In a message dated 97-08-23 02:32:37 EDT, Michael writes: > >From a fairly simplistic practical and monetary perspective, I look at it > as a provider agreeing to see patients for a discounted fee in exchange > for having patients preferentially directed to his/her office. One > problem is that if an office runs at 50% overhead (fairly common), a 20% > discount off the gross receipts translates to a 40% cut in net income. > And the numbers are frequently worse. A 50% discount means the visit > barely covers the office overhead. So unless one can accept a > significant cut in salary (especially difficult for those having tens of > thousands of medical school loans to re-pay), it becomes necessary to see > a higher volume of patients just to pay the bills. This can be done by > giving shorter visits (not inadequate, just shorter), having ancillary > help do things previously done by the provider (telephone calls, history > taking, medication/vaccine explanations, etc.), seeing patients less > often (but still staying, of course, within acceptable minimum > guidelines). > > The net result is care which is certainly adequate, but likely not what > either the provider or the patient is used to. And studies have never > shown that managed care consistently reduces > <underline>overall</underline> medical costs. They're just re-directed > somewhere. > > Here's food-for-thought: If a <underline>non</underline>-profit > insurance company will give hundred's of millions of dollars to charity > in order to obtain government approval to become a > <underline>for</underline>-profit insurance company, there must be a lot > of profit to be made. So where do you suppose the costs are being > re-directed? (hint - it's not toward lower insurance premiums for > consumers or increased reimbursement for providers). > > > Michael Sachs, M.D. > > General Pediatrician I would like to add another option. Don't sign a contract that is unfair to the patient or the doctor. It takes a little soul searching, but you can determine your "bottom line." My experience is that the payor, insurance company, employer, and/or patient will often be willing to negotiate. It is better to have a patient change because you are not on a particular insurance company than to have them change because you no longer provide the services that you used to provide.