MANAGED CARE November 2008. ©MediMedia USA
Managed care is a topic that’s hard to avoid even in one’s casual reading. In “The Doctor’s Office,” a regular column that appears in the Wall Street Journal, Benjamin Brewer, MD, laments the changes in his profession. The complaints will sound familiar to readers of this publication as, for instance, when Brewer states that “Somewhere along the line too many doctors stopped being healers and became prescribers and technicians.”
That’s a frequent complaint, and worth addressing.
“I can’t put my finger on a day the profession was transformed,” Brewer says, “but the change is driven home every time a health insurance company calls me a ‘provider’ instead of a doctor.”
Brewer understands that this is a nod to those health care practitioners who are not MDs but who treat patients, but it still rankles. I do sympathize with Brewer and I think health plan administrators should as well.
However, when Brewer complains about not being able to spend as much time as he’d like with patients and points to managed care as the cause, he leaves something out. There are fewer caring family practitioners like Brewer in the market. About 70 percent of medical school students are graduating as specialists.
The money isn’t as good in primary care, and the hassles seem to get worse each year. It’s quite expensive to run your own business, for instance. Brewer states that “there are months when the practice isn’t profitable.”
The crisis in primary care can present itself as an opportunity to health plans. If insurers do all that they can to ease the burden on PCPs then who benefits? The entire health care industry, that’s who. Including health plans. Perhaps the burgeoning advanced medical home movement will make a difference. Something to think about as we await the changes that a new presidential administration will bring.