Medical care, as we know it is in crisis.
The high quality personalized health care that this great country of ours has been known for, is heading straight for extinction. Small private practices are closing and physicians are joining hospitals at a record pace. The forces behind this change appear to be to a large extent driven by our neglectful government and health insurance companies that have been slashing medical services reimbursement rates mercilessly for the last decade. All the while insurance companies continue to pay out multimillion-dollar compensation packages to their CEOs and build new business offices that cost billions, as they scream at the top of their lungs about astronomical and prohibitively increasing cost of health care.
As physician / owner of a medical practice, I watched my soon to be former medical practice and many practices of my colleagues around the country become busier and less personal, and physicians themselves more frustrated and exhausted.
I have witnessed aging physicians that would normally have at least 10 more years of productive practice retire and young talented people avoid medicine as a future career choice.
And in the midst of all of this change, I have been amazed to see that the physician has been named as the wrong doer, the culprit behind these cost increases!
Well I am here to say, that we have been sold out by the government and stand wrongly accused. The reasons for my beliefs are so numerous that they would fill many pages. To spare the readers and myself, I have come up with a short but illustrative list of how we are held to a double standard.
- Physicians that own private offices are small business owners that provide many jobs. Nerveless we are not afforded same tax breaks or benefits that are afforded to other small business owners.
- As the cost of living rises, medical insurance companies raise their rates while reducing our reimbursements. We sit helpless by the sidelines watching our earnings dwindle. My former partners have noted that their incomes were higher in the late 1980’s then they are currently.
- We are unable to make deals with other medical service providers that would allow us to save the cost of doing business and pass on these savings to the patient. In the world of business this is known as good business. In the world of medical care this is known as a Stark law violation and is punishable by large fines and even jail time.
- Medicare and medical insurance companies cut service reimbursement indiscriminately without care for the quality of service actually provided. I’d like to provide just one example: It is unfortunate that in the field of procedural medicine, unscrupulous medical providers take advantage. So it was in the field of Electro diagnostic medicine, where only two medical specialties are trained extensively in this field during residency. With essentially no regulation or guidance provided by the government, medical specialists and non medical health providers that had no formal residency training in this procedure started offering this complex diagnostic service, creating high utilization with extremely poor competency. The office of Medicare in it’s infinite wisdom decided that rather than containing costs by allowing only medical doctors that were residency trained in this field to perform the service, to allow bad medicine to continue and cut the reimbursement of this service indiscriminately and across the board. Medical insurance companies were only too happy to follow suit.
- Medical health insurances time and time again hiding under the cloak of procedures being “investigational”, have opted to deny safe, minimally invasive treatments, and authorize invasive alternatives that cost tens of thousands of dollars more. These procedures have been shown to create more complications, provide slower recovery time, and delayed return to work, thus adding to the ultimate health care bill.
So what happens next? In my humble opinion health care as we have known it is coming to an end, and is a train out of control on a fast track to third world medicine standards, suffering from a critical shortage of physicians, and governed by bureaucrats and bean counters interested only in lining their pockets.
I for one, choose not to stay on this train. I choose to get off. Concierge style medicine allows for a time honored health care approach, where the patient is at the center, the relationships are being built, and there is no middleman dictating how the patient is to be taken care of. I’m privileged to be part of this new adventure and am looking forward to the journey ahead.