Regarding the cover story “Physicians face stark choices under Medicare pay proposal,” none of these payment schemes have been proven to be effective. What has been proven is that small, private primary-care physician practices cut down on hospital admissions and readmissions, saving the healthcare system a lot of money. But we are the very ones that could be forced out of business. It makes no sense unless you are a wonk or a lobbyist.
The solo family practice I now own was started in 1932 by a doctor who delivered me, that my dad joined in 1957 and that I joined in 2002. I also employ one nurse practitioner. We survived all the changes in the industry and have served thousands of people really well. We are the ones who know how to deliver the most cost-efficient medicine.
The American Academy of Family Physicians is not helping us. It looks as if we need to sell out to the hospitals and be miserable and give up our idealistic goals. I won't do it. What other professionals are bound by all of this stuff? Despite low reimbursement rates, we have to spend more money to keep up with regulations, buy electronic health records, hire new people to do the paperwork and help us document meaningful use, etc. The only way to stay afloat is to see more patients, order more tests, increase ancillaries. That doesn't improve care.