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What About Health Care Providers? — Why Now?
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What About Health Care Providers?

For obvious reasons most people have focused on the people who are left out of the system by the NME, the un- or under-insured, but what about the doctors?

A former nurse/office manager for a solo practice physician is writing a three-part post about what a doctor goes through to get paid in the current system. Part one and part two are up at The Confluence, with part three to come.

After you read these posts you will understand why so many doctors are joining group practices, and see the potential for cost savings by simplifying the office procedures with a single payer plan.

The problems described in part one are on display at my Mother’s primary physician with a list posted by the nurse’s desk telling people which lab they have to visit for tests based on who their insurance company is. On Medicare my Mother goes where she wants, and changes labs if they annoy her.

I have some experience with the problem discussed in part two, as I was offered a job writing software that was used by insurance companies and medical practices. I did some maintenance work for them, but turned down their kind offer of employment based on a gut feeling about half-way through the interview that I should be reading these people their rights and booking them.

There were some odd code modules in the source code that had unsettling comments associated with them. The overall effect was the feeling that this software was doing something other than what discussed in the brochures. There was also the fact that the individual who actually wrote the original had left under other than friendly circumstances, and rumors of disputed ownership of the rights to the software. I wasn’t interested in a commute to a job that might involve courts in the near term.

I readily admit a personal prejudice – there is something dodgy about a small software firm in which none of the principals can write code.


1 Steve Bates { 08.25.09 at 10:54 am }

[P]rinciples? don’t you mean “principals”? [Steve edges toward the door…] I know from unfortunate experience that small software firms don’t have any principles…
.-= last blog ..Friday Cell Phone Cat Blogging =-.

2 Steve Bates { 08.25.09 at 11:00 am }

Aside: if you think all the (probable) legal action is a new phenomenon, read John Man’s biography of Gutenberg. We’ve got nothing on the 15th century when it comes to business-related legal battles.
.-= last blog ..Friday Cell Phone Cat Blogging =-.

3 Bryan { 08.25.09 at 12:49 pm }

Ah, yes, how could I ever forget “the principal is your ‘pal'”. [Aside: My ability to spell and select the correct homophone has seriously degraded with the advent of spell-checkers.]

Often “tort reform” in earlier times meant changing the selection of weapons for the trial by combat.

Actually, I was fairly sure I wouldn’t like the employment contract, as I saw a probable total loss of creative license and a non-disclosure, as well as, non-competition agreement being included. I accept that the people who pay me control my present, but I don’t like them controlling my future.

4 Steve Bates { 08.25.09 at 3:35 pm }

The only non-compete clause I ever agreed to named specific companies and products, and named an explicitly limited, very short time period. The client was as good as his word. He gave me no hassles about other work I took, and I worked for him many times over the span of a decade.

In at least one other case in which I refused to sign (and did not get the contract), the business owner didn’t seem to understand a) that the skills he was asking me not to ply were skills I independently learned on my own, long before I ever met him, and b) why I would be reluctant to sign away my right to make a living in the town I’d lived in all my life. Somehow, I had a feeling I wouldn’t get along with that fellow.
.-= last blog ..Howard Dean On Individual Health Insurance =-.

5 Bryan { 08.25.09 at 5:32 pm }

My basic problem was reading their advertising brochures on their product, and then seeing the source code. There were carefully worded sentences that masked what was really going on in software, and didn’t talk about some other “features”. I definitely felt that any contract they offered was going to cost me attorney’s fees.

A non-compete has to be extremely specific. I did work for some people who competed, but I checked before I did the work to make sure everyone was OK with it, and I never did exactly the same thing for two competitors.

I pretty much had a personal non-disclosure policy, unless the client wanted something talked about for marketing reasons, and I thought it was a good product.

People hear buzzwords and don’t know what they mean.