Why Family Doctors Are Dying

[marmar]

via ReclaimDemocracy!:



Why Family Doctors Are Dying
Cost of dealing with insurance bureaucracy is hurting doctors and endangering patients

By John Brady
Posted Dec 30, 2008. First Published by The Virginia Pilot



I love being a family physician. I love the history rooted in the country doc who did his best to help comfort and heal his neighbors. I love the broad scope of practice where I am always seeing something different and something challenging. But most of all, I love the long-term relationships with my patients. So it is with a heavy heart I admit that my specialty is dying.

This matters not because of the nostalgic loss of the way things were; it matters because studies have proved the essential foundation of a less expensive and higher quality health-care system is effective primary care.

Specifically, as primary care dies, access becomes limited, waits become longer and costs soar.

With this silent but looming crisis becoming ever more evident, we have to take an open and honest look at the reasons for the demise.

We are dying because of an insane payment system. Primary-care doctors mainly get paid for visits to the office, with each visit having its own particular insurance code. Although this sounds straightforward, every insurance company pays different amounts for different visit codes, and every patient has his own individual deductible and co-payment, so no one knows who owes what or what the final bill will be until the insurance company signs off weeks to months after the visit. .............(more)

The complete piece is at: http://reclaimdemocracy.org/articles/2008/family_doctors_dying.php

[Warpy]

1. I go to a surgeon who got sick of the HMO merry go round

and opened up a storefront family practice. He's now got 4 other docs with him part time and business seems to be booming. Plus, in the two years I've known him, he's relaxed and seems a lot happier.

I'm delighted. Labeled uninsurable and shut out of primary care for 16 years in this state, I've finally got a doc for all the ordinary stuff.

He takes BC/BS and Medicare but no longer has to fight some HMO bean counter for everything he does.

[BrklynLiberal]

4. My OB-GYN and my orthopedic MD do not take any insurance.

The patient pays them, and then the patient has to get it back from the insurance co. This way, they do not deal with the insurance companies at all.

[Warpy]

7. That might be the wave of the future

Docs are sick to death of every treatment being second guessed and forced to conform to some cookie cutter computer model that fits less than 10% of their patients.

Every doc I know has had it with the HMO system.

[jwirr]

11. Doesn't that mean that they will not take Medicaid and Medicare?

[BrklynLiberal]

2. I know of one family doctor in my neighborhood who said he is gong to

dispense with insurance soon. Just charge everyone a flat rate for an office visit..cash. Not too much..maybe $10-$50, depending on what he does. He says the overhead of doing the paperwork, or even hiring someone else to do it is just a waste of his medical.
education. And if he treats someone and they insurance won't cover it, he either has to get the cash from the patient, or take a loss on the time he spent with the patient. The alternative is to have to check out every new patient with the insurance co BEFORE he treats them...and that is time consuming as well.
It is ridiculous...being a physician nowadays is almost the same as being a bean counter in a big bureaucratic corporation. The one big argument against the "socialized" way of medicine as it is practiced in the UK or Canada, is the supposed long wait to see doctors. If you have to see a specialist here, even if you have insurance, you can wait six weeks to see them. So what is the big deal? People are waiting to see doctors here too...Or they are being denied payment by the insurance companies for services they need.

[csziggy]

12. My family doctor of 25 years retired from general practice because he was losing money

As an independent practioner. He had his own clinic with a receptionist, nurse practioner, two registered nurses and somewhere between four and six insurance clerks. Each insurance clerk specialized in certain insurance companies. It was insane - there were more people in that small office to do the billing than there were medical professionals.

We had been with him since he was a resident in the local family practice program so he helped us find another doctor. My old doctor went on to work part time at a locally run HMO. He may have to see a certain number of patients but he does not have any of the worries of running his independent office.

My new doctor is in a large group practice with fifteen to twenty other physicians most of whom are family practice and some number of physicians assistants, nurse practioners and nurses. The medical professionals are scattered among a number of small office buildings so I don't know the current total. The group has a three story building for billing, records and all the paperwork they have to manage. But there is not as much pressure on the individual doctors.

[leftofthedial]

3. Obama's plan will enshrine the insurance companies as the permanent custodians

of our health system (it doesn't really qualify as "care" anymore, and "health" is neutral--could be good or bad).

[4 t 4]

6. I know a few Doctors that

have in office visits, medicine in brown bottles and I love them. How can we bring this back because I find it so comforting and true. What to do ?

[proud2BlibKansan]

5. My doctor complains about this almost every time I see her

It's nuts. She knows what treatment her patients need yet has to clear it through a freakin insurance company first.

Just last month, she found a drug that eases neck pain I have had for 15 years. It's leftover from a whiplash injury. She gave me a month's worth of samples, they worked wonderfully and when I went to fill the prescription I was told my insurance wouldn't cover it. Reason is there is another drug that will do the same thing. But there is not. So now my neck hurts again and unless I win the lottery, I just have to deal with the pain.

[AnneD]

8. Docs are fed up with the system and so are Nurses....

I loved working in the rural areas but had to give it up. Why? The pay was so low I had to take 2 jobs just to make ends met. Because it was a 'resort area' with all these trophy homes-there was no affordable housing. The cost of living in that rural resort was about what it cost in the large city I came from-and I got 1/2 the pay. .Think they had had trouble getting docs (docs would stay there just long enough to get their loans forgiven) Nurss left at a higher rate . They paid a lot to get me there but treated me like shit once I was there. I left, but not because I wanted to.....I couldn't afford to keep doing charity work-I was a single mom and had responsibilities. One Doc I talked to once said if he knew then what he knew now-he'd have become a plumber. That is so sad for all of us.

[Mika]

9. Cuba's entire health care system promotes local Drs/clinics.

That's why Cuba has the highest Dr per capita ratio in the world.

Of course, Cuban Drs don't get the bug bucks compared to everyone else's professions - they get just a little bit more than most everyone else - but the cost to set up their practice and employ staff and outfit it with equipment is zero.

Access is instant and no extra costs.


Same goes for education and teachers - the highest ratio per capita in the world.

Access is instant and no extra costs.


Been there. Seen it.

[Greyhound]

10. But, but, but, Castro is EVIL! He's an atheistic commie! Cubans are willing

to die or kill to get away from there. I know this because every "leader" of both parties tells me so.

Fucking imbeciles.:eyes:

[slipslidingaway]

13. Not good for the future...

http://www.pbs.org/newshour/bb/health/jan-june09/doctors_01-06.html


States Faces Shortages of Primary Care Doctors

http://www.pbs.org/newshour/bb/health/jan-june09/doctors_01-06.html

"While universal healthcare legislation in Massachusetts means more people today are insured, the new demand for primary care doctors outstrips the supply. Educational loans, low wages and fights with insurance companies are turning growing numbers of students away from the field. Betty Ann Bowser reports...


...BETTY ANN BOWSER: The students listen respectfully to the primary care physician, but the truth is very few of them will ever go into the field.

A recent survey published in the Journal of the American Medical Association found that only 2 percent of medical students plan to go into primary care. And since 1997, the number of medical school graduates going into the field has dropped 50 percent..."