Perspective on Health Care - Primary Care Physician

Health care is obviously a big concern to me and my family.  We no longer have the option to be unaware or nonchalant about that part of our lives.  I have been through a lot of workplaces in my lifetime and I don't ever remember even checking to see what the health insurance was, let alone what the co-pays were or prescription coverage.  As long as there was some kind of health care, I was fine with it.  But now, I have to be concerned.  I went to our benefits fair for the first time this year, just to ask whether any changes were happening to our health coverage and if so, what they were.  (Luckily, there were none - we're paying more each month, but considering I was on furlough for the entire year last year, my take home is still more than it has been, so we'll take it.)  I've never been to a benefits fair for any reason other than getting free stuff before!  So, I follow the health care discussions and try to figure out how new laws may change things for us.  And I am definitely someone who has concern over the high cost of health care.  But, I think its interesting to hear different perspectives on the issue.  My debate team did a panel presentation on health care a few semesters ago, and I remember someone in the audience introducing himself as a local doctor and discussing how the health care issue was making him struggle as a physician - I had never thought of things from the doctor's perspective prior to that.  After all, I had fallen for the urban myth that all doctors were rich and they were part of the problem, not the solution, for cost in health care.  But, that night changed my view.  As I was reading through a medical newsletter I receive, my eye landed on a similar story and I thought I would share it with you - just in case you are still believing the myth of he rich doctor overcharging for services...


The blog post, simply titled, "Caring" was written by Dr. Rob, a primary care physician in the Southeastern U.S.  He writes of his experience as a physician, adjusting to the new "patient-centered" health care (of which he is a fan), but he also writes of his challenges:

So why is it, then, that those of us who try to be patient-centered in our care end up getting penalized?  If the days of the doctor-god are over, then why are we still paying premium dollar for those huge egos?  Why do we pay more for technology than humanity?  When I face the continued threat of declining reimbursement (don't forget, the next SGR battle will be over a 30% drop in Medicare reimbursement) I feel angry.  I am the point of care, not cost.  I am cheap. I spend my day trying to keep people well, trying to find cheaper medications for them, trying to avoid expensive procedures and consultants.  How am I rewarded for fighting the tide of spending?  With increased expectations, increased fear of the future, and decreased pay.  I see the gratefulness of my patients, and that keeps me from fleeing altogether; but I also face the callous cuts by CMS, the increased micro-management by the insurance industry, and accusations of being a "greedy doctor" for not wanting my pay cut.

 First off, this is not the first time that I have heard of primary care physicians getting major cuts in the amounts they are reimbursed from both the government and insurance companies.  But he talks of other things that I was not so aware of and that make me kind of sad:

 In the past few weeks I have done three "mobility evaluations" for people who are trying to get scooters.  They have done this in response to the commercials or direct phone calls from the companies that provide these devices.  Beyond that, I have seen a huge increase in the number of ludicrous requests by these companies who prey on innocent and ignorant patients.  They are leeches.  They are bloodletters removing the life-essence from a dying patient.  Yet their presence is growing.

We all laugh at those commercials where the person is cruising around the lake on their scooter, but I didn't realize the implications of those commercials.  I had never thought beyond the ludicrous commercials to the ludicrous requests they may be causing.  He goes on to discuss the complexities now involved in prescribing medicine - something I can definitely related to when looking at the costs on our monthly medication bill (thankfully, we only pay a $5 or $15 copay for Bean's medicines, but I see the actual cost charged to the insurance company as well - and for some of them, wow...).  He closes his post with a plea:

We have a bunch of hands being plunged into the coffers of healthcare, and yet we are penalizing those who are too busy caring for patients to do so.  I honestly get depressed when I see all of the waste around me and yet face huge cuts to my reimbursement.  It shows people don't understand.  It shows people don't care.  Do you want doctors who care?  Then put your money where your mouth is.  Stop rewarding the parasites.  Stop throwing money at the turnstiles.  Stop rewarding the spenders.
There are some of us who still care, but it's getting harder to stay that way.

I know that there are lots of problems with health care.  I know that we have been the lucky ones - getting the emergency and long term care that Bean needed so desperately when she needed it without problem and without much cost (comparatively speaking to the total cost) to us.  But, I also realize that doctors are so important to us.  I respect them and I am indebted to them.  I do not want them unfairly vilified or unable to maintain their practices due to a flawed system.  So, I thought it important that I share this story and hopefully raise awareness about the struggles of our primary care physicians and pediatricians who are the first line of defense in maintaining our good health.  Let's figure out a way to reward those who care and make this system better for everyone involved - the patient, the doctor, and those who work in the health care industry.