Overburdened doctors are shunning all types of insurance...

http://finance.yahoo.com/news/Overburdened-doctors-are-cnnm-2582479372.html?x=0&sec=topStories&pos=2&asset=&ccode=

"Like a lot of their patients, doctors are sick of long waits in the waiting room and dealing with insurance companies.

That's why a growing number of primary care physicians are adopting a direct fee-for-service or "retainer-based" model of care that minimizes acceptance of insurance. Except for lab tests and other special services, your insurance plan is no good with them.


..."I had to change the model": Dr. John Kihm, 51, an internist based in Durham, N.C., converted his solo private practice to a retainer-based model in May....His goal is to continue medicine for another 20 years, "but I want to practice it the right way," Kihm said. That means spending more than 15 minutes per patients and doing house calls. "I had to change the model," he said, as he adopted the retainer-based structure.


...But she agreed with Heim on one point: "If doctors further reduce their panel size of patients through these models, that will only enhance the shortage of primary care doctors," Cassil said.

What's more, the model creates a "tiered system" of access to care where even for the insured, if you pay more, you get enhanced access..."

making doctors money.

"What's more, the model creates a "tiered system" of access to care where even for the insured, if you pay more, you get enhanced access..."

Mix this with universal medical care and you have a problem. Hopefully there will be enough medical personnel when we all have the ability to see the doctor.

is doing a better job caring for their needs.

Not every doctor is looking to maximize their income, only about 2% of med students say they will enter the primary care field.

Sanders has spoken about the coming primary care shortage.

"Not every doctor is looking to maximize their income, only about 2% of med students say they will enter the primary care field."

Since primary care pays less than going into a specialty, this seems to refute your point.

Some medical students are looking at specialties that will allow them to avoid dealing with insurance companies.

Not saying this is the determinig factor, but it is a consideration.

"My income is about the same as before, but I have less overhead costs from half as many patients and half the amount of supplies that I need," he said.


His goal is to continue medicine for another 20 years, "but I want to practice it the right way," Kihm said. That means spending more than 15 minutes per patients and doing house calls. "I had to change the model," he said, as he adopted the retainer-based structure."


Some medical students are looking at specialties that will allow them to avoid dealing with insurance companies.

He now has 3 other physicians in practice with him.

He does house calls.

The AMA has done a fantastic job at protecting entry into the club.

Well done.

and navigating their care according to a person's insurance plan.

In the UK it's your GP (aka primary care physician) who is your gateway to care. And in most cases, you get to choose your GP (any GP can take you on - it's their choice - but in practice you get to choose from the docs serving your local area who are accepting new patients). Need a test? GP orders it. Surgery? GP orders it. Paperwork? Oh, you mean signing the back of the prescription? And there isn't a "check out" desk at the doctors office? You're too sick to get out of the house? Oh, the GP or the one on duty will come see you at home. 2am in the morning and have transport? No problem, the after hours clinic is there to help you. Need nursing care and are homebound? You'll be getting familiar with your district nurse then. Pregnant? Yep, the midwife makes house calls too; birth at home is an option - not very common but it is possible.

Yep, NHS is bloody fantastic. And all for a third of the cost per head of population than US health care.

Mark.

have been too kind towards the NHS, until they arrived in the US and needed care....rushed experience and large bill at the end.

Over dinner they mentioned all the good experiences they had with the NHS, they also have private insurance, but love their primary care NHS doc.

But I'm having trouble accessing their site right now.

spending and then think of all who cannot get care or who file for bankruptcy due to medicals bills.

We should be getting more for the money.

:(

for elective cosmetic surgery. They contribute nothing to the field of health care while sucking precious health care dollars away from that industry.

The whole concept is a cancerous leech on the field of health care in the same manner as for profit prisons are on the justice system and for profit mercenaries on the nation's defense.

Some things just shouldn't be driven by profit.

Did you see that OP last night written by a guy from Scotland who works for the UK's NHS? You both make excellent points about why it makes no sense to have health "insurance" as a way of life.

I say nationalize the health insurance companies, turn 'em into strictly regulated non-profits, or eliminate them altogether. What they're doing is immoral and should be illegal.

:thumbsup:

The very idea; that some corporations having nothing to do with health care should profit from the American Peoples' illness and injury is ludicrous, shameful and bordering on national insanity.

The tragic consequence of our society's worshiping at the altar of the Almighty dollar; which in turn has compromised and corrupted our so called "fourth estate" free press along with our "We the People's" government supposedly representing the best interest of the American People by "promoting the general welfare."

but people would be stupid to cancel their insurance, and if faced with something major, that insurance would insist on a referral from one of THEIR doctors, to tend to that pesky little cancer thing.

This whole concierge medicine thing is for rich folks who don;t want to rub elbows with the riff-raff in the waiting rooms,..

amount to the doctor.

Some doctors are tired of dealing with the various plans, see the post above by Warpy.

Fewer and fewer specialists take any insurance. They'll help you submit claims but the bills go to you. Good luck collecting from your insurance company.

The family docs continue to get squeezed and burdened with the insurance overhead.

by grouping together various specialties. If they can cut out the profit-making middlemen managers, it might be an interesting option. A few years ago, I developed pain in my abdomen and I knew it was a recurrence of a urinary tract infection. I called every urologist in my area and none of the doctors would see me, as I had no insurance and they were booked for at least a couple of weeks, or so they said. Even the free clinics in my area said they had no openings, not even on an emergency basis, even though I told them I was perfectly willing to pay. The problem got worse and the pain became so intolerable that I had to go to the emergency room on a Saturday night. After about 4 or 5 hours, they released me with a prescription to cure the infection, after giving me an MRI and pain-killers. The result was a bill of over $10,000. I was stunned. Fortunately, I was able to negotiate the bill down to $3,000. When I visited the hospital to pay the bill, I was directed to their billing office. I couldn't get over how enormous it was, taking up maybe a third of the floor space of the hospital, with shelves of files as far as the eye could see. The lady with whom I had negotiated the bill told me that a great deal of their work was merely handling the many insurance forms from various insurance companies and arguing with them and negotiating with them over treatment. I think the profit-making middleman needs to get taken out of this equation.

forced the for profit insurance companies out of business.

Funny and sad moment when Moore asked where the billing department was in the UK hospital, as you mention the billing departments here are very large to deal with the various companies etc. People would understand if politicians told them that the insurance companies provide no value.

Glad to hear it worked out OK for you. :)


Great video, a little over two minutes...

"The product of Health Insurance Companies is to move money and skim profits..."
http://www.youtube.com/watch?v=IoPjExTu-dM

that she was switching her practice to a boutique or retainer model and paring down the number of patients in her practice. If he wanted to pay her $1500 a year, he could be one of those lucky few. If he paid, he would be eligible to receive house calls, same day appointments and guaranteed 15 to 20 minutes of office visit. I believe she also was not accepting insurance plans anymore. He declined and she is now his former GP.

and I'm sure different doctors have different motivations.

I posted this link last year...


States Faces Shortages of Primary Care Doctors

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

"...BETTY ANN BOWSER: But there are other reasons medical students are steering away from the field. Because primary care doctors are generalists who deal with a wide range of medical issues, they have to justify more types of treatment decisions with insurance companies.

Brian O'Gara recently shadowed a primary care physician, and he did not like what he saw.

BRIAN O'GARA, Medical Student: I just saw how difficult his life could be at times. I could see sort of the stress of having to see so many patients every day, not having enough time to see them. They're so overwhelmed currently, undercompensated, and I feel like a lot of people who are primary care physicians are not very happy with their job...


BETTY ANN BOWSER: The 46-year-old Dr. Atkinson often works seven days a week and spends a lot of time on the phone dealing with insurance issues.

DR. KATE ATKINSON: I spend more time doing paperwork and less time talking to patients. And every time there's a problem, the solution is to generate another form or another hurdle that the doctors need to go through.

If you come to me and you have stomach pains, what medicine I can put you on depends upon your insurance company. I wasn't trained to say, "What's your insurance company before making a treatment decision?" And now I have to.

Now, this is just what I received in one week.

BETTY ANN BOWSER: Dr. Atkinson says some insurance reimbursements don't cover what it really costs her to see a patient. Still, even with all of her frustrations, she says she's sticking with it..."

...at the end of last year.

He said they were squeezing him tighter and tighter every year, paying less and less for the same procedures. Said his income had been dropping about 10% every year for the last five years, even though he was seeing more patients. He finally got sick of it and dumped them all.

We decided to stick with the doc, realizing it would cost us a little more. The first time to see him, my health insurance company, United Healthcare, totally screwed up the claim forms that the doc had completed for me, but I'd filed. UHC paid the doc, when they should have paid me. Took several months to straighten it out.

End result, I end up paying about $25 more per visit, and about $20 more for the usual blood tests, directly to the doc. I'll live with that, because I like the guy. If I didn't like him, I'd go elsewhere.

My second visit to this doc is tomorrow. I wonder how long it will take the paperwork to get "fixed" properly this time?

Health insurance companies are LEECHES!!

pay the additional amount then I see no reason to switch.

So far we have not had to make that choice, thanks for the reply.

:)

A medical education shouldn't take more than 3 years

private practices to train the students.

:shrug:

Teaching hospitals can easily expand; there's usually nearby hospitals that aren't connected directly with a university where facilities can be ramped up very quickly for clinical practice.

Also if med school was made much more affordable then that would help matters too.

More spaces made available cheaply.

and yes med school costs leave some to choose another field as well.

Thanks.

I'd rather not have a doctor who got the dumbed-down version of a medical education.

... the doctors, nurses and staff are efficient, compassionate and skilled. I can't say enough good things about them.

However, my doctor (an Obama supporter, who is completely on-board with health care reform) stunned me by saying that the practice is "barely making it".

What a tragedy it would be for the patients, if this office was forced to close.

providers, so to hear that some are just making it is scary.

Here's hoping you will never have to find out, also sending good thoughts your way!

:)

Half the states have restrictions on NPs' ability to practice.
This is a pity, especially because many areas are undersupplied
with doctors. And the doctors may be too costly.

Of course some people don't think NPs are that good.
But on several occasions now I've seen an experienced NP
showing better judgment than an inexperienced GP. So if given
a choice, I would go with the practitioner with more experience.
Unfortunately, NPs are discouraged in my state.