 |
 |
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] **********************************************************