Some people swear by the Mayo Clinic experience. Some people leave with no better understanding of their disease process. Some folks can't even get through the front doors. Regardless of the disease process, if you wan't to be a great hospital system in the eyes of your patients, you must have the perception of greatness. You see, providing high quality care is not what matters if you want to draw people through your front doors.
What does? Image. And image starts with being nice. In fact, being nice is so important that soon, CMS (The Medicare National Bank) is going to start paying hospitals based on their patient satisfaction scores. Enter the Studer Group's
AIDET initiative to help hospitals win the game of being nice.
What does that have to do with The Mayo Clinic? I don't know if they use the AIDET process or not. They might. It's not a bad process. In fact, more communication is always better for patients and doctors and nurses. If I was a patient, I would appreciate the concept. But given that the
Mayo Clinic refuses Medicare, their payment may not be dependent on winning the game of nice.
There is nothing special about the doctors and nurses at Mayo. They trained where I trained. They completed the same residencies in the same academic settings as hundreds of thousands of doctors in local hospitals across our country.
What I do presume Mayo to have is a massive foundation that allows them the freedom to pick and choose which insurance companies or government entities they are going to accept. Mayo system is rightfully denying seniors access to their care. They are taking a stand against members of Congress who choose to ignore the failed economics of CMS. The recent Super Committee fiasco doesn't hold much promise.
The worst is yet to come. The yearly threats to physician payment currently sit at just under 30%. Unless Congress acts by January 1st, 2012, physicians will experience a nearly 60% cut in take home pay.
How is that you ask Happy? Because when Congress cuts physician pay, they do not cut overhead expenses. They don't cut the electric bill or the rent. They don't cut the nursing salary or their health insurance benefits. They don't cut the capital expenditures or the legal fees associated with running a physician office.
In an all Medicare practice with a 50% overhead, a 30% physician cut is equivalent to a 60% pay cut. Four years ago I predicted this exact scenario and wrote about it when
doctors earn less than Burger King.
So, what will happen?
Doctors will demand cash for care. ERs will close. Physicians will retire. Nurses will get fired. Nurse practitioners will get fired. Doctors will stop accepting Medicare. Physicians will stop going to hospitals and patients will lose access to care. The most effective way to reduce the cost of senior care is simply to stop paying for it. Where will all the patients go?
Not Mayo Clinic. They refuse Medicare. And why wouldn't they? It makes perfect sense. For all the other medical systems stuck in that giant vortex known as the Medicare Black Hole, it's going to be really hard being nice when that day comes.
I once heard a physician say 85% of their day was spent on Medicare patients who accounted for only 15% of their revenue. Taking a 15% pay cut and spending the other 85% of one's time with an entrepreneurial spirit sounds like a winning road to success.
It's time for physicians to start an Occupy Medicare rally to counteract the
preOccupied America rally participants. It's time we got a bunch of doctors to stand around and hand out fake sick notes to members of Congress so they don't have to show up during the Christmas holiday season. Oh wait. They are already on vacation from October 11th -December 31st as they round out their schedule with
23 1/2 weeks of vacation a year.
For every patient that tells me they went to the Mayo Clinic and had a wonderful experience, I have one patient that tell me their visit provided no insight into their disease process and another one tell me they were not accepted as a patient.
It is what it is. The Mayo Clinic is a hospital system filled with excellent doctors and nurses who trained at the same institutions that doctors in hospitals all across this country trained. They have an image most hospitals would die for. This gives them the highly lucrative out of network or cash paying royalty that fly in from all over the world. They have a powerful foundation that gives them options and control on their terms, at least until the Federal Reserve is done destroying that with their artificially low interest rates. They have clout that can demand higher fees from the better paying private insurance companies.
And they can refuse Medicare because, well, they can.
By the way, the looming physician cut is minuscule compared to the Europe mess. If you're paying any attention at all to the
Europe catastrophe unfolding in front of us, you might find this read informative. Over the last decade, debt has grown at 12% annually while GDP has grown at 4%. Something has to give.
It is.
Time to eat some turkey.
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