Physicians Practice - July/August 2008 - (Page 32)

HEALTHCARE REFORM pre-existing physician-shortage that the new mandate is exacerbating. “It’s getting people insured,” says Dale Magee, a Shrewsbury OB/GYN and past president of the Massachusetts Medical Society. “Right now we are down to 5 percent uninsured, which is half of what it was a year ago.” Magee argues that more patients insured means less potential heartache for patients and physicians alike. “We don’t want to be in the position to diagnose a patient and then ﬁnd out they are uninsured and unable to pay for their meds and treatment. That can be heartbreaking. Now, that’s less of an issue, and we know that patients, even those with $2,000 to $3,000 deductibles, coverage, they have extensive networks of PCPs. We don’t have that. We have a shortage of PCPs and have to ﬁnd a way to build the PCP base to make this work.” “The shortage speaks to the fact that we really have to look at how people choose specialties in residency, and encourage them to go into primary care,” says Magee. “In Massachusetts, we currently have one PCP for every three specialists. Residency programs are turning out six or seven specialists for every one PCP, so the problem may only get worse.” The newly insured are waiting as long as 10 months for a new-patient or well-patient appointment, when they are choosing other paths, opting out of ofﬁce-based medicine for jobs as ER docs and hospitalists, says Magee. And that’s not all. “There are a number of PCPs between 50 and 65 years old who are considering retiring early because of the increased stress,” says family physician Dennis M. Dimitri, president of the Massachusetts Academy of Family Physicians. “We need to work to retain the PCPs we have by making sure people don’t leave because of the difﬁcult environment in which they are practicing — low reimbursements, heavy patient loads, and administrative details having to do with insurance requirements for getting paid.” Lawmakers, in search of a solution, are looking at ways to decrease the administrative burden on PCPs and improve reimbursement. They’re also considering loan-forgiveness programs and other incentives for medical students who choose primary care. The increase in patient loads has an upside for physicians, too. After all, because these patients are insured, they are paying customers. “All of us have been providing some amount of care to [free or reduced-cost] uninsured patients,” notes Dimitri, “and now that many more people have insurance, that’s helping practices, particularly the smaller practices — it’s an opportunity to get paid for care they were already providing.” Hospitals, too, are reaping beneﬁts by decreasing the amount of unreimbursed care and easing the squeeze on their emergency departments. In 2007, the number of claims to the state’s uncompensated care pool for uninsured hospital visits dropped by 13 percent, and the cost of hospital claims submitted to the pool dropped 8 percent. “We need to be realistic about the PCP shortage over the next several years,” says Dimitri. But, he continues, “If some of these legislative changes and incentives are put into place, we will see positive changes in the next ﬁve to seven years.” WWW.PHYSICIANSPRACTICE.COM “The [primarycare physician] shortage speaks to the fact that we really have to look at how people choose specialties in residency, and encourage them to go into primary care. … Residency programs are turning out six or seven specialists for every one PCP, so the problem may only get worse.” WHERE ARE THE DOCS? Dale Magee, MD won’t be forced to go bankrupt to pay for their medical care.” But patients and physicians are discovering that access to insurance doesn’t always equal easy access to care. The inﬂux of more than a quarter of a million newly insured residents has led to overcrowded waiting rooms and overworked, overstressed primary-care physicians who were in short supply in Massachusetts (as elsewhere) even before the legislation. Patricia Sereno, a primary-care physician in Malden, points out that “in other countries with universal 32 | PHYSICIANS PRACTICE | JULY/AUGUST 2008 can ﬁnd a primary-care doctor willing to accept new patients at all. Physicians are feeling the pressure, too. “I’m now seeing 24 patients a day, and it’s a heck of a lot busier than it used to be,” says Sereno. “But the patients are being squeezed on all ends — they can’t ﬁnd a doctor, they have to wait, then, when they ﬁnally get to come in, they come with a list of 10 things to address, and yet they are not getting the time with a physician that they used to.” The increase in patient load and paperwork has become so stressful that some primary-care physicians http://WWW.PHYSICIANSPRACTICE.COM

Table of Contents Feed for the Digital Edition of Physicians Practice - July/August 2008

Physicians Practice - July/August 2008 Contents The Bigger Picture: Battle Royale in the EMR Market Letters Physicians Practice Pearls: Hire Right Noteworthy Cover Story: Healthcare Reform: Voting for Change Patient Relations: Dealing with Problem Patients The tech Doctor: Is Self-Service Medicine Inevitable? Technology: Do EMRs Make You a Better Doctor? The Guide Idealab: Cash-Only Care Still Works The Administrators Desk: Who’s in Charge? Ask The Experts What Went Wrong: ‘Why Our Great Idea Didn’t Work’ Coding Start It Up: How to Launch a Practice: Operations Partnership: Don't Let Partner Conflict Destroy Your Practice Appraisals: What’s Your Practice Worth? Getting Advice: How to Hire a Consultant Classifieds Advertiser Index

Physicians Practice - July/August 2008

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