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Episode Chapters

  1. Introduction2:23
  2. Ultra Summary26:04
  3. Rick’s Rants: The Cost of Getting Paid10:31
  4. Time To Talk A Little Nerdy: Odds Ratios, Relative Risk Etc14:59
  5. Reflections of a Skeptic: Critical Appraisal Of A Study - Part II: Bias25:08
  6. Then And Now: A Short History Of TPA For Stroke20:52
  7. Farewell1:05

Rick’s Rants: The Cost of Getting Paid

Rick Bukata, MD
00:00
10:31
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Tag Ethics

Rick Rants about the cost of sending out a bill and collecting the money owed.

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Kevin G. -

in 2011 I worked for 4 months in a rural Canadian hospital after having been away from the system (working in NZ and Australia) since the late 1980s. Despite the many advances in team work, RN involvement, medicine and techniques, the billing and admin system was the same.

In NZ, the system has been repeatedly upended and tinkered with. With harm and cost and ill informed argument as to causes and remedies (always more paperwork) I am not sure it has been entirely through ignorance and devotion to adminstrative convenience. This burden may cost money, but if makes the correct targets sad, well - who can say what is in someone elses heart.

How much is too much subjectively to an addict? The answer to such is there can't be too much.
How much 'information' tax and paperwork is too much to the proposer but never the receiver? If the system proposer and tinkerer is of ill will?

W. Richard B., M.D. -

Clearly, the Australian and Canadian systems have challenges. But the fact is that we spend $10,000 per citizen while they're at about $6,800 per citizen and their outcomes are at least as good as ours. Billing is just one part of the challenges. For a while our ED group had a great relationship with a capitated .medical group -- we calculated how many patients we saw of theirs and what we got paid and just used that average payment for all the subsequent patients of the medical group the following year. Could send out one bill to the medical group monthly for all of their patients we treated that month -- not one per patient. Yes, any time there are efforts to improve a part of our very complex health system there will be mistakes made -- bout overall the goal is generally the same -- to achieve the most cost-effective system that we can while still providing evidence-based care. Not easy.

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EMA 2019 April Full episode audio for MD edition 257:07 min - 123 MB - M4AEMA 2019 April - Individual Abstracts Zip File 5 MB - ZIPEMA 2019 April Individual MP3s 251 MB - ZIPEMA 2019 April - Printable CME Questions 25 KB - PDFEMA April 2019 - Abstracts PDF 377 KB - PDFEMA Citations - April 2019 193 KB - PDFTime To Talk A Little Nerdy: Odds Ratios, Relative Risk Etc 192 KB - PDF

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