Friday, September 14, 2012

Pluralistic Physician Organizations
Societies in all developed nations has become more pluralistic day by day.  It is splintering into a myriad of institutions more or less autonomous, each requiring its own leaders and each having its own specific task.
Peter F. Drucker (1909-2006),  The New Pluralism (1999)
September 15, 2012 -  Physicians are a pluralistic profession  with a number of  organizations representing various points of view. 
We have the AMA, said to represent all physicians but only having 15% of physicians as members.  We have a myriad of specialty societies, over 150 at last count.   We have the Physicians Foundation, which was formed after winning a lawsuit against national health plans. The Foundation  represents  major state medical societies. We have Physicians for a National Health Program,  18,000 progressive souls seeking a single-payer system. 
And beginning a year ago,  we have the Doctors and Patients Medical Association (DPMA) in Alexandria, Virginia, a spin-off of the conservative American Association  of Physicians and Surgeons, located in Tucson, Arizona.  The  DPMA tag line is “Freedom in medicine for doctors AND patients.”
What does the DPMA stand for?  In a recent email,  its President, Mark Schiller, MD, a California psychiatrist,  enunciated these ideas and principles.

·         The Resuscitation of “Marcus Welby” Practices

Under this headline, Doctor Schiller says,
"There are two ways to get medical care: (1) pay for it yourself, or (2) get someone else to buy it for you. There is prepayment through insurance or postpayment through cash or credit. There is direct payment or "assigned payment through an insurer.” One can request charity, or use force, the latter most often through government, the largest third party."

"Though it may be dismissed as irrelevant, the method of payment is critical. It affects almost everything else in some way: the patient-physician relationship, the type and quality of service, the availability and promptness of service, the conditions for delivery of service, the documentation, the morale of medical professionals and the cost."

"Almost all the complexities that have ensnarled medical offices during the past 50 years and distracted physicians from attending patients and expanding their medical knowledge are the consequence of third-party payment. Physicians are forced to game the system and bill $200 if they have any hope of getting reimbursed $43. "

"Without the third party there is no need for coding, claims forms, authorizations, eligibility checks, documentation of medical necessity, postpayment audits, payment delays for "re-pricing," compliance plans, or expensive consultants."

·          Opting Out of Medicare Without Leaving Your Patients Behind – The Concierge Model of Practice.

Here Dr, Schiller explains how physicians can opt out of Medicare without leaving their  patients behind by adopting a concierge practice model to provide  higher level of access to a smaller number of patients.    The DPMA sponsors national teleconferences featuring physicians who have set up concierge practices and offering services to help build a web design to attract and keep patients.  The DPMA will also offer a telemeeting “Doctors in the Drivers Seat – Physicians Regaining a Rightful Voice in Medicine, ‘ featuring Marc Siegel MD, a New York City internist and Fox News Contributor.
Where the DPMA and other organizations are going no one knows.  It’s all about the Washington merry-go-round and the game of medical music chairs.   Where it stops no one knows. 
Tweet:  Pluralistic medical organizations include  AMA, specialty societies, Physicians Foundation,  Physicians for National Health, AAPS,  DPMA.


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