25 May 2012

Restoring the sanctity of the patient-physician relationship. Part 7

Posted by Jody under: Wellness .

Sometimes corporations, in their desire to save a few bucks, unknowingly push their employees into health plans that may or may not be in their employees’ best interest. Having to switch doctors frequently is more than likely not in one’s best interest, health wise.

Insurance companies and managed care firms have succeeded largely through sales and marketing efforts. They must sell themselves effectively to large employers to get the sizable, premium-generating contracts. They must also sell doctors, hospitals, and other healthcare providers on participating in their plans and offering their services at a reduced, or discounted, rate. Insurance companies make their money from limiting care to patients and by obtaining increasingly large discounts on services from doctors, hospitals, and other care givers.

“The nation’s big for-profit health maintenance organizations had a banner year in 1994 by doing what they are set up to do: squeezing every penny possible out of the fees charged by doctors and hospitals,” said Milt Freudenheim, writing in The New York Times. “But as they put pressure on health-care providers to cut costs, the HMOs were rewarding their chief executives with sizable pay packages. The cash and stock awards to the chiefs of the seven biggest for-profit HMOs averaged $7 million in 1994.”

Many doctors are forced to participate in managed care plans, whether they believe in their underlying philosophy or not, simply to stay afloat financially. Some doctors regard it as a necessary evil; others regard it as a game. Managed care companies keep careful tabs on doctors, not only on their individual practices and care-utilization patterns, but also on whether or not doctors are “managed care friendly” — that is , whether or not they are cooperative, easy to work with, and whether or not they speak favorably of managed care, especially in public.

I’ve heard accounts of doctors getting cut from managed care panels because they spoke out against managed care in newspaper editorials. This, if true, is not right. Doctors should have the right to say what they will about anything that stands to have such a far-reaching effect on patients, patient care, and healthcare delivery in this country. After all, doctors will be the ones giving the care, or most certainly spearheading the teams giving the care. In our democratic society, we have always had the opportunity to question, analyze, and speak out against something if we think it may not be right. If doctors want to question managed care in the newspapers or on the Internet, for that matter, that should be their right and privilege. It should also be the right of managed care organizations to voice their opinion, should they desire to do so.

Accordingly, The Medical Reporter will give equal time to physicians and managed care organizations to voice their opinions about some of the issues mentioned here. The Medical Reporter stands for patient advocacy, education, and support. We will be watching managed care organizations to make sure they are not violating the rights of healthcare consumers in any way. We will also be watching all other groups and organizations that play a role in the provision of healthcare today. And I can assure you of this: the various World Wide Web sites and healthcare media to which we are linked will be watching as well.

We believe it is time to bring back trust to the practice of medicine and to restore the sanctity of something long-cherished and truly invaluable: the patient-physician relationship.

For, in the final analysis, as Elizabeth DeVita so sagely pointed out, “Doctors and patients need each other to survive.”

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