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Monday, 21 March 2016 15:09

Free Healthcare Market

As healthcare is moving towards rewarding value not volume, follow evidence -based Medicine,measure outcome and coming down to one thing which is providing quality healthcare at low cost.

The dynamic changes in the economy and political landscapes is enforcing new reality in every aspect of life including healthcare. Financial decisions have become more important than clinical decision making. If you believe that more than 60 hospitals have closed  in America since 2010 and another 673 rural hospitals are vulnerable to closure across 42 states!

Proposed solution is direct Care , or Concierge Medicine ( mentioned by Presidential Candidate Dr Ben Carson during the debate answering the healthcare question) and recently. As On March second with the support of doctors ( proud to be one of them) and small businesses, The Florida House passed unanimously Direct Primary Care Bill which will cut down the role of insurers and described as ( important step forward in providing quality affordable healthcare. Direct contracting (between the payer and provider without third party) along with Transparency with regards to pricing for different services offered. This will actually save money through proactive care  with emphasis on Wellness and Disease Prevention to empower patients. Also empowering physicians to become the financial  advisers who deliver the healthcare and control 100% of dollars spent anyway.

Self-funding insurance especially for small, medium sized -Businesses is becoming attractive with direct contracting between physicians and employers which really puts the physicians and patients in control while saving money to employers and patients and improving outcome.

This is the formula for the successful future practice of Medicine. Yes, there is going to be viable options for the struggling middle class American with  ever-rising cost of their healthcare. Basically bring it all back full cycle just like the way it used to be direct doctor-patient relationship. Yes, free healthcare market with transparency  and quality services at are truly affordable will be the major elements of the overall solution to chronic unsustainable healthcare crisis.

Dr Adel Eldin,MD, FACC,FACP

Founder, CEO

www.brooksvillecardiology.com

Affordable Quality Healthcare Program

Founder, CEO

www.floridamedicaltourism.com

Wesley Chapel , Florida

Tel 877-DR ELDIN

LinkedIN

Twitter. Adel Eldin @LCQHealthCare

President ,Society of Physician Entrepreneur, Tampa Bay Chapter

www.sopenet.org

Published in Medical Tourism
Monday, 21 March 2016 15:06

Patients Cannot Afford Medications

Many times patients ask me the question when I am prescribing them medications they need ,Doc, how much does this medicine cost and is it covered by my insurance plan or not? Is there a generic version of this medication? How much is my out of pocket cost even with insurance coverage? It is clear that if the patient can not afford to get the prescribed medications, then his or her medical condition will worsen and will in most cases when medications are denied, will end up being admitted to  the hospital as it is the only place left for patient to get the medication they need at high cost which could simply be avoided by making the medications affordable and accessible.

Recently, there was a Bill introduced to deny the deductions for all advertising and promotional expenses for prescription pharmaceuticals which many spend on Direct to Consumer advertising ( Radio, TV,Newspaper, Internet..etc).  while consumers pay  ( very high prices) while the drug makers are getting tax breaks on their drug ads have resulted in a consumer outcry.

The American Medical Association has called for a ban on drug ads as they put so much pressure on physicians to prescribe very expensive medications to make patients happy  however most of these drugs have been found to be mostly unnecessary. There were about  3.6 billion dollars spent on advertising in the first half of 2015 by drug makers!

In our Concierge Medicine Program , we have most of the generic medications at only $3 .00 and some other medications are being dispensed free as well.This is to help patients eat, pay bills and prevent them from getting devastated and stressed out then get sick and become depressed which leads to more stress with accumulation of mountains of bills.

Just to give you examples of a blood thinner medication given to patients with a common heart rhythm ( non-valvular  atrial fibrillation) which can lead to stokes without the blood thinner.Usually , the better tolerated medication is  denied on first and second attempt for pre-authorization because of high price. It happens that way the patient finally gets it approved the patient had GI bleeding that required costly hospitalization!   

It will not help drug makers to continue to raise the prices as more and more patients can not afford to pay for them thus become sick and go to hospital with costly devastating events like acute stroke or heart attack, control of pain  due to cancer or spread of disease which could be kept under check with taking the proper medications. This will obviate the need of having micro sensors placed in the medication capsule to record when the patient took the medicine to monitor compliance of medication intake , which will lead to a favorable impact on cutting cost of hospital readmission and related procedures as it relates to compliance of medication intake.

Unfortunately, patients are stuck in the middle as on one hand they can not afford to buy their necessary medications during tough economy and on the other hand they can not afford to not take their needed medications to get well and stay well!

Dr Adel Eldin,MD, FACC,FACP

Founder, CEO

www.brooksvillecardiology.com

Affordable Quality Healthcare Program

Founder, CEO

www.floridamedicaltourism.com

Wesley Chapel , Florida

Tel 877-DR ELDIN

LinkedIN

Twitter. Adel Eldin @LCQHealthCare

President ,Society of Physician Entrepreneur, Tampa Bay Chapter

www.sopenet.org

Published in Medical Tourism
Monday, 29 February 2016 12:25

Celebrating the Heart Month!

As I a heart doctor honoring the American Heart Month( February ) I can not help it not to wonder  about the future direction of  healthcare. Almost everybody agrees that Heath-care is about relationships as some will ask, can you automate medicine, and is it going to be successful?

With automation you do not need doctors as they will be replaced with less paid ( Nurse Practitioners) , you do not need  Nurses , as they would be replaced with less pay ( nurse aids), you do not need  pharmacists, as they would be replaced by Pharmacy Technicians and so on ans so forth, you get the idea. This is already happening in so many places and would certainly have inevitable adverse consequences to the entire community.  So many young doctors are switching to non-clinical careers as they are done with Medicine and do not want to have further burnout after finishing long years of training with big burden of student loans which they need to pay off  fast as these loans  usually have very high interest rates in a time we are suffering critical physician shortage.

Automation is also taking place as you see in banking, checking out in shopping centers as so many jobs are lost such as the check out cashier and the person who helps customers bag their groceries and thank them for their business. In case of Healthcare, it is difficult as you need the human interaction , empathy and sympathy with patients as they don not need to see a Robot but rather some one to talk to and listen to them without being rushed out from the exam room.

This special doctor-patient relationship is what makes patients feel comfortable , relaxed thus combating anxiety and would certainly lead to better Health Outcome measured by many parameters ( patients feel better, save lots of out of pocket money spent as a result of less or no ER visits or costly hospitalization and procedures, more personal satisfaction,..etc). Now with internet accessible from mobile phones,  patients compare doctors , prices and customer service instantly. After all, their Health is most valuable commodity. So, there has to be a balance between the automation of Medicine and the essential role of those relationships which will foster the best health outcome.

Talking about the ( Heart Month) , patients are really searching for the compassionate caring doctor who has the Heart , knowledge and skills to help his patients. So many patients complain about the lack of sincere care as I joke with my patients who sometimes talk about other medical and non-medical issues such as their jobs, aspiration, challenges, frustration, sadness, damage to their homes by a sink hole, storm, flood or hurricane, marriage, kids as some ask for my advice. Those patients before leaving the office and start the medications prescribed, they would say ( Doc, I feel better already!)

We owe it to our patients to do our very best to help them, establish direct healthy patient / doctor relationship without the third party control or hassle. It is what people need and want and it is the right thing to do. That is why we made our Motto for our Direct Care Medicine program going on its 6th year as (We bring the Heart back in Medicine). Without the human interaction, passion for helping people, fight disease, save them big ,give them hope to uplift them through tough times which more and more people are going through these days. February is also the time to honor Black History Month by working hard to narrow the disproportionately high  incidence of  Heart disease ,strokes and kidney Failure among African Americans through healthy nutrition , education and fighting poverty.There is so much need out there.

No Robot will be able to replace your caring doctor, but a successful strategy will be combing the most effective affordable technology with the caring element to deliver the best care from the Heart. This is true not just on Valentine Day, or during the Heart Month but valid strategy all year round.

Dr Adel Eldin,MD, FACC,FACP

Founder, CEO

www.brooksvillecardiology.com

Affordable Quality Healthcare Program

Founder, CEO

www.floridamedicaltourism.com

Wesley Chapel , Florida

Tel 877-DR ELDIN

LinkedIN

Twitter. Adel Eldin @LCQHealthCare

President ,Society of Physician Entrepreneur, Tampa Bay Chapter

www.sopenet.org

Published in Medical Tourism
Monday, 29 February 2016 12:23

Support Small Business.

Every business was once small and then grew and became a big business. This is the natural healthy sequence of events . Small business is usually referred to as the engine of the economy as 60-80% of the new jobs come from small business. Small businesses employ 57% of the country's private workforce and pay 44% of the US Payroll. Unfortunately, only 50% of these small businesses survive the first 5 years, increasing the burden on small businesses with minimal or no reserve. For example in 2009 , and average small business went bankrupt every 8 minutes as 70% of small businesses are/were owned and operated by a single person. 

Recent challenges to the small businesses have sharply increased during the current phase of  surge in merges and consolidation.

For example, there are now four major financial institutions( Citibank, Wells Fargo, Chase , Bank of America) out of previous 37 financial institutions only two decades ago . Similarly, big insurance companies are merging , so there are maybe only three or four choices for patients to choose from. The same would apply for retails shops , and local restaurants which are now being replaced by big businesses that invested in technology which makes it easier for people to order online. And since only big businesses can afford these technological advances, people usually flock towards them due to the extra services. Now also a trend towards limiting number in outpatient surgery centers as they compete with hospitals and big medical centers.

 Recent articles have echoed the looming death of small business in America and also found small business optimism is crashing as all businesses need working capitol which may not easy to access with limited options and prohibitive cost.

On the bright side, some realize what is going on and now are trying to give support back to small businesses such as Shop Small on Saturday and others to keep the traditional engine of the economy working to keep overall economy alive and well. Small businesses are going through transformation to adopt to the changing economic climate and challenges through innovation, entrepreneurship, and adopting new technologies and reaching out through social media.

There is always a niche for small business where consumers find satisfaction in quality customer service and personalized care.

We have adopted these concepts to make small business have big impact on people lives through improved health outcome, saving big for individual patients, and small  and medium sized businesses through establishing the (Direct care Medicine) as we can very much share the value of  affordable quality healthcare that does not break the bank. This has been proved over the past few years in our program and being replicated all over the nation.

 This holds true for all independent physicians who have been running their small businesses for a long time but now realize the importance of  unity, cooperation, transparency as they owe it to their customers( patients) . This will be the healthiest response to thrive during changing economic climate.

Dr Adel Eldin,MD, FACC,FACP

Founder, CEO

www.brooksvillecardiology.com

Affordable Quality Healthcare Program

Founder, CEO

www.floridamedicaltourism.com

Wesley Chapel , Florida

Tel 877-DR ELDIN

LinkedIN

Twitter. Adel Eldin @LCQHealthCare

President ,Society of Physician Entrepreneur, Tampa Bay Chapter

www.sopenet.org

Published in Medical Tourism
Tuesday, 15 December 2015 11:17

Peace on Earth

There are so many shared values in this holiday season including peace. Although Muslims do not celebrate Christmas, they celebrate the message of Jesus (peace be upon him) everyday. Muslims love Jesus and his mother, The Virgin Mary, as she is described as the most honored woman on Earth with an the entire chapter in the Holy Qura'an named after her. The Prophet Muhammad, Peace Be Upon Him is only mentioned 5 times in the Qura'an, while the Prophet Jesus ( PBUH)was mentioned 25 times. This reflects how Muslims cherish Jesus and his Mother, the Virgin Mary,(peace be upon them) as well as their common message of peace.

Looking at current world events, we know that we have to work together to achieve the common goal of peace similar to the ways of the Prophet Muhammad and  Prophet Jesus peace be upon them. Talking is not enough, so proposed remedies and solutions to achieve peace locally and globally are needed. With  common enemies such as ignorance and hate there is a duty we all have to combat such notions. As we see in current events, violent terrorists groups are  killing innocent civilians with a majority of these casualties being Muslims. Their ideology as well as their actions create a wedge between Islam and the West which as we see is impacting the legislature of bringing refugees, asylum and immigration to the west from the Muslim World.

When we shut the door in the faces of refugees , this creates a recruitment tool for these "thugs"  into their twisted ideology.  And when they see Islamophobic acts and remarks such as those made by presidential candidate, Donald Trump, they will  have even more people believing their sick narrative. 

Such reckless, irresponsible and hateful statements will jeopardize world peace and will send a wrong message that would hurt America's image and interests around the world. As for Mr. Trump it will get him disqualification form his candidacy and he will loose his business globally. Contrary to what he claims as a successful business  man that he "gets along with everybody" he is actually doing the opposite with his hateful statements such as his false claim that there was cheering after the falling of the world trade center after 9/11 just to get his numbers up in the polls.

So here is a prescription to achieve peace locally and globally:

Support legislation to ban fire arms purchase without going through background checks!

Support the work done by Secretary of DHS Jeh Johnson  who visited community mosques and acknowledged their significant contribution in working well with law enforcement. Such actions will push terrorists groups such as ISIS out of their propaganda business as America will stand united against them and their sick ideology. Similarly,  FBI Director, James Comey has expressed the excellent relationships with the Muslim community claiming that they have been very helpful. 

During this holiday season with so many parties and gift exchanges, as it has always been, give generously and invite your neighbors, Muslim, Christian or Jewish do not differentiate and do not let such hatred come between the positive relationships you have with one another. Together we can fight ignorance, hunger, disease, hatred and global climate change and bring peace on Earth to all of us. 

Happy Holidays !

 Dr Adel Eldin,MD, FACC,FACP

Founder, CEO

www.floridamedicaltourism.com

Wesley Chapel , Florida

Tel 877-DR ELDIN

Low Cost Quality Healthcare Program.

www.brooksvillecardiology.com

LinkedIN

Twitter. Adel Eldin @LCQHealthCare

President ,Society of Physician Entrepreneur, Tampa Bay Chapter

www.sopenet.org

Published in Dr. Adel Eldin
Tuesday, 15 December 2015 11:16

Physician burnout, why does it matter to you?

Feeling of physical and emotional exhaustion , reduced sense of accomplishment, negative attitude towards patients or their concerns all constitute symptoms of ( Physician burnout syndrome) which is on the rise in America!

After so many long years of extensive studying, testing, training, and big loans owed , now there is a greater number of physicians either retiring early or change careers all together!

Why?, their work load increased with less revenues , more bureaucracy, regulations,paperwork, and since more doctors have no ( business experience ) , they have lost control!

With mounting daily pressure on physicians to survive financially and navigate the long list of challenges just to be able what they were trained to do which is taking care of people, they are wondering daily if there is anything left for them after paying all the over head costs or at least break even!

Although doctors control 100% of healthcare dollars, they get paid less and less when compared with CEOs and administrators and this was verified by published  Medicare data.  The CEOs and administrators get to make all Business-related decisions and physicians ( have to do what they were told if they want to keep their jobs!)

Even with that, doctors are loosing jobs from hospitals, healthcare systems, insurance companies and even retail clinics as they are being replaced by ( cheaper labor provided by Nurse Practitioners) under growing financial stresses again to keep overhead down. So , doctors have to lead again this time in the ( Healthcare Business ) in addition to delivering healthcare to be able to thrive financially and continue to provide care for patients.

I am very concerned about the long ignored ,non publicized ( physician burnout which is in some survey studies reached as high as 60% among practicing physicians) and will lead sadly in some instances to an alarming rate of physician suicide when physicians loose control, income, job, and ability to function as a healer not as a ( slave)!  so here are some practical solutions that will help both physicians and patients  alike

1. Adopt Direct Care Medicine between physicians and patients  without the third party added stress and hassle to both especially when the doctors are doing fine job serving their patients.

2. Adopt cost effective Healthcare strategy with early detection and management of diseases  which will prevent costly hospitalizations and procedures . The data are very robust and reproducible not only in our ( Concierge Medicine Program) but others as well with direct relationship between patient and doctor  have shown better outcome and significant savings to patient, as well as employer and insurance company .

4. Adopt evidence -based medicine guidelines and established protocols in various disease entities to help cut down healthcare cost to the patient .

5. Invest in your personal relationship with your patient to build the trust which makes the practice of medicine very special!

Together as physicians , we can restore the dignity of the patient and the honor of our noble  profession  bypassing the third party control and abuse which has contributed to physician burnout in a free healthcare market. After all, a good caring doctor brings added value which can never be replaced !

Dr Adel Eldin,MD, FACC,FACP

Founder, CEO

www.floridamedicaltourism.com

Wesley Chapel , Florida

Tel 877-DR ELDIN

Low Cost Quality Healthcare Program.

www.brooksvillecardiology.com

LinkedIN

Twitter. Adel Eldin @LCQHealthCare

President ,Society of Physician Entrepreneur, Tampa Bay Chapter

www.sopenet.org

Published in Dr. Adel Eldin
Tuesday, 15 December 2015 11:14

More Hospital Closing in America?

Recent article showed 8 hospitals filed for bankruptcy protection or actually closed since October and it is happening all over the country as more than 50 hospitals already shut down mostly serving rural America before!

For example, St. Mary Hospital in  Illinois plans to discontinue services and sell to another company which may use it as an outpatient facility!

Bonnie Memorial Hospital in Texas lost critical vote to get property tax revenues and the Board started to shut down the facility with loss of hundreds of jobs. In East Orange General Hospital , New Jersey has been financially troubled and filed for bankruptcy. Pioneer County Hospital in Newton, Miss. closed their ER doors on Dec.1st as the ( operations of hospital became no longer financially feasible!

Forest Park Medical Center Hospital in Dallas, Texas shut down and even employees were told ( sorry, funds will not be deposited into your account today!). New York based summit Park Hospital and nursing care center expected to shut down on December 31st as they were loosing $800.000 per month!  In North Carolina , Franklin Medical Center was closed due to declining patient volume !

The question now , what are all these hospitals have in common ?, answer is simple , unhealthy financial structure spending more than you earn as revenue  , so the inevitable decision to close hospitals, let go all the employees and all other supporting businesses of various vendors and services also become secondarily devastated.  Unfortunately, the pattern of hospital closure started across America in small towns about one year ago and it looks like the pattern of more hospitals closing in 2016 will continue mostly affecting small and medium -sized hospitals!

Hospitals already started to take measures to cut down overhead cost, which will unfortunately include replacing physicians with cheaper ( Nurse Practitioners), replace nurses with minimum wage nurse aids, pharmacists with pharmacy technicians , cut health coast benefits to employees with more out of pocket cost being shifted to the employees and sadly massive lay offs . Some other Hospital systems got more creative and offered ( to issue refunds to  unsatisfied patients) ranging from $100 to $2000, as they will download an APP on their mobile phone and communicate their concern and input directly to the hospital system which will issue the refund as ( a Token of appreciation to the patients) according to CEO David Feinberg of the Geisinger Healthcare .http://www.healthcareitnews.com/news/geisingers-bold-move-dissatisfied-patients-offered-refunds

Here are some practical solutions to help prevent further potential hospital closures!

1. Adopt Concierge Medicine programs by teaming up with all small and medium sized medical practices to make a model of partnership to truly serve the community and help lessen the burden of healthcare cost that is unsustainable and crushing the Middle Class even further.

2. Collaborate to bring transparent and discounted ( Hospital- based services) which will help the cash flow cycle and prevent the looming financial crash and closure of hospitals

3. Adopt technology and social media to engage the community and inform them on what is the best way to save cost without compromising the quality of care.

4. Recognize the reality of healthcare shifting trends from in-hospital to out patient ambulatory care with rapid but efficient turn over of patients, then restructure hospitals accordingly.

5. Adopt alternative Medicine strategies and Wellness which is cheap and non invasive  to avoid illness which is costly involving risky procedures.

It is crazy with our current healthcare crisis and shortage of doctors that further devastation is taking place in the with further losses affecting local economies that depend on hospitals for jobs, services and vendors all across America! 

Dr Adel Eldin,MD, FACC,FACP

Founder, CEO

www.floridamedicaltourism.com

Wesley Chapel , Florida

Tel 877-DR ELDIN

Low Cost Quality Healthcare Program.

www.brooksvillecardiology.com

LinkedIN

Twitter. Adel Eldin @LCQHealthCare

President ,Society of Physician Entrepreneur, Tampa Bay Chapter

www.sopenet.org

Published in Dr. Adel Eldin

If you live in Tampa  Bay area , you should be excited about the effort that is being done to make Tampa Bay a World destination for Medical Tourism. Why not, and Florida has been visited by millions every year ,so in addition to beautiful beaches and vibrant cultural diversity with places like Busch Gardens , Aquarium , Lowery Park Zoo and the list goes on . Tampa Bay happens to have great Medical Institutions providing World class  services such as Moffitt Cancer  Center , All Children Hospital with its International Program run by John Hopkins Medicine International, Tampa General Hospital where there are more Para thyroid surgeries done there more than any other facility anywhere just to name a few. Tampa is also a natural extension of Orlando as it is one hour straight shot on Interstate 4  in the heart of many Disney World attractions and Tampa International Airport is easily accessible directly without changing flights with the recent Lufthansa started operating its non stop flights from Frankfurt , Germany to Tampa International, what a great service to so many travelers especially those coming from the Middle East and North Africa  , just like Emirates Airlines opened a non stop flight from DubaI to Orlando last month!

This is expected to bring in a lot of folks to our home town Tampa and with education and improved culturally-sensitive services will help to bring lot of jobs and economic prosperity to Tampa Bay and beyond. Welcoming those visitors , speaking the language will be a plus like Spanish or Arabic for example will help to get rid of anxiety and put them at ease and feel home right away!

We have developed a pilot phase of  Wellness Tourism Program where anyone visiting our Tampa Bay can take advantage of while spending the day with us having Fun and also get a Wellness Check . So it is not only who are coming for a specific procedure or treatment, but their families and friends who are coming along can take advantage of this unique feature as everyone is being encouraged to get into healthy life style while enjoying the Sunshine State visit. 

Together, we can show case Tampa Bay to the world and will be delighted to provide and coordinate and streamline services to make a very favorable overall experience as we strive to do in Florida Medical Tourism.

Yes, tell your friends and loved ones to come and visit with us in Tampa Bay with us , relax while you recover , have a Wellness check and recharge your battery here in Tampa, Florida!

Dr Adel Eldin,MD, FACC,FACP

Founder, CEO

www.floridamedicaltourism.com

Wesley Chapel , Florida

Tel 877-DR ELDIN

Low Cost Quality Healthcare Program.

www.brooksvillecardiology.com

LinkedIN

Twitter. Adel Eldin @LCQHealthCare

President ,Society of Physician Entrepreneur, Tampa Bay Chapter

www.sopenet.org

Published in Medical Tourism
Thursday, 15 October 2015 17:35

Risk sharing versus Risk shifting

Are you ready and prepared yet? The risk is being shifted and being ( dumped) on the consumer , that is what is happening and became official. It is seen in many cases whether with the new credit card machines , if you do not update your machine, the risk will be shifted from the financial institution literally to become laid on your shoulder, similarly if you do not ( code it right ) referring to the ICD 10 coding  system , you will be delayed and denied payment for your professional medical services even in some cases with hiring professional billers that are well trained in this transition , turning again all the responsibility on the provider who are most likely will have most of the denials and delays in payment!

Similarly , with subprime mortgage crisis , when someone who may not qualify brought home or property and then the bubble burst , and the economy went into a recession, then millions of Americans lost their homes and properties with foreclosures that devastated millions  of families and businesses with effects of which still being felt throughout the nation!

So many people struggle to make ends meet and good luck jumping those hoops to make it on a day by day basis, with a significant crunch in the cash flow cycle which is going to impact so many industries , for example the medical offices give business to many suppliers of medical equipment and supplies, hires staff , pay taxes and contribute to overall economy. But those small entities that contribute up to 84% of the total engine of the economy , may come to full stop as the cycle of business is not moving and forcing so many to early retirement or bankruptcy! On the contrary the bigger providers are merging together( for example Anthem merger with Cigna and Humana merger with Atena insurance companies) to get stronger and richer with stronger control of the market leaving consumer with less options and more risk shifting on the patients with more out of pocket expenses , co payments for office visits, testing , deductibles to the point that people are refusing the coverage simply when they add up what they have to pay on top of their insurance ,they will not have enough left to feed their families or pay bills .

The rising trend of risk shifting is not good for consumers as there is no balance and sense of security left anymore . Everyone is afraid to loose their shirt if they get sick !. This is unsustainable and is bound to fail. We have to restore a well balanced model when we all enter into a fair and transparent partnership with all our providers and go back to fair risk sharing rather that devastating and stiffing risk shifting to the consumer with more options. That is why we advocate direct care model to cut unnecessary cost of third party involvement and advocate on patient behalf to put patient first rather that send them to the cleaners!

Dr Adel Eldin,MD, FACC,FACP

Founder, CEO

www.floridamedicaltourism.com

Wesley Chapel , Florida

Tel 877-DR ELDIN

Low Cost Quality Healthcare Program.

www.brooksvillecardiology.com

LinkedIN

Twitter. Adel Eldin @LCQHealthCare

President ,Society of Physician Entrepreneur, Tampa Bay Chapter

www.sopenet.org

Published in Dr. Adel Eldin
Sunday, 30 August 2015 12:16

Gate keeper Medicine!

Before seeking  sub-specialist help first the patient  needs an authorization to see a sub-specialist that originates from their primary care physician who is serving as the "gate keeper". No problem of having a gate keeper for cost control and monitoring utilization and outcome criteria, but the big challenge is when a free patient  is using his or her own choice to go and see a sub-specialist that he or she liked, got impressed with, or simply have been unhappy with the one they currently have. So, if this patient  dares to do that on their own, now the saga continues with a lot of hassle in the process. It begins by first getting the records from the primary care physician who would ask for the NPI number which is a National Provider Number  then they would ask about the Tax I.D. number for the business of the sub-specialist then would ask about the billing codes used and the level of billing for office visits. And then they would be asked about what tests the patient is going to have and when are these tests going to be done since the referral is only limited for a certain period of time beyond which would expire.

In the mean time, this courageous patient who is seeking help will be either forced to cancel or at least delay seeking help from a sub-specialists until seeing his or her primary care physician even if the patient confirmed that the sub-specialist is a participating provider in that particular insurance company. So the patient will ultimately not be free to choose even from the limited selection given to them and so many sub-specialists who will be blocked from the gate (i.e no referrals) for that patient even if they have verified all the information about the participating sub-specialist even after going  through the investigation and verification process. So the patients ultimately have no choice but to go where ever he or she is directed to only when the "gate keeper" decides to let them through!

As patient advocates and pro choice supporter for patients rights would be certainly violated or at least interfered with every time even when a patient attempts to get a second option for his or her medical condition. Eventually it will be up to the consumer to decide when and where to seek help that they trust without being dictated by the "gate keeper". Or even worse, deny the patients access to any sub-specialist especially with high-risk contracts would mean money out of their pockets if they refer patients out and usual message said to the patients "we will take care of everything for you, you don't need to see any other doctor." There has to be a better way where the main focus is providing the best care to the patients rather than collecting the most money!

Dr Adel Eldin,MD, FACC,FACP

President , Society of Physician Entrepreneur, Tampa Bay Chapter

www.sopenet.org

Founder, CEO

Low Cost Quality Healthcare Program.

www.brooksvillecardiology.com

Founder, CEO

www.floridamedicaltourism.com

LinkedIN

Twitter. Adel Eldin @LCQHealthCare

Toll Free 877-DR-ELDIN

Published in Dr. Adel Eldin
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