Followup to the WSJ story earlier blogged today. Physicians who don’t limit Medicaid patients find themselves in binds like this:

On a recent day, 22 out of the 37 patients were on Medicaid, and another 12 had Medicare or other government-sponsored insurance. Only three had commercial health coverage. Dr. Tynes tries to make ends meet with a bare-bones staff. He has also cultivated a loyal patient base by offering specialty services such as sexual-dysfunction treatment and marriage counseling. Depending on how good business is, he tries to pay himself an after-tax salary of $500 to $750 a week to support his family of five children.

But three times so far this year, he’s forgone his biweekly paycheck to keep the practice out of the red. Last year, he cut his office staff from seven to four people. “We [primary-care physicians] are the ones keeping this Medicaid system together, but we’re the ones getting killed,” he says.