Doctors Fleeing Medicare, Moving to Direct Primary Care

By:  Bob Adelmann
Doctors Fleeing Medicare, Moving to Direct Primary Care

Concierge medicine and its more modest iteration, "direct pay" medicine, are looking more and more attractive to both doctors and patients fed up with dealing with the complexities and difficulties of Medicare and insurance companies.

Concierge medicine, or “direct pay” medical practices, are looking more and more attractive to doctors fed up with the difficulties, paperwork, and unreliability of Medicare, according to a January 30 article by Bruce Japsen, Forbes magazine’s healthcare specialist. Within the next three years, one of every ten physicians practicing in the United States today expects to move from “mass-medicine” to individualized healthcare by walking away from Medicare altogether and letting their patients pay them directly.

The reasons to leave "mass medicine" continue to mount as the federal government’s involvement in healthcare grows. There are the most obvious ones: red tape, delays, low payments, excessive overhead, the pressure to see enough patients every day to keep the practice viable, and so on. There’s also the pressure to refer patients out to expensive specialists as a way to relieve the workload of trying to see 30 to 40 patients every day. There’s the fear of malpractice lawsuits as well, often resulting in doctors ordering unneeded tests “just to be sure.” Then there’s the uncertainty about fees: At the last possible moment, Congress decided to extend the so-called “doc fix” by putting off once again the 27-percent cut in Medicare payouts.

Back in May 2010 the American Medical Association (AMA) could see the handwriting on the wall. At that time 17 percent, or more than one in every six physicians contacted, said they were already restricting the number of Medicare patients in their practices, with 85 percent of them saying it was because Medicare payment rates were too low, and 78 percent saying the threat of further budget cuts made Medicare an “unreliable” payer. Nearly two-thirds of the doctors polled said they were seriously considering opting out of Medicare and using some form of private agreement with the patients directly.

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