to manage the clinic and see patients, because I'd have help. 
     I am not intimidated by all the changes in medicine:  electronic records, ICD-10, insurance company audits, DOJ investigations of doctors, take-backs, and slimy, one-sided contracts with corporate health insurance companies.  I am not cowed by the federal government and its bogus raid on my clinic.  I have not been rendered insolvent as a result of the forfeitures of the clinic's bank accounts.  I am not so angry at Medicare for refusing to pay for legitimate services that I would turn away my Medicare patients, who have been loyal for so many years, and who have depended on my medical know-how and intimate understanding of their physical and psychic make-ups.  I still believe in private practice, especially solo doc medical clinics.  I am American, and think that a free enterprise economy is the best thing going. 
     I'd pay these doctors and mid-levels a high salary--as I always have--higher than the local and national rates.  I'd put into place bonus schemes that would improve patient care and help the clinic to be more efficient.  I'd schedule group visits for patients with similar medical problems.  I'd reinstate housecalls and do community outreach.  I would stay on the east side of Gainesville, where medical care is in short supply.  I would continue to stay open for Medicaid patients, who have very few choices these days.
     I just can't do this alone. 
     Who wants to work for me?   Unfortunately, no one.  Not since the government's raid.
     What doctor would feel safe working for a clnic that's under investigation by the government?  Those are big words.  The government is a scary entity.  It can destroy you.  Doctors, in general, like to play it safe.
     Therefore, my clinic is on its trajectory to close.  Soon, this vibrant, busy, necessary clinic will be gutted, with nothing but light and shadows, cast through the trees, to fill its corridors and exam rooms.
     Let's all give credit to our government officials for keeping us safe and well, for forcing closure of suspicious clinics like mine before they damage society.  They're getting away with a form of corruption that seems impossible to undermine, and allows government peons to express their neurotic, petty quests for power at the expense of everyone  around them. 

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