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Saturday, January 7, 2012

Elderly To Suffer As Medical Practices Shut Down

Elderly To Suffer As Medical Practices Shut Down

Doctors Reject Medicare Patients As The Economy & Regulations Force Bankruptcy & Closure

By Dell Hill

“Count your blessings” is always good advice.  Today, I’m doing just that over the blessing of finding a personal physician who accepted me as a patient, despite the fact that payment for my medical services is exclusively through Medicare and Medicaid.  Most doctors are simply not taking Medicare/Medicaid patients because to do so could speed up the process of going broke.

I recently spoke with the senior partner of the medical service that accepted me as a patient.  For obvious reasons, I won’t identify him or his office, but suffice to say, he’s been in a highly respected practice for over 25 years and - along with his partner - runs a medical facility with five additional MD’s.

“You were lucky”, he said with a smile.  “You were still listed in our database as having been a patient before you moved to Texas and, now that you’ve returned, you’re still on our list.  When I saw your request I recognized the name and approved you.  Otherwise, you’d probably still be looking (for a doctor)”.

So why is this happening?  Why are medical doctors closing up shop, filing for bankruptcy, and not accepting Medicare/Medicaid patients?  I wanted to know, so I asked.

His answer surprised me.  I’ve never thought of doctors as being poor or “going broke”.  In fact, the opposite is true.  I’ve always thought of doctors as being well-to-do - rich, even.  And then I saw this piece posted by CNN Money and it all started to make much more sense.

NEW YORK (CNNMoney) — Doctors in America are harboring an embarrassing secret: Many of them are going broke.

This quiet reality, which is spreading nationwide, is claiming a wide range of casualties, including family physicians, cardiologists and oncologists.

Industry watchers say the trend is worrisome.  Half of all doctors in the nation operate a private practice.  So if a cash crunch forces the death of an independent practice, it robs a community of a vital health care resource.

“A lot of independent practices are starting to see serious financial issues,” said Marc Lion, CEO of Lion & Company CPAs, LLC, which advises independent doctor practices about their finances.

Doctors list shrinking insurance reimbursements, changing regulations, rising business and drug costs among the factors preventing them from keeping their practices afloat.  But some experts counter that doctors’ lack of business acumen is also to blame.

Loans to make payroll: Dr. William Pentz, 47, a cardiologist with a Philadelphia private practice, and his partners had to tap into their personal assets to make payroll for employees last year.  “And we still barely made payroll last paycheck,” he said.  “Many of us are also skimping on our own pay.”

Pentz said recent steep 35% to 40% cuts in Medicare reimbursements for key cardiovascular services, such as stress tests and echocardiograms, have taken a substantial toll on revenue.

“Our total revenue was down about 9% last year compared to 2010,” he said.

“These cuts have destabilized private cardiology practices,” he said.

“A third of our patients are on Medicare.  So these Medicare cuts are by far the biggest factor.  Private insurers follow Medicare rates.  So those reimbursements are going down as well.”

Pentz is thinking about an out.  “If this continues, I might seriously consider leaving medicine,” he said.  “I can’t keep working this way.”

Also on his mind, the impending 27.4% Medicare pay cut for doctors. “If that goes through, it will put us under,” he said.

Federal law requires that Medicare reimbursement rates be adjusted annually based on a formula tied to the health of the economy.  That law says rates should be cut every year to keep Medicare financially sound.

Although Congress has blocked those cuts from happening 13 times over the past decade, most recently on Dec. 23 with a two-month temporary “patch,” this dilemma continues to haunt doctors every year.

Beau Donegan, senior executive with a hospital cancer center in Newport Beach, Calif., is well aware of physicians’ financial woes.

“Many are too proud to admit that they are on the verge of bankruptcy,” she said.  “These physicians see no way out of the downward spiral of reimbursement, escalating costs of treating patients and insurance companies deciding when and how much they will pay them.”

Read the entire CNN report by clicking here.

Dell’s Bottom Line:

That, in a nutshell, is exactly what my personal physician told me just a few days ago.  He operates a private practice and his costs of operation continue to go up while his income for medical services continues to go down.  As he said, “I’d be much better off if I just closed this entire office down and went back to a ‘one horse’ practice.”  Meaning open a much smaller office and screen out all Medicare/Medicaid patients.  “But, if I did that, I’d be leaving about a thousand people without any primary care physician and I just can’t do that.  This is a small community, by comparison.  These patients are my friends and neighbors.  I can’t just leave them without medical service”.

So - when I turned 65 and became eligible for Medicare and Medicaid - I was indeed fortunate that my long-time primary care giver allowed me back into his medical practice as a patient, even though he knew that he was going to lose money by doing so.  Now I just have to hope and pray his practice doesn’t suffer the same serious financial woes of the doctors identified in the CNN report and he’s forced to shut down.

I live in a very rural area and the loss of such a service would be devastating, to say the least.  Thanks to his service, I now see better, hear better, and will be undergoing a medical procedure for the removal of another kidney stone very soon.  Most especially, at my age, I hate to think of what life would be like without having a doctor available.


  1. Welcome to readers of Conservative Refocus

    And thanks to Barry Secrest for the repost and linkage.

  2. My pleasure Dell, glad someone besides me and a few others are still talking about this...thanks for writing it my friend.

  3. That earns a blog roll spot from me. I read Barry's posts regularly, so it's a natural!