but the landscaper has a photo of the clean yard after they finished. They send it to you but you ( as the insurance company) say they need to call a specific time and speak to your 12y/o who is the yard representative of the house.
The 12 y/o say ‘no you stink’ and hangs up. Then you send the landscaper a letter saying ‘sorry your peer to peer was denied’
( I know this is exaggerating a bit and made to sound funny but it mostly works like that in healthcare )
sometimes, but extra hours dont get paid extra, so very little incentive to do so. there are many different models for compensation but you can think of it as a 'fixed salary with optional bonuses'.
EDIT to add:
Most places have a base + bonus structure. You get your base salary, and you see patients, for each patient seen you generate 'RVUs' which is how your group/practice generates income ( by billing insurance companies ). Once you generate enough RVUs to cover your base salary, you start accumulating 'bonus' and that gets paid out down the line using whatever formula your employer uses. There is some variation to this but for the most part groups follow a similar scheme.
EDIT #2: This is US centric, i dont know how other countries do it.
The pharmacies issue is a constant problem: patient lives out of town so prescription is sent to his home pharmacy at his request, on the day of discharge he realized his pharmacy is closed and wants them sent to a local pharmacy, of course this always happens at 5pm when you are driving in traffic, the patient is angry because they want to leave but there is not much you can do. This happens very frequently, doesnt matter if you ask ahead of time for the patient to confirm the pharmacy, something inevitably happens.
The other issue is peer to peers and prior authorizations, these take up a significant amount of time and are essentially ways the insurance companies put barriers to care and reduce their costs.
I think some of your ideas could work but good luck getting anything past the politicians, some of these things would be expensive and others would be unpopular to those that donate to the politicians.
The docs dont get paid per hour, they are salaried, so 2 docs is double the cost of 1 doc.
This is why they are overworked, why pay 2 docs if 1 can do the work, the burnout of the doc is irrelevant as there are more docs to hire after they burn-out.
The 12 y/o say ‘no you stink’ and hangs up. Then you send the landscaper a letter saying ‘sorry your peer to peer was denied’
( I know this is exaggerating a bit and made to sound funny but it mostly works like that in healthcare )