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Blue Cross and Blue Shield of North Carolina invites you to learn how we’re fighting to rein in medical costs, and how you can too.
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Blue Asks You
from Blue Asks You 2011
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February 18, 2011
Dana L. commented on February 18, 2011
Medical schools are extremely expensive and most med students come out in more debt than students who majored in other fields. If there was a way to decrease costs of medical schools I think that would help entice more people to go into the medical field.
Robert A. commented on February 19, 2011
The community needs to sell it's advantages to doctors and make it easy to move to the area.
TDorriety commented on February 21, 2011
Nurse Practicioners are a viable alternative, as are RNs working in tandem with doctors. Encouraging RNs to purse becoming a NP with education incentives could be effective.
I'd be curious to know what are some of the concerns young doctors have about opening practices in rural areas. Is it that the cost of operating a business may not be practical in a potentially low volume area. If that's the case, what can an insurance company do? Provide resourses to handle claims and/or records management? Incentives to nurses to work there or rotate nurses through on intern programs to offset their cost?
Perhaps some kind of partnership between local and state governments, insurers, pharmacies and medical schools to open strategically-located facilities would be appropriate.
ADRIAN commented on February 21, 2011
Possibly encourage better employee/employer arrangements for physicians who are employed by hospitals. By nature, many physicians are probably more entrepreneurial or individually motivated & perhaps the restrictions, guidelines, requirements, etc. placed by hospitals who employ them may not be desirable. In rural areas, they likely have 1 major hospital to deal with and the employee/employer arrangements may not be that nurturing or rewarding.
John S. commented on February 21, 2011
We need to help lower the cost of being a doctor, such as the extrememly high cost of malpratice insurance. Tort reform is desperately needed.
Mayur G. commented on February 22, 2011
Provide incentives for Physicians to serve in under represented areas..lower interest rate on student loan..partial loan forgiveness based on years. Insurance companies could also chip in to provide assistance via providing financing to set up practice. Increased competetion would lead to cost savings for insurance companies.
expatrefilioque commented on February 22, 2011
Many communities use a team approach. UNC health care does this with Family Practice and it is highly effective and respectful. Appletree Clinic in Ottawa, Ontario also has a very effective program which is like a walk-on family care. They see a tremendous amount of people every day and have access to excellent specialists quickly. We need to study practices that already work and see if we can do that.
nc-cyclist commented on February 25, 2011
There are existing incentives for doctors to do primary care in underserved areas. The problems is that doctors have families. Loan forgiveness for working in a small town in Texas or New Mexico that's 60 miles from a hospital does not provide employment or great education for the spouse and children of the doctor. The responsibilities are also greater. Rural doctors go in the ambulance with the patient to the hospital, because the community has only ambulance drivers, not EMTs.
Medical students have to look at the various loan options very carefully - some give the debtor more choice in where they work as a doctor, and some give less choice.
There was a 1-time ECU-Duke joint program which had some success. Over 3 years, they trained existing RNs to be NPs (they earned Masters degree) using distance education mixed with some travel to Duke or ECU. Only RNs who lived in rural underserved parts of eastern NC could apply, and they were asked to stay in those counties to practice. There was a 1-time grant from Robert Wood Johnson Foundation.
Many people don't know that the rules and laws for NPs vary by state. In North Carolina, a Nurse Practitioner can practise on their own, and does not require supervision by an MD. An NP can write prescriptions in NC.
ani commented on February 28, 2011
When I didn't have health insurance a nurse practitioner did the chek up for my son.I like better than the doctor.She noticed some things that the doctor missed.
David N. commented on March 1, 2011
Less than 5% of medical school students are going into Primary Care. Specialties are where the big moeny is and that needs to change. Higher pay for primary care physicians, tort reform and a single payer system are all needed to tip the scales the other way. One option may be scholarships and other incentives in exchange for a commitment to serve in primary care for a certain period of years - think military service in exchange for a college education. Another option may be to require primary care service for a number of years before licensing a doctor to work in a specialty area. A single payer system would simplify the business side of any practice and eliminate the need for so many administrative positions. Not a positive development for insurance companies but sorely needed.
alcat commented on March 3, 2011
allow more people to go to med school...especially for primary care. It's very hard to get into med school even if you are well qualified and would make a good doctor. I also think there should be tuition incentives for serving rural areas for x number of years after graduation.
dawn0218 commented on March 4, 2011
Just one idea...for simple symptoms/dx that ppl have been treated for in the past or have chronically, they should be able to email or communicate with the healthcare professional without actually having to come into the office.
Lynn commented on March 4, 2011
Tort reform. If a lawsuits filed just for the sake of a lawsuit...the plantiff and his attorney should pay all courtcosts and the physician's defense fees. Lawsuits should be discouraged for anything less than true malpractice.
StayinFit commented on March 4, 2011
If NC already gives other companies incentive's to move to the area, maybe the health care profession could get incentives to move into more remote areas. It is tough for the elderly to drive into the big cities to see a doctor or specialist. By the time they get their the heart rate is up and they are a nervous wreck. Some don't always have family members or friends that can take them to every appointment. In my mother-in-laws case, she tried to find a local doctor and they were all nice and said they had openings until she asked if they took medicare. At that point almost all the doctor offices said "Oh, we've already met our medicare quota." I was shocked to stand there with her and hear this. With the baby boom generation getting older, this problem is going to increase. And it is for this reason that she has to drive so far to just see a doctor. She has high blood pressure as it is and becomes a nervous wreck and will refuse to drive to some more populated areas if she has to see a specialist. I know medicare falls into it's own separate category, but should be looked at due to the aging baby boom generation.
lindi commented on March 5, 2011
stop paying more for services that specialists provide- give the incentive and money to primary care physicians- this will keep cost low as they already know the patient and the history. can utilize a team approach with patient centered medical home, but still need the PCP as close to the center as possible.
twonk commented on March 7, 2011
Providing relief from medical school debt for servicing in underserved communities is certainly part of the solution. However, there also need to be environments where practitioners (especially new practitioners) can operate safely with proper review of medical procedure and malpractice protection. Seed clinics with the right technology, equipment, and business models could encourage medical entrepreneurship which could benefit these smaller communities. Nurses can (and should) only go so far for providing medical care. For common care, Nurses are great. For less common conditions and certain types of disease management, they don't seem to excel in what I've seen.
Wouldn't it be more appropriate to pose this question to the doctors?
BILLIE commented on March 16, 2011
I see Dr's that are super being subjected to overwhelming patient responsibility due to the $ factors when they are part of a large health group. They get burnt out and lose what it was that made them great Dr's to begin with because they just don't have the time that they used to for the patient relationship that is so important. Perhaps smaller communities could offer to set up their practice, rather than the Dr's having to come up with the outlay it takes for the initial set up.
barbara77 commented on April 19, 2011
decrease med school costs. more scholarships.
Karen S. commented on May 8, 2011
Limit the amount that can be awarded in a malpractice cases except in obvious malicious injury. Doctors are leaving their careers because of the high cost of doing business. It is necessary for them to have more staff just to deal with insurance claims which adds to the overhead of running an office. I don't like the high cost of medical care but I know some doctors personally and they are not getting as rich as everyone seems to think.