Mercy Health physician moving - terminating only older patients?

[kelly73099]

My mother and I have used the same doctor for years. Yesterday, we each got a letter that this doctor was moving to a new address. My letter said, "I sincerely hope you choose to make this move with me". Mom's was a patient termination letter - she's 65 and has since confirmed with Mercy that all patients over 65 (Medicare age) were sent the termination letter instead. It encourages them to choose from a list of other Mercy doctors. Does anyone have any insight on why a doctor, or Mercy, would choose to handle this situation like this? It just doesn't seem right to me. Oh, from the letter she received yesterday, the termination is effective March 31.

[Hawk405359]

If I had to hazard a guess, it'd have to do with Medicare. Medicare is a bit more of a hassle to deal with, and may not pay out as much as other providers.

[BoulderSooner]

If I had to hazard a guess, it'd have to do with Medicare. Medicare is a bit more of a hassle to deal with, and may not pay out as much as other providers.

yep this .. more and more doctors are no longer taking medicare patients

[kelroy55]

Reading the title I thought he was killing off his older patients before he moves.

[SoonerDave]

Yeah, everything I've read suggests doctors are just getting fed up with ever decreasing Medicare reimbursements and all the hassle factor associated with them, so they just bail on the whole thing. More broadly, looks like more and more doctors are starting to just bail on their whole practice, retiring early and shutting things down between malpractice insurance premiums and government presence..

And I suspect its' gonna get a lot worse before it gets better.

[OKCTalker]

It sounds like Obamacare is accelerating the segregation of Americans into health care "haves" and "have nots." The former have private insurance and are seen by better doctors at private practices, and the latter have Medicare and are seen by not-as-good doctors who are affiliated with hospitals.

I don't mean to disparage doctors in hospitals, but if I'm good and I can earn more money by striking out on my own, then I will. If I'm not as good, then I'll remain behind as a hospital staff physician and be paid less.

[old okie]

Just returned home from taking my 91-yr-old mom to her doctor. He was going on and on about the paperwork and DETAILS now required by Medicare...and that it did not matter whether or not we had supplemental ins. or even if we were going to pay for her insulin ourselves (which we have to do, as the kind she uses isn't covered by Medicare--in spite of what those ads on TV say!). He said the rules have changed greatly, namely because people were wanting a "double" rx for their meds, so they would only have to do one co-pay. Both the ins. cos & the feds were drawing a line and saying "no" to that approach.

Fortunately, he is still treating older patients, but he is planning on retiring in 2014!

[WilliamTell]

The problem is part doctors and part government.

We've all seen news stories about (bad) doctors billing medicare / medicade billions in fraudulent charges for test and procedures that never happened. So the government rolls out with more regulations and more guidelines that further pushes away good doctors because the amount of staff they have to hire and the amount of time they have to commit to filling out the paperwork.

This is from first page google search but we've all seen the same ones in the metro every year.

50 million in fraud
http://www.upi.com/Top_News/US/2013/...1551363391854/

17.3 million in fraud
http://www.justice.gov/opa/pr/2012/D...-crm-1498.html

375million in fraud
http://articles.latimes.com/2012/feb...fraud-20120229


Can I say I blame Mercy - no
Can i say i blame good doctors for being fed up - no
Can i say i blame the government for trying to prevent fraud - no and im actually ecstatic that they are atleast trying to eliminate people who steal from the tax payer and are actually doing a good job at it.

But if im a good, ethical doctor who is in high demand i would want to move on myself.

[rezman]

[QUOTE=WilliamTell;630770]
Can I say I blame Mercy - no
Can i say i blame good doctors for being fed up - no
Can i say i blame the government for trying to prevent fraud - no and im actually ecstatic that they are atleast trying to eliminate people who steal from the tax payer and are actually doing a good job at it.[/QUOTE

I can say I blame the government. They're the biggest thief to the taxpayer there is.

[PennyQuilts]

I don't see a thief here. I see a program that doesn't work. The doctor isn't getting paid enough to make it worth his/her efforts when you consider the time and resources medicare requires. So it makes sense that he/she wouldn't want those sorts of patients, particularly when the doctor patient relationship is eroded by bureaucratic red tape.

I tend to agree that we are liable to just go to a have and have not system where people who can afford private insurance will be able to get geriatric care.

Frankly, I don't agree with the cadillac health insurance plans mandated by the government. If I had to choose, I personally would rather have had some government help for catastrophic illnesses and leave the bulk of garden variety health care to private insurance. I am becoming pretty skeptical about all the pitches for diagnostic testing allegedly "catching things early" so you can cure them. And I haven't seen many people willing to make real lifestyle changes upon doctor's advice to ward off chronic illnesses, candidly. Other than paps and colonoscopies, a lot of that stuff seems like snake oil. I constantly get advertisements for various medical scans and whatnot and figure they wouldn't be out trying to scare up business if those procedures were everything they claimed they are.

[Hawk405359]

It sounds like Obamacare is accelerating the segregation of Americans into health care "haves" and "have nots." The former have private insurance and are seen by better doctors at private practices, and the latter have Medicare and are seen by not-as-good doctors who are affiliated with hospitals.

I don't mean to disparage doctors in hospitals, but if I'm good and I can earn more money by striking out on my own, then I will. If I'm not as good, then I'll remain behind as a hospital staff physician and be paid less.

The problem is that specialists get paid a whole lot, while general practitioners, whether they work in a hospital or private practice get paid much, much less. We have a serious shortage of family practice and internal medicine docs out there precisely because they just get paid so much less than their peers, and still have the exact same med school loans. So grads often go into specialties, while only those who really, really want to do internal medicine get into it. Add the increasing medicare problems and malpractice insurance rates and you have a disaster waiting to happen.

Other than that, there's not some huge skill gap in doctors who work in private practices and those who work in hospitals. It's largely a preference thing and, in fact, many tend to work in both for a variety of reasons (when my dad was in private practice, he had to go see patients all the time in hospitals. You don't just pass off a patient to another doctor just because they can't get to your clinic). Private practice tends to have it's own associated costs that can make it hard to even break even unless you see an absurd volume in patients, which is one reason why doctors visits tend to be so short in private practice.

[Hawk405359]

Frankly, I don't agree with the cadillac health insurance plans mandated by the government. If I had to choose, I personally would rather have had some government help for catastrophic illnesses and leave the bulk of garden variety health care to private insurance. I am becoming pretty skeptical about all the pitches for diagnostic testing allegedly "catching things early" so you can cure them. And I haven't seen many people willing to make real lifestyle changes upon doctor's advice to ward off chronic illnesses, candidly. Other than paps and colonoscopies, a lot of that stuff seems like snake oil. I constantly get advertisements for various medical scans and whatnot and figure they wouldn't be out trying to scare up business if those procedures were everything they claimed they are.

I don't know what ads you see in particular, but these diagnostic tools all tend to work just fine assuming the operator is skilled. I don't know why companies are starting to run them on demand like tanning booths, but these things being new doesn't mean they don't work. They all have their value.

[bombermwc]

The reimbursement thing pisses me off, but not because of what you probably think. The doctors bailing on it aren't getting paid back as much, so they are abandoning their patients. Boo freaking hoo doctors. So that meants you have to drive a lexus instead of a mercedes. Get over it. These same physicians are also still taking private insurers, so don't start feeling too bad for them. All the Blue Cross/Blue Shields/United/Cigna/etc commercial insurers out there are still paying them. What you will see, is that they will start adjusting down to match the medicare levels though. So the physicians will start to see the reimbursement on those decrease as well.

If you ever thought the system wasn't broken, just take an MRI bill for example. That'll run you $6K, and your part depends on your insurance. That same scan on the same machine in Canada, couple hundred bucks (what it's actually worth). Why all the high overhead? That's the millino dollar question in the U.S....litterally. If you ever watch your EOB and see how much is "discounted" by being a memeber of insurance, you'll see how crazy the mark-up is. In no way does it actually cost that much money to run an MRI...in no way, shape, or form. That goes merely to pockets of shareholders, flat out.

Our system rewards those physicians who request unrequired tests...the more you do, the more you charge, the more you make. So until we can come up with a new system that rewards QUALITY medicine rather than just quantity, without just passing the cost on to the patient, we're screwed. Why should i be forced to pay astronomical amounts if my doctor is unexperienced and asks for a million tests when a more experienced one might have it resolved in 10 minutes? The current system doesn't really encourage the two physicians to discuss the case either....and they would both charge for their services as well.

It's broken in every way possible.

[Hawk405359]

We have a lot more MRI machines per capita than Canada, because patients don't want to have to wait 30 days or more to get one, which you might in Canada depending on where you live and how big the line is in front of you. If you need an MRI in the US, the amount of time you need to wait to get one on can typically be measured in hours, rather than weeks.

Health care is like anything else, it's customer driven. People who use the emergency room as doctor visits, people who want those tests and those very, very expensive machines and want it now, people who demand every physician be perfect and have no qualms litigating every issue even if the doctor did a good job, all those things get rolled into health care costs. A country like Canada rations things a lot more closely. You can't have it both ways, either you give the patient every possible tool and technique at their disposal, or you have low costs and patients have to wait, possibly living in excruciating pain for longer while waiting for their hip replacement. Doctor payments are a paper tiger in the debate.

The idea that a good doctor can look at you and come up with an accurate diagnosis is just false. Fact is, while there are unnecessary tests done, I'd be wary of any doctor who just decides in 10 minutes what's wrong with you. Our knowledge base involving diseases is expanding, we know more now than we knew 30 years ago and we have a lot better idea what we need to rule out. Unless it's a really, really obvious issue that no doctor should miss, it should take a little more time than that.

[SoonerDave]

The infuriatingly self-perpetuating evil in all this is that the litigation drives doctors to unnecessary tests merely for the CYA principle. And I'm a perfect example - had a minor shoulder pain that I could not explain, wouldn't go away; went to my doctor, she ordered an ultrasound. Shoulder is fine. But she thinks there may be some kidney cysts on the ultrasound. Now, when I hear that, it's a little spooky - but then I did research, and found out that many if not most people my age have tiny, harmless, benign cysts in the kidneys, but the doc insisted I should have an MRI to check them out. Sure enough, that's exactly what I had, precisely in line with statistics, but the doctor's assistant tells me, "well, we have to be sure." And that was purely due to the CYA factor.

And the doc never did one other thing to further diagnose my shoulder issue.

The point is that doctors are spending no small amount of their time engaging in "preventive" lawsuit medicine rather than healing.

And I realize the other extreme is that we must have mechanisms to keep incompetent doctors from maiming people, and malpractice suits are one of those mechanisms, but reality sure needs to settle somewhere in the middle. The only ones profiting are the lawyers.

[OKCTalker]

Medical care has the most complicated pay structure of anything we purchase. From my last doctor's visit:
- The examination and tests totaled $415.00 (100.00%).
- Insurance paid $173.93 (41.91%).
- "Adjustments/Discounts" were $167.90 (40.46%).
- My portion was $73.17 (17.63%).

[PennyQuilts]

I don't know what ads you see in particular, but these diagnostic tools all tend to work just fine assuming the operator is skilled. I don't know why companies are starting to run them on demand like tanning booths, but these things being new doesn't mean they don't work. They all have their value.

My point is the independent advertising. I have to think that if my physician thought I needed them, he'd send me in that direction. I don't doubt they do "some" good with certain people but just bringing in the hordes is what they appear to be doing. That's a cash cow.

[MikeLucky]

Easy answer... Medicare/Obamacare. This is just the beginning too. We'll see more and more of stuff like this happening.

[PennyQuilts]

If you ever thought the system wasn't broken, just take an MRI bill for example. That'll run you $6K, and your part depends on your insurance. That same scan on the same machine in Canada, couple hundred bucks (what it's actually worth). Why all the high overhead? That's the millino dollar question in the U.S....litterally. If you ever watch your EOB and see how much is "discounted" by being a memeber of insurance, you'll see how crazy the mark-up is. In no way does it actually cost that much money to run an MRI...in no way, shape, or form. That goes merely to pockets of shareholders, flat out.

Our system rewards those physicians who request unrequired tests...the more you do, the more you charge, the more you make. So until we can come up with a new system that rewards QUALITY medicine rather than just quantity, without just passing the cost on to the patient, we're screwed. Why should i be forced to pay astronomical amounts if my doctor is unexperienced and asks for a million tests when a more experienced one might have it resolved in 10 minutes? The current system doesn't really encourage the two physicians to discuss the case either....and they would both charge for their services as well.

It's broken in every way possible.

Correct. What you are seeing is that if you have insurance, you are billed astronomical rates. The insurance pays and you are left feeling thrilled that you were wise enough to get insurance and happy that you didn't pass on such a huge burden to others. Regardless of what it actually ends up paying, the insurance makes money because so many people want to do the right thing and purchase it. It is a scam and Obamacare, which is an insurance plan, plays right into it.

If you don't have insurance or you have a high deductible, you don't get billed the insurance rate. They bill you pretty much what they do in Canada, i.e., what the stuff is actually worth. I have a high deductible insurance plan and haven't paid more than 20% of any "standard" rate in years. In fact, I can't recall paying more than $95.00 for anything, including emergency care, EKG's etc. Total. Usually, it is about twenty to fifty bucks, including for specialists.

[WilliamTell]

We have a lot more MRI machines per capita than Canada, because patients don't want to have to wait 30 days or more to get one, which you might in Canada depending on where you live and how big the line is in front of you. If you need an MRI in the US, the amount of time you need to wait to get one on can typically be measured in hours, rather than weeks.

.

I've spent months in Canada for work and worked with Canadians at past jobs for years that were working as contractors here in the US.

You are completely wrong and you are allowing propaganda to influence your thought process.

There are billions of dollars to be made with misinformation and fear, and this is one of the areas that it is prevalent in. People allow themselves to forget that we are #1 in cost and #34 in the world in patient outcomes.

[zookeeper]

The CYA has been in place for years and something else that increased the number of testing ordered was doctor-owned hospitals. They are/were routinely referring patients to the hospital X-Ray room, or whatever, while owning a part of the hospital. Obamacare outlaws such chicanery as doctors must divest themselves of hospital ownership by a certain date.

I agree about Canada as well. The people living in Canada seem to like it very much and every system has its horror stories. It would take some real whoppers to beat the stories that come out of our own rotten for-profit system. It will take removing the insurance companies out of the system completely to ever really fix our health care system.

[Jersey Boss]

We have a lot more MRI machines per capita than Canada, because patients don't want to have to wait 30 days or more to get one, which you might in Canada depending on where you live and how big the line is in front of you. If you need an MRI in the US, the amount of time you need to wait to get one on can typically be measured in hours, rather than weeks.

Health care is like anything else, it's customer driven. People who use the emergency room as doctor visits, people who want those tests and those very, very expensive machines and want it now, people who demand every physician be perfect and have no qualms litigating every issue even if the doctor did a good job, all those things get rolled into health care costs. A country like Canada rations things a lot more closely. You can't have it both ways, either you give the patient every possible tool and technique at their disposal, or you have low costs and patients have to wait, possibly living in excruciating pain for longer while waiting for their hip replacement. Doctor payments are a paper tiger in the debate.

The idea that a good doctor can look at you and come up with an accurate diagnosis is just false. Fact is, while there are unnecessary tests done, I'd be wary of any doctor who just decides in 10 minutes what's wrong with you. Our knowledge base involving diseases is expanding, we know more now than we knew 30 years ago and we have a lot better idea what we need to rule out. Unless it's a really, really obvious issue that no doctor should miss, it should take a little more time than that.

Now compare how many wage hours it takes for the average Canadian to obtain the test, versus how many for the US worker. Doesn't matter if there is a 30 day or 1 day wait if the service is priced out of reach.

[foodiefan]

. . . all I know is that is is getting increasingly more difficult to find a Dr that will take a "combo" with Medicare. I have federal BCBS. . .elected to take Medicare as primary when I turned 65 with BCBS as secondary. Decided to switch Dr (and her lab) after a HUGE snafu with some medical tests. Still trying to find an internist who will take me mention the word Medicare, and the answer is no. Also heard "thru the grape-vine" that (under federal BCBS) if you don't take Medicare when you turn 65, all BCBS will pay is what Medicare would have approved. . . but don't know that for a fact. I fear we are in for a royal "cf".

[bombermwc]

All the bull people spread about Canadian healthcare taking sooo long to do anything is just that....bull. There are plenty European countries out there that have a better healthcare system than ours as well. In case you didn't know, the U.S. ranks pretty freaking LOW in terms of QUALITY healthcare. All the litigation crap and the drive for more money has turned it into this mess.

Sometimes I wonder if a single payer system would be better. Level the field and dont give poeple the option for all this nonsense. It's not as though all these people would be out of the job...they'd just have to transfer from the private companies over to the public system. Guess what, more people to help fun those lagging pension plans too. Oh wait....we won't have crazy insurance crap anymore with that....hmmm.

[BoulderSooner]

Lived in Canada for a short time and have many employees in Canada. They wouldn't take the US health care system for anything.

unless they want special care or the best surgeons ..