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Is Primary Care Medicine Toxic?

10 Responses

1. Frank, on January 3, 2011 at 11:13 AM said:

   Is this the best of times and/or worst of times for solo and small medical practices?

   http://idealmedicalpractices.typepad.com/ideal_medical_practices/2011/01/this-is-the-best-of-times-and-worst-of-times-for-solo-and-small-medical-practices.html

   What do you think?

   Frank

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2. Ann Miller RN MHA, on March 17, 2011 at 9:24 PM said:

   Doc Supply Won’t Keep Pace with Medicaid Enrollment
   [A New Report]

   Under the Patient Protection and Affordable Care Act, some 16 million more people are expected to receive Medicaid coverage by 2019, but according to a Center for Studying Health System Change research brief, most of those new patients in the system live in states where primary-care physician shortages are looming or where a large segment of these doctors are not seeing new Medicaid patients.

   In fact, the report concludes that “most of the nation will likely observe Medicaid enrollment increases that exceed increases in Medicaid (primary-care physician) supply.”

   Based on 2008 data from the Health Resources and Services Administration’s area resource file, 42% of all primary-care physicians are accepting all or most new Medicaid patients, compared to 61% accepting all or most new Medicare patients or 84% of those with private insurance.

   Source: Andis Robeznieks, Modern Healthcare [3/17/11]

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3. Dr. David Edward Marcinko MBA CMP™, on September 18, 2011 at 11:55 AM said:

   On the Primary Care Medicine Revolt

   Recently, Anna Wilde Mathews of the Wall Street Journal ran an article detailing the activities surrounding primary care’s gradual awakening and mobilization.

   It is well worth a look and brings together what we have been saying in our more formal print publications:

   http://online.wsj.com/article/SB10001424053111903648204576554903022884780.html

   Dr. David Edward Marcinko MBA CMP™
   [Editor-in-Chief]
   http://www.BusinessofMedicalPractice.com

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4. Ann Miller RN MHA, on October 11, 2011 at 1:29 AM said:

   Medicare Tests Monthly Incentives for Innovative Primary Care
   [Maybe not Toxic]

   Medicare will partner with private insurers to offer physicians patient management fees and the opportunity to share savings under a primary care payment initiative led by the Centers for Medicare & Medicaid Services. Participating practices will receive an average of about $20 per patient per month to coordinate quality care for Medicare and private patients.

   The Comprehensive Primary Care Initiative is a new collaboration between public and private payers to strengthen primary care, CMS officials said during a Sept. 28 news conference. The Center for Medicare & Medicaid Innovation is inviting insurers to join government health plans in trying a new approach to paying for primary care starting in 2012.

   Source: Charles Fiegl, amednews [10/10/11]

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5. Alice, on November 9, 2011 at 5:24 PM said:

   Walmart Wants To Be Largest Primary Care Provider
   [Or … Physical exams on ailse #3]

   Dr. Marcinko, did you know that Walmart — the nation’s largest retailer and biggest private employer — now wants to dominate a growing part of the health care market, offering a range of medical services from basic prevention to management of chronic conditions like diabetes and heart disease, according to NPR and Kaiser Health News?

   Click to access Walmart%20Strategic%20Health%20and%20Wellness%20Partnership%20Request.pdf

   Any thoughts?

   Alice

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6. Anaka, on July 11, 2012 at 3:59 PM said:

   Recruiting Firm Reports That Solo Practices are Dead

   It’s no secret that solo practice by doctors has been diminishing.

   http://www.healthcarefinancenews.com/news/recruiting-firm-says-solo-physician-practice-dead

   But, a new finding by recruitment firm Merritt Hawkins declares that solo practice is all but dead.

   Only 1 percent of its search assignments in 2011/2012 (down from 22 percent 11 years ago and 2 percent in last year’s report) were for recruitments of doctors into solo practices, according to Healthcare Finance News.

   Anaka

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7. Ann Miller RN MHA, on July 14, 2012 at 10:44 AM said:

   Physicians Have Unique Challenges and Opportunities

   Physicians today “are getting squeezed from both ends” when it comes to their finances, according Paul Larson, president of Larson Financial Group.

   http://www.mississippimedicalnews.com/retirement-and-succession-planning-cms-1524

   On one end, collections and reimbursements are down; on the other end, taxes are up. That’s why financial planning, including a far-sighted strategy for retirement, is a necessity.

   Ann Miller RN MHA

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8. Dr. Angelino, on July 19, 2012 at 12:50 PM said:

   More money no RX for Doctor Shortages

   Medicare should not try to address the shortages of doctors and health care providers in some areas of the country by raising reimbursements to lure practitioners there, the Institute of Medicine just recommended.

   http://www.physiciansnews.com/2012/07/18/higher-payments-are-no-cure-for-doctor-shortage/

   The committee concluded that while “there are wide discrepancies in access to and quality of care across geographic areas, particularly for racial and ethnic minorities,” those variations did not appear to be due to Medicare payments and were unlikely to be influenced by changes in rates.

   Dr. Angelino

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9. D. Kellus Pruitt DDS, on July 10, 2013 at 5:45 PM said:

   Managed care and doctors’ suicides

   Want to know why it is becoming increasingly difficult to find primary care physicians? Many are leaving the profession – some by suicide. Since in dentistry, managed care CEOs similarly encounter no resistance to cuts in preferred providers’ pay, can leaderless dentists be far behind?

   “Healing the healer in healthcare” by Thomas Dahlborg, July 5th, 2013

   http://www.hospitalimpact.org/index.php/2013/07/05/healthcare_needs_to_heal_the_healer?goback=%2Egde_3349257_member_255687720

   Dr. Dahlborg, a family physician in Eugene, Oregon, writes: “Many studies have highlighted the fact that physicians have a significantly elevated suicide rate in comparison to other professionals. In her article ‘What I’ve learned from saving physicians from suicide,’ Pamela Wible, M.D., highlights that not only are doctors overworked, exhausted and depressed, but few are seeking help.” As naturally stoic dentists are increasingly pinched between maximum allowed fees and increasing overhead expenses, does Dr. Wible’s diagnosis sound credible, Doc?

   A primary care physician friend tells Dahlborg that “he was feeling his role had moved further away from that of a healer and more toward a ‘production worker.’” Dahlborg continues: “Rather than focus his energy on best positioning his patients for optimal healing, he was pressured to triple book every 15 minutes to generate the required 30 relative value units (RVU) per day and thus ‘earn’ his salary.”

   Have you heard Delta CEOs’ selfish, disingenuous justification for cutting powerless dentists’ already discounted fees even more? (They lack business skills).

   Two years ago, Washington Dental Service (Delta Dental) made the news when KING 5 in Seattle featured “Executive pay soars as one of WA state’s largest non-profits makes cuts” – an investigative report written by Chris Ingalls.

   http://www.nwcn.com/home/?fId=150968095&fPath=/news/local&fDomain=10212

   Ingalls points out that the CEO of WDS, James Dwyer, earned $1.2 million in 2010 as part of a 45 percent pay increase he has enjoyed for the previous 5 years – even as he cut preferred providers’ already discounted fees by another 15 percent, which is likely more than a third of their take home pay.

   Ingalls writes: “WDS said the cuts allowed it to reduce the premiums it charges employers for dental insurance, a move that makes its service more competitive in the marketplace.” When asked how paying less for Delta clients’ dental care affects their dentists, the CEO responded, “They’ve lived in a wonderful, insulated world. God love ‘em. But it’s changing.” Dwyer added, “Number one, they could start by working 5 days a week.” James Dwyer earns $1.2 million, and he cannot fix teeth.

   If you are a dentist or a dental patient, Delta Dental’s James Dwyer doesn’t like you. And neither does David Haynes, president and CEO of Delta Dental of Missouri (salary unknown). In Haynes’ recent letter to Missouri dentists announcing a 7 percent fee reduction – take it or leave it – his explanation for quietly investing less of Delta clients’ premiums in their care is as transparently pitiful as Dwyers’:

   “Our competitors are offering premiums significantly below ours due to lower fee agreements with their dentist panels, and we see employers taking notice. Our clients are demanding lower premiums and greater cost savings from Delta Dental of Missouri for our dental benefit plans. Many are saying they will be forced to seek other sources for dental benefits or discontinue the offering of dental benefits to their employees, if we are not able to reduce costs.”

   For the nation’s employers who are paying attention, more than one Delta Dental CEO have inadvertently warned you that the giant discount dentistry broker will cease to exist unless it can continue to pay less and less for your employees’ dentalcare. If Delta plays fairly, its CEOs’ incomes might drop by 100 percent.

   In my opinion, it is far better for our community to lose Delta Dental and a few millionaires rather than dentists, and the public desperately needs my profession to find leaders with enough courage to save lives.

   D. Kellus Pruitt DDS

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10. Ann Miller RN MHA, on September 19, 2014 at 4:34 PM said:

    New Thoughts on the Future of Primary Care

    Reform, whether mandated by the Affordable Care Act or not, is needed to address citizens’ demands for quality health care services. Medicaid, state employee health care and now, health insurance exchanges are potential policy levers to increase quality, improve states’ health outcomes and hold the line on costs. This session highlighted replicable initiatives undertaken by states to build an improved health care system responsive to today’s fiscal policy context.

    http://www.healthsharetv.com/content/thoughts-future-primary-care

    VIDEO: Presentation by Dr. William Rowley at the 2012 CSG National Leadership Conference in La Quinta, California.

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