I think being a PCP is the greatest thing in the world. I feel like all of my patients come to me for the way I take care of them and expect me to be up to date on every aspect of their care. They want everything done in one stop and I am happy to do that until it reaches a point where they need a specialist and they are happy to go. They appreciate not having to go to different places to have things done. and specialists copays on managed care plans can be high. Mine personally is $60.

If a woman doesn't want a Pap because of her past history- no problem, just let me document the reason for liability purposes. Thats all.

When my nurse calls back results she can only read what I have written. I am worried someone can screw up the Vitamin levels. Back office issues. It's always something. I think it stings more in healthcare than at KMart though. Good help is hard to find. I communicate well with my patients so I call most my own results, if normal I will send a card. The patients know that. If it is
bad news I contact them myself. I have even made house calls to speak with them if they have been long time patients ( I have been at this for a little over
20 years... And I do have boundaries if any eyebrows are going up...but I am in therapy..hmmm mm)


If you don't want your blood pressure checked- no problem, BUT can I please just tell you that if you are using your insurance I will need to have 3 vital signs documented and we love blood pressures. Same goes for weight. When the insurance audits the chart and we are doing "our" job ( which they are dictating) then we don' t get the NEGOGIATED rate for the office visit. Which, by the way, is what you will see on your explanation of benefits. Not the superbill. When I went to see my neurologist the copayment was $60, when the EOB came in he was paid $12 . Plus my $60. Almost makes you wonder about the purpose of insurance. Now I just have my partner treat me. The Medical Board watches everything too. The days of writing a prescription for a sick family member or neighbor are done. There has to be an established relationship. I keep " new patient" forms in my car and at home in case someone needs something. WTF? Marcus Welby would be turning over in his grave ( I hope someone knows who that is)

Sorry to rant. It is hard to be a PCP. The economy is so bad, healthcare is so expensive and people want a lot from us. That's fine. It's what we do. And
sadly insurance is what is it and with the low re- imbursement some providers schedule a patient approx. every 8 minutes. Screw that. I did it when I was
younger. I up to one every 15 minutes. Seems to work out fine if you know
what you are doing.

And to my cyber friend Bipolar med student: SPECIALIZE . Sadly that is what I tell the students today. Primary Care is difficult. In the states the kids can't make enough money to pay back their loans . But GOOD Primary Care will be the most important job ever. Just look at the person, listen, accept them, be kind, and give them peace of mind. Do the right thing. It isn't hard. ( but you already know that)