I read with interest and concern the article by Howard Isenstein, "Plan B, PSOs lose steam as providers opt to form state-regulated HMOs" in the June 1999 issue of Modern Physician (page 20). This article paints a neutral to optimistic scenario for provider-sponsored HMOs. However, the jury is in.
The vast majority of provider-sponsored HMOs are dismal failures. In the article, Dr. Sokolov provides general anecdotal information "about 200 provider-sponsored health plans-many of which have been around for decades."
In general, provider-sponsored HMOs have been, and continue to be, bad businesses. A more balanced approach to reporting on this topic will save your readers millions of dollars.
Nathan Kaufman Senior Vice President Superior Consultant Co. San Diego
As a general practitioner, I am experiencing a holocaust. Organized medicine is determined to exterminate the general practitioner.
Now there is a move to unionize--a bad thing for a professional. Any physician who sells his soul to the devil, third parties or the government is no longer a professional.
Years ago, as an employed physician, I endured insult after insult from my employers. My decision then was to never again be employed except by myself. I became a general practitioner. Though I am board-certified in a speciality, I limit myself to office practice, so I can be available to my patients, 24 hours a day. This way, I do not have to be involved in hospital committees or similar activities.
I take credit cards and expect payment at the time of service. I see patients by appointment, but I'm available for emergencies. I refer indigents to the local facility supported by our taxes.
Although employers have sold them to third-party payer plans, some patients still choose to see me. Some opt out of insurance plans because their medical bills are less than their insurance premiums, or they do not want to pay for other's healthcare.
Physicians (must) practice medicine; let everybody else do healthcare.
Robert M. Webster, M.D. Jasper, Ga.