Streams

Primary Care

Wednesday, December 09, 2009

To examine the state of primary health care and the doctors who provide it, Albany School of Public Health professor Timothy Hoff, discusses his new book Under Pressure: Primary Care Physicians and Their Medicine in the Twenty-first Century (Rutgers University Press, 2009).

Guests:

Timothy Hoff

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Comments [8]

Mike from Monroe, NY

Joe from Flemington is correct - physicians are paid for procedures and treatments, not preventive consultation and this has to be reformed to reduce cost. Even having annual physicals with your primary care physician omits many important items. I have never had a doctor check for signs of skin cancer or inquire about or perform elementary screening related to dental health, nutrition, changes in stress, sexual health, vision or hearing. Only when something is obviously wrong to you does the doctor pay attention and then refer you to a specialist. Some earlier elementary screening might avert a problem. Maybe I just need a better doctor?

Dec. 09 2009 10:09 PM
David from New York

The health care pie does not need to change its size. We have become a procedure driven society where a test is more important then the time spent with the patient. If insurance companies were to reverse their reimbursement method, a dermatologist will not be paid $xxxx for a 5 minutes procedure but rather $xx and hopefully even less. The primary care physician spending 30-45 minutes with his patient will be reimbursed not the customary less the $x but rather $xx and hopefully more. We have to create a reasonable balance in the system so that patients are happy to see a doctor that spends time with them using the gift he has between his ears (his brain) and not ordering costly tests, and resent seeing a physician that sees them as a number only thinking about what he will have in his/her pocket at the end of the visit rushing the patient out and ordering unnecessary tests.

Dec. 09 2009 01:20 PM
Joe from Flemington

The sad truth is physicians are paid for treatments, not prevention. That is where cost savings will roll from. We need a new way of thinking but the healthcare debate is not geared for this.

Dec. 09 2009 11:46 AM
Edward from NJ

Just how much money do primary care physicians take home? Is there another job where you can make that much and take Thursdays off?

Dec. 09 2009 11:44 AM
RJ from brooklyn

Seems that docs could afford lower Medicare reimbursements if they didn't have to lay out massive amounts for support staff etc. to handle paperwork, as the last caller was saying.

Dec. 09 2009 11:44 AM
Karen from Manhattan

Just a note about something I learned yesterday, when I received a $410 bill from the "staff physician" who treated me when I went to a local, "in-network" emergency room for a respiratory problem.

Apparently -- according to the hospital' patient advocate, whom I called after receiving the bill -- even though you may go or be taken to a hospital that is part of your health care plan, and treated, not by a specialist, but by a "staff physician," that physician may be out of network, and you may receive a hefty bill from that doctor.

I was not notified before treatment that the doctor would bill me separately. The advocate told me that the hospital "did not have time" in emergency situations to determine whether the doctor was in a patient's network. Yet the hospital did expect me to read "fine print" in a release that I signed -- in the same emergency -- that warned me, or so I've since been told (I didn't read it; I couldn't breathe), of the billing policies.

The advocate agreed with me that the "freelancer" policy "stinks" -- the staff physician has examining privileges in the emergency room, and is called a "staff physician," but bills separate and apart from the hospital. The advocate also said that such policies were legal, and widely practiced, in NYS, and advised me to complain about such policies publically. So I am.

Dec. 09 2009 11:01 AM
Karen from Manhattan

Just a note about something I learned yesterday, when I received a $410 bill from the "staff physician" who treated me when I went to a local, "in-network" emergency room for a respiratory problem.

Apparently -- according to the hospital' patient advocate, whom I called after receiving the bill -- even though you may go or be taken to a hospital that is part of your health care plan, and treated, not by a specialist, but by a "staff physician," that physician may be out of network, and you may receive a hefty bill from that doctor.

I was not notified before treatment that the doctor would bill me separately. The advocate told me that the hospital "did not have time" in emergency situations to determine whether the doctor was in a patient's network. Yet the hospital did expect me to read "fine print" in a release that I signed -- in the same emergency -- that warned me, or so I've since been told (I didn't read it; I couldn't breathe), of the billing policies.

The advocate agreed with me that the "freelancer" policy "stinks" -- the staff physician has examining privileges in the emergency room, and is called a "staff physician," but bills separate and apart from the hospital. The advocate also said that such policies were legal, and widely practiced, in NYS, and advised me to complain about such policies publically. So I am.

Dec. 09 2009 11:01 AM
Sabrina from Manhattan

MOST internists, gynecologists and general practitioners in NYC DO NOT take Medicare. And when they do, they exclude certain visits such as an annual exam. This is a very serious problem for me.

Dec. 09 2009 10:35 AM

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