Charles King: “I practiced with my wife””also an internist””and we tried to practice exactly as the ABIM proposes. Eventually, we were forced to retire and leave patients whom we had taken care of for as long as 39 years. We practiced preventive medicine and tried to protect our patients; our motive was only to help them, and we chose never to compromise those ideals. We never treated a patient differently from the way that we would want to be treated, and we always tried to put our patients’ point of view first.
For the ABIM’s proposal to work, there must be a change in the way payers reward physicians, and unfortunately, I do not see how that can be controlled. Presently, doctors are rewarded for letting their patients get sick enough to require hospitalization, and payers reimburse for technology (radiology and special procedures).”
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There is no foreseeable future of third party payers paying for primary care docs to practice the way it should be done. The only way to support that financially is direct patient payment. While that means that quality ethical medicine is only available to the few, better that than for it to perish from the face of the earth altogether. Those who drop out of the system and practice medicine as it should be practiced do all the rest a service by setting an example and preserving the light as medicine enters a bureaucratic dark age.
Gosh-damn, it’s such a miserable state of affairs. As undergraduate freshman who is considering pursuing medicine, I have to consider if want to enter into this kind of hell. I’m ignorant and naive, but I champion primary care nevertheless. However, there is so little damn incentive to become a primary care practitioner. That sucks. All my ideals of medicine have evaporated ever since I caught wind of the many issues pressing medicine these days.
I’ve been jaded!
anon 3:18
you are correct to be negative here. If you must do primary, try to develop a business model that is based on cash, not insurance, and keep your costs down!!
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