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At 06:43 PM 4/3/97 -0500, you wrote: >Jeff Newton posted a question for another web site which I answered. My >reply might be of interest to some of the list members receiving care >from managed care organizations: >QUESTION > at "http://www.amso.com". The topic is: > >"We currently have many 'for profit' HMO's in the healthcare industry >today. >Does their "for profit" status improve or impair the quality of >healthcare?" >Please share your viewpoint(s). > > > > >As both a physician (psychiatrist)practicing part time in a managed care >situation, and as an individual with a chronic illness, (Parkinson's >Disease) I highly doubt for profit status improves patient care and I >think it pushes us toward mediocrity. While the fee for service system >rewards over treatment and certainly contributes to increasing costs, >the incentive is to not treat in order to make the maximum profit. This >makes sense to bean counters but is the antithesis of why I got into >medicine. While I could go on in detail about various aspects of this >let me give one example and invite anyone to provide logic which proves >me wrong. > >If I as a physician wanted to have the group start a Parkinson's Clinic, >hire a movement disorder specialist instead of having Parkinson's >patients treated by a general neurologist, how could I sell that to my >HMO. I live in an area where there are 4 competing HMO's. A large >portion of the population has a choice yearly as to which they enroll in >for that year. If HMO "A" provides the best Parkinson's care in town >where are all the Parkinson's patients going to go. If HMO captures its >market share by providing the best Parkinson's care and best care for >other chronic diseases, where are Parkinson's patients going to enroll >when they hear in their support group that HMO "A" has the best >Parkinson's treatment in town? > >The economics are simple- you get a reputation for providing the best >care, you get rewarded by a a large percent of the patients with a >chronic disease to join your HMO and then you get saddled with a group >of patients who utilize an incredible amount of recourses for the rest >of their lives. Excellence = negative cash flow. > >If you advertise and invest your resources in Sports Medicine, well baby >care and obstetrics you attract a population who is not sick. Yes you >may provide preventive care which is valuable but who is going to take >care of the sick patients? I invite anyone to counter this argument. >-- >********************************************************** >CHARLES T. MEYER, M.D. >MADISON, WISCONSIN >[log in to unmask] >********************************************************** >