November 19, 2003
Situation critical, “reforms” expected to worsen as doctors bail out, refuse patients Wouldn’t take part if starting over & predict rationing
Washington, D.C. – More doctors will bail out of Medicare, while those who remain will continue to refuse new patients and restrict services, leading to severe rationing in the next ten years.
Those are the dire predictions of physicians revealed in a new survey titled “Demoralized Doctors, Disheartened Doctors, Patient Problems: AAPS Biannual Survey of Physicians on Medicare and Patients’ Access to Care” to be published in the Journal of American Physicians and Surgeons (JP&S), winter issue due out in December. (See: www.jpands.org)
While the future looks bleak, the present isn’t much better, according to 344 physicians responding to the respondents, who are involved in patient care at least 20 hours and an average of 23 years in practice.
"This study is concrete documentation of the atmosphere of fear and frustration in which doctors practice today," said Kathryn Serkes, co-author of the survey and public affairs counsel for the Association of American Physicians and Surgeons (AAPS). "Money is not the issue – control is. More doctors would rather treat uninsured patients, possibly for free, than jump through Medicare hoops.”
The results show that increased government involvement in Medicare is actually responsible for increasing physician demoralization and practice changes that are making it tougher for patients to find doctors who are willing to treat them. And the impact is being felt by all patients, not just seniors, and will get worse if an open-ended, costly drug benefit is added.
“Tacking on some cosmetic changes as Congress is now considering in the conference report will only make things worse,” said Serkes. “It’s like the sick patient who was in deep denial. He delayed treatment for so long that he became terminally ill, and then ran out to have expensive plastic surgery - that bankrupted him. But his friends say he was a good-looking corpse.”
The survey supports 6 conclusions:
Some of the findings:
Of particular note is that physicians prefer uninsured to Medicare patients, turning them away 50% less frequently than Medicare patients (17% and 33% respectively).
“This regulatory roulette is affecting every patient in the country. Doctors have less time to spend with patients, and are retiring earlier than ever,” said Serkes. “Medicare expansion will only bring more of the same.”
Serkes says one respondent’s comment sums it up: “Unless things change soon, the best and the brightest will leave Medicare. It’s simply not worth it.”
AAPS is a dues-supported, non-partisan, professional association of physicians in all specialties, dedicated since 1943 to protecting the sanctity of the patient-physician relationship.