Conflicts of Interest in Modern Medicine & Doctors Getting Paid More to Make Patients Sicker. #442 Part 2

Let us know what you like , what you don't like about the show and , ultimately , let us know who's winning these arguments , because I need to know that I'm beating Renee in these debates . Run the tape .

Yes , he sent in the question um where he said I do think that there can be a conflict of interest from a hospital and a doctor . I don't think locums prevents that , though in my department protocols apply whether you are a part of the group or locums .

Only difference is the hospital can fire the doctor directly , versus firing the locum group or twisting their arm to get rid of the doc . So this was an older episode and we'll link it in the show notes as well .

Like there's multiple ways that you can be working for a hospital and they come together as a group , like four or five , maybe 10 , possibly 15 .

And then they form a company , right , so you'll have a company of ER docs and then they have like a structure within them , like who's going to be negotiating contracts , who's going to be doing billing , all these different things .

But they as a group will then go to a hospital or a bunch of hospitals and , in essence , like sell their service as a group to a hospital or several hospitals , right , and then not only that , right , like they in essence kind of run the hospital's ER department from within .

So it's almost like there becomes like you become , when you the ER docs that are part of the group , they are basically like employees of the group . But then the question is , are they also employees of the hospital ? It could get real intricate and so forth , but there are some conflict of interest things that you may have to read up on , guys .

But that's a very and like it's a very unique issue . That I think is mainly for things like ER docs and so forth . But those are for ER docs who are in a group that is negotiating with that same hospital that you're at . But if you , as a locum's ER doc , is trying to go to any other regular hospital by yourself , you don't have to worry about that .

So because there is no conflict of interest . But that is a good point , dr . Okay , because I think dr love he works . He's like a um . I believe he's a medical director through a company that he works with that contracts their services to a hospital , I believe . So he may want to write in if he hears this and go from there .

So he's given the example of you know , if you , as a doctor , see that a patient has a certain lab value that we all think is consistent with diabetes , we will give a diagnosis of diabetes and hence we will get paid a certain amount from the insurance company . That is true , right , and hence we will get paid a certain amount from the insurance company .

That is true , right . But that's how we base our ability to diagnose . That's , these are guidelines and , yes , some of that stuff has to do with how insurance companies pay and so forth .

Like , could you imagine , as a patient , you're scrolling , scrolling , scrolling and this is what you come across and he is your doctor and you're like , well , damn , yeah , when he told me that I had x , y and z , is that even like , did I really have that ?

You go and then they say well , you know , your cv , joint times two needs to be replaced like what are you going to say ? No , the most thing you will be able to say is I can't afford to get it fixed . But how ?

But like I wonder if it ever happens to men , like when men all that , right , whereas they know how to craft you know , in general they craft the story that they know will tug at women's emotions , which is , yeah , like you're let's say like you're driving , and you lose control of X , y and Z , you don't want that to happen to you , do you ?

Or let's say , you're picking up your kids and X , y and Z happens and guys don't care about their kids , right ? They're like , look , man , I'll be all right , like we'd be skidding the whole way and stuff and we'll figure it out , right ? All I'm saying is is that they know there's certain psychology that they use differently to manipulate men versus women .

But in essence , the same thing . And if you have a dude who don't know the lingo of what the mechanic is saying , he going to say this , he's going to say something to make you pay for it . The same way , maybe a little bit differently , that he'll say to you as a woman , you know what I'm saying , but it's the same outcome .

But basically what I'm saying is the public doesn't know . Like they don't understand . Like , if they understood , like how we diagnose and some of the things that we do , I think they'd be very shocked to find out about certain things . Like it's like you go to a restaurant do you really want to know how your food is being made ?

But ultimately , I think if they knew how things were being made , they'd be like oh , I get it Right . Like there's nothing really from a doctor standpoint . There's really nothing you know on the what's the best way I want to describe it ? There's nothing . I can't see people being upset about the way that they're treated .

From the doctor's standpoint , I think they'd be like yeah , I didn't know you had to deal with all this garbage as an insurance , with insurance companies , you know .

When I watched the video , I was like I watched it and I was like I think he's sensationalizing certain things , like like , for example , if somebody comes into my hospital , right , and they get into , let's say they get into a motorcycle crash and they break their arm , they get a head injury and they break ribs like I'm going in and let's say they're also

diabetic , they break ribs , and let's say they're also diabetic , right , if I'm treating all of those different things , I'm going to list all of those different things that I'm treating , and that's going to increase the level of reimbursement that I get , right .

So , yes , I am getting reimbursed more , but that's because I'm treating more stuff , right , but that's because I'm treating more stuff , right . And the question , though , is do I have ? sinister intentions by doing that ? Right , do I have sinister intentions by doing it ? And I think most people listening would be like , no , like .

If you're taking care of somebody who has all of these issues going on , there should be a potential that you should get reimbursed for taking care of all of these different things .

Right , I see an allergist regularly for the multitude of allergies I've developed as an adult , and I find it redundant for me to go in just for him to check on me . Hey , how's your breathing , how are you doing ? I think that's redundant . Yeah , I always get charged a lot more for that , so I cancel those appointments .

He's like oh , I want to see you in six months , I just don't schedule that . But then it comes to a point where he will stop me from getting my shots until I see him .

She was like , yeah , they won't let me get any more of my high blood pressure medications . I called the doctor and the doctor says yeah , we've been trying to schedule follow-ups with your mother for over a year , so I don't know how she's doing . I can't check her blood pressure when she comes in . How do I know that the medication is even working ?

So there's that component also , right , which is I just need to make sure you , Kiara , are responding very well to the medications , that I am doing right ? It may sound redundant , but , yeah , part of that is just doing the due diligence of making sure that you're doing well and that you have a good reaction with the medications .

Right Now , the question that you are having like is All the questions necessary , all the questions that they're asking you , actually necessary , correct ?

If there's something wrong with me , I will let you know . I will come to you and let you know , but I also , I see , I see your point .

Right , there's that component and I think , like I can't cape for every doc that's out there , like there are docs who like , skirt the business , right , there are docs who figure out how to make this work in favor of them .

I can't , I don't know what everybody does and stuff , but I'm sure that there's some people who do manipulation , right , that's the reason why some doctors get sued by the government or by Medicare and so forth . That occurs . I would say the majority of them don't do that , majority don't .

right , which means that when you're working for a hospital , you know who does the billing the hospital , right , like they do it based off of what you write down and what you document , and then that money doesn't come directly to you as a doc , that money goes to the hospital and then the hospital takes whatever they get and they divvy it to the doctor , right

. So it's , it's a little bit , or actually it's very different . Now the incentives to do all those different things that he's talking about , I think for the most part are gone , because now you've just entered somebody else , a big middle man or middle woman , into the picture .