An old phrase admonishes..."Physician, Heal Thyself". There is new meaning to the phrase these days.
More and more, physicians are growing disenchanted with the practice of medicine. They still love to treat their patients, but they do not necessarily like the manner in which they're forced to practice medicine. Physicians have long chafed under the mantle of managed care. The idea that some 'suit' would tell a doctor how to run his or her practice simply galled the doctors.
Managed health care has changed the way in which doctors are permitted to interact with patients. Doctors are required to see a certain number of patients each and every hour. If they don't, they stand out amongst their peers. If they're part of a large physician group, they become what is known as an 'outlier' meaning simply that they do not fit the norm. If they fail to correct their status, they are seen as a detriment to the group with which they're affiliated.
Patients have become more or less accustomed to this form of health care. They are used to waiting and then to seeing their doctor for a few minutes. The doctors are often harried. They were accustomed to the continuum of care where they decided when and where to refer patients whom they were unable to help at the primary care level. Those decisions are largely made for the primary care doctors today. If someone has a problem with an eye, the referral pattern dictates that the patient see the ophthalmologist that is part of the group practice. If there is a skin condition, the dermatologist sees the patient. If there are behavior issues, the patient will be sent to the psychologist or psychiatrist that is part of the group practice. And on and on in that manner. The art form today centers on maximizing the billable charges.
In defense of the group practice, it has been forced by managed care companies...the insurers...to adapt if it is to survive. The practice leaders are likely to sympathize with their primary care physician team members, but that can't be permitted to get in the way of running the business side of the practice.
On top of this phenomenon is the seemingly continual consolidation of practices, and the acquisition of practices by hospitals, and so on.
How then are physicians 'healing themselves'?
More doctors are moving 'back to the future' by ending their contracts with the insurers, and simply practicing medicine as they thought they would practice medicine when they graduated. They are sometimes called 'fee-for-service' doctors and they get paid cash upon the delivery of their services. The patient is given the paperwork to support their own claim filing for reimbursement from the insurer. In many instances, the doctor can afford to take less money from the patient because he or she is not waiting months to get paid after re-submitting the claim once or twice. And, because they don't require the large staff they used to need to interact with the insurers.
Some are opting to become what are known as 'Concierge Physicians'. That is where the patient pays an annual fee of $1,000 or $1,200 or $1,500 in return for being able to call the doctor and see him or her the same day. Some make house calls. These physicians do not interact with the insurers either. They practice medicine as they always wanted to practice medicine. They take the time they feel is necessary to care for their patient. They see fewer patients for longer times and earn more money.
This movement began 10 or more years ago and has spread steadily throughout the country. Recruiters are enticing snowbirds to move to Florida or California where they'll become part of the Concierge movement. They'll still be part of a larger entity, but they'll be guaranteed a maximum daily patient load so they can take the time they need with each patient.
On top of everything else, they often make more money in addition to having the contentment of practicing as they desire. That is a difficult combination against which to compete.
Will some of the Advanced Healthcare and Medical Associates doctors begin to think about going 'back to the future'?
