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Why Medical Providers are Dis-enfranchised

Dr. David Edward Marcinko; MBA CMP™

[Publisher-in-Chief]

Despite the purported benefits of managed care, anecdotal evidence suggests that MD’s are less happy about managed care, compensation and their profession than ever before. Some might say they are even “desperate.”  

There are other reasons for despair, as well: 

• Fewer fee-for-service patients and more discounted patients
• More paperwork and scrutiny of medical decisions
• Lost independence and medical morale 
• Healthcare providers are making less money, as Medicare reimbursement was cut 5.4% for 2002, and 4.4% in 2003. Much more may be in store for late 2008.

Furthermore, such cuts also stand to hurt physicians with private payers since commercial insurers often tie their reimbursement schedules to Medicare’s resources.

Of course, many doctors feel that the profession of medicine is no longer satisfying or ego enhancing since almost 40% are now merely corporate employees.

And in the past few years, the following has occurred: 

• The Health Care Financing Administration (HCFA) became known as the Centers for Medicare and Medicaid Services (CMS). Formerly administered by Thomas Scully, it was re-organized into three parts: 1] The Center for Medical Management runs the traditional fee-for-service program. 2] The Center for Beneficiary Choices expands the number of Medicare beneficiaries belonging to private plans. 3] The Center for Medicaid and State Operations shares responsibility with state governments.
• Certain administrative requirements for the Health Insurance Portability and Accountability Act (HIPAA) went into effect in April and October 2003. And, for many doctors, their biggest liability may be a single unfortunate event that could result in a lawsuit, an HHS investigation, and/or bad publicity. 
• The executive committee of the Pharmaceutical Research and Manufacturers of America (PhRMA) adopted a new marketing code to govern big pharma’s relationships with physicians. Although now voluntary, DHH is urging compliance as critics charge that Direct to Consumer (DTC) advertising results in appropriate prescription patterns, frustrated patients and increased costs.    

Assessment: And so, do you believe the above is more true than not; and are doctors really getting desperate? 

Conclusion: Your thoughts are appreciated.

Speaker: If you need a moderator or a speaker for an upcoming event, Dr. David Edward Marcinko; MBA – Editor and Publisher-in-Chief – is available for speaking engagements. Contact him at: MarcinkoAdvisors@msn.com

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