…Kevin Pho on kevinmd.com comments with his article, Shortage of primary care threatens health care system….

…It’s one thing to gripe as a patient, but it’s another to try to do something about it.”[...]

All complainers should be dismissed from care, as not needing it.

If distressed by a symptom, I don’t care if my doc is Lucifer on a bad day. I want relief. I do not want a friend. I get my friends outside of care, and I do not have to pay high fees.

The reason patients are angry is because the physicians DON’T spend enough time with them, mostly because they keep signing up to be paid for maximum turnover.

I place most of this at the foot of the altar of arbitrary guidelines and fear of malpractice.

What is do be done? Will doctors ever regain their voice in truly advocating for patient care? I am not holding my breath but I hope that doctors will start listening to their patients and not just following whatever guidelines have just been published! I hope that doctors will again be advocating for their patient’s best interests. But that is just my opinion……

Unfortunately, I don’t think that will happen as many docs have become comfortable with the status quo and do not want to discuss their fees with patients. The only time I get information on fees is when a claim has been denied and the usual fee for an ov is listed at $150-200, not the $60 (paid by insurance companies) reported in previous comment sections on this site.

I do blame the patients. They are not innocent in all of this. No, they do not enjoy the benefit of "transparency", something that has been nicely obscured by insurance companies and Medicare with their payer-specific schedules. But the patients are complicit; they and their employers who pay for "coverage" are willingly although sometimes ignorantly shrugging not just the sense of obligation to pay but also the obligation to have to even bother learning about payment.

There are no innocent parties here.

Payors (medicare , medicaid, and/or insurance companies), patients and doctors represent 3 corners of a triangle. It is absolutely in the payors best interested to pit the doctors against the patients, so they, ie the payors, continue to smell like a rose.

How often do we in the primary care world hear patients state, “You need to get this approved for me” rather than “My insurance company does not cover this.” How many times does a mail order pharmacy, which saves insurance comanies money, screw up a scrip and the patient blames the doctor for not making the refill request in a timely fashion? How about copays? “Why do I have to come in, you just want my copay.” We do not set your copays, your employer and insurance company do. I can go on and on.

Although frustrated, I do not blame the patients. This is a concerted effort to pit patients against doctors, and vice versa, when the problem is the payors. “Transparancy” is meaningless. What we need is mutual respect, reaffirmation of the doctor-patient relationship, and a concerted effort against the payors, which are the problem.