Saturday, April 4, 2009

Doctors and Medicare

Medical bloggers have been sounding the alarm for a good while, for years
-- and today's New York Times' article, "Finding a Doctor Who Accepts Medicare Isn't Easy," reiterates their warnings.

Poor reimbursement rates and mounds of paperwork are not much of an incentive to stick with this mammoth -- and, of course, the extended fear these days is that the paucity and inefficiency of the Medicare paradigm will form the structural basis for the new [Socialist] Health Plan for All.

A shortage overall of internists/primary care physicians already makes finding basic health care difficult. Add to that the fact that, increasingly, these doctors are opting out of the Medicare system, and the future does not look promising for Medicare patients seeking a primary physician. A significant number promise to keep the Medicare patients they have, but decline to accept new ones.

Some are doing what my internist decided recently to do: open a concierge practice. He told a group of his patients at an informational meeting last Fall that he feared losing his passion for practicing medicine -- losing it to the steady drain of paperwork and insurance interference.

I did not comfortably have the financial resources to stick with him in this new paradigm -- but I did it anyway, and at a time where I had just lost about 55% of my financial resources. In what proved to be a series of embarrassing moments, he tried to offer me a "scholarship," saying that the overarching company (MDVIP) allowed for a certain number each year. This was an affront to my pride, so I declined. That proved to be the right decision, for I have ended up seeing him roughly every 4-6 weeks, with telephone and email communication at least weekly. In other words: I am getting my money's worth!

This is something of an odd duck, this article. It's tucked away in the Retirement section, a subset of Business. There are no ideological arguments. It is short and to the point, clear -- so much so that I'd wager (if only I had a good bookie) it aimed for about an 8th-grade reading comprehension level.

Exactly what I need on a bleary-eyed Saturday morning.

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