Wednesday, May 26, 2010
Perspective: Who Speaks for America's 650,000 Independent Private Physicians, Part I
-observes that independent physicians care for 80% of America’s patients,
-describes the physician culture – its belief system, desire for autonomy, and reliance on clinical judgment,
-deplores independent private practice decline, which has shrunk by about 10 % over the last 10 years? (See “The Independent Physician: Going, Going ….” NEJM. February 12, 2010),
-explains accelerating departures of private doctors into retirement, non-clinical careers, hospital employment, and new practice models devoid of 3rd party interference.
- comments at length on the fast-growing physician movement, locum tenens, traveling physicians for hire.
-says that much of American medicine’s costs stem from lack of competition, open-ended comprehensive plans, mandated guaranteed benefits, restrictive regulations, physician malpractice expenses, ensuing defensive medicine practices, and litigious practice environments,
- discerns that much of the so-called fraud and abuse occurs in Medicare and Medicaid and is perpetrated by non-physicians using stolen identities, rather than physicians in their practices,
-notes that hospital-based medicine, with salaried physicians, as opposed to ambulatory-based medicine conducted by private physicians, drives costs up,
-warns the American people about the impending doctor shortages, the coming access crisis, and longer waiting lines for doctor appointments,
-highlights polls indicating patients trust their doctors more than government data-wielding bureaucrats,
-tells Americans that only 2% of medical students are entering primary care, and that these are the physicians they are expected to visit to sort out problems and to coordinate care,
-points out to Americans that many of the new 34 million who may gain insurance will be assigned to Medicaid rolls and that fewer and fewer doctors will accept new Medicaid recipients because of low reimbursements,
-explains problems imposed by third parties that erode time spent with patients,
-documents that for every hour spent seeing patients, another hour is spent on paperwork and getting permission to perform a test or a procedure?
Who articulates these things?
I would like to say, I do. And I have in my blog, Medinnovation, in my books, and in www.modernmedicine.com, where I regularly submit blogs and interview national thought leaders.
But a more reliable , balanced, and prestigious source is the Physicians Foundation, a nonprofit C01C3 organization that represents all American doctors belonging to state medical societies. These societies are close to the ground. The Foundation and state societies know what moves physicians , what discourages them, what is good and bad for their patients, and how to improve the system.
Visit the Physicians Foundation website, www.physiciansfoundation.org, read about its charitable work, listen to the beat of the culture of individual physicians, who provide most of the care for patients in the United States.
Part II will be continued in my next Medinnovation blog.
The information contained in this blog does not necessarily reflect the views or position of the Physicians Foundation or its Board members.