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Charles, I am not particularly a fan of HMO's because I want to be able to use the best doctor I can find, when I need one, whether for myself or my family, I am forced to belong to a PPO which is slightly better than an HMO, but still prevents me from using the medical professionals I want to, unless I want to share more of the expense. SInce I am already having thousands of dollars taken from my paycheck each year to subsidize what my company contributes, so I can be insured, I resent not being able to use a hospital within a mile of my home, except for emergencies, and having to go many miles away to use a hospital "in the plan". Since a person's mental attitude can affect the outcome of medical care, I believe it is important to use a doctor I know, and trust, or one reccommended by a friend or family, as opposed to one who;s greatest attribute is being willing to work for less money, and see more patients, in order to enhance the profits of the HMO, or other organization. ANYTIME a profession is invaded by money-hungry businessmen, it loses the ability to do the best work. If a car is not repaired "to perfection" it is rarely a threat to life and limb, if an appliance is repaired by a technician who is too rushed to do a thorough job, and requires another visit, it is usually not a major ..catastrophy, BUT if a doctor misses a symptom of cancer, for example, because his time is limited, or misreads an xray, and lets me walk on a fractured leg, which makes is worse, etc, and if this is all due to the doctor being "managed" by businessmen...I think it is wrong. ALSO if HMO's were so good, they would not have to advertise on TV to convince the public that they provide good care. If they spent the millions of advertising dollars to make better care available, word-of-mouth adcvertising would make thm prosper. Doesn't that make sense? [OO] LOOKING FOR RADIOS! Ken Becker [log in to unmask] On Thu, 3 Apr 1997, Charles T. Meyer 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] > ********************************************************** >