Doctors Opting Out

May 25, 2011
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While the Washington bureaucracy and all its minions scramble around trying to craft just the right regulations that will magically make doctors and hospitals coordinate care, make primary care medicine more attractive as a profession, and improve access for millions of new patients, all at the same time, there is a hearty band of physicians who have solved these problems — at no cost to the government.

While the Washington bureaucracy and all its minions scramble around trying to craft just the right regulations that will magically make doctors and hospitals coordinate care, make primary care medicine more attractive as a profession, and improve access for millions of new patients, all at the same time, there is a hearty band of physicians who have solved these problems — at no cost to the government.

Not only are these physicians hearty, they are also happy. They have fallen in love again with the practice of medicine. They are happy to do primary care — the orphaned step-child of American medicine.

Their patients are happy, too. They have doctors who know them inside and out. They don’t have to feel guilty about contacting their own doctor at any time of day (or night.) And they have someone who will advocate for them if they need to be hospitalized.

A couple of recent articles highlight this important trend. Jim Doyle reports in St. Louis Today:

Fed up with managed care and yearning to spend more time with patients, a small group of physicians in the St. Louis area are focusing their practices on personalized care — and shunning payments from insurers and the government.

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And in San Diego, R.J. Ignelzi reports:

In 2005, (Dr. Martin Schulman) jumped off the traditional primary care treadmill and started Encinitas Personal Healthcare, a so-called concierge medical practice. Instead of the usual 2,500-patient load, Schulman now has just 250 patients. Hurried 10- or 15-minute appointments now stretch to one or two hours. And, patients can call, text or email him 24/7.

These are just two examples of thousands of physicians around the nation who have grown weary of government and insurance companies trying to control the practice of medicine. They are returning to the time-honored tradition of doctors and patients working out mutually agreeable arrangements for the very best of patient care.

They are making a mockery of Washington’s efforts to invent “accountable care organizations” and “medical homes” through “pay-for-performance” and “value based purchasing” incentives. They are solving the “primary care shortage” by making primary care attractive again. And they are “coordinating care” by having personal physicians go to bat for their patients.

They are putting the “care” back into “health care” by having one doctor (not a committee) take care of one patient (not the entire population.) These doctors know that “population health” is best achieved one patient at a time.

Once the current “health care system” collapses like the house of cards it has become, there will still be individual patients seeking and willing to pay for the services of individual doctors.

These physicians are simply showing the way — with no help from federal grants, bureaucrats, or insurance company administrators getting in the way.