Sunday, December 21, 2008

When Primary Care Physicians Go Tone Deaf

By the way, not all physicians are necessarily sympathetic to the plight of primary care. It’s not just a matter of the members of the House of Medicine jostling over who gets a bigger share of the fixed economic pie, but, according to this newsletter, the PCPs losing their way.

With that in mind, it was with some interest that the Disease Management Care Blog – who is a “Fellow” of the American College of Physicians (ACP) - decided to investigate when it found out a letter had been sent to HHS Secretary-designee Daschle on its behalf.

The letter recommends that another ‘stimulus package’ be created that a) assists persons who are newly unemployed to access insurance coverage, b) expands Medicaid and SCHIP, c) increases Medicare payments for primary care physicians (PCPs) including a 10% payment bonus over 18 months and d) provides incentives (grants, interest free loans and tax incentives along with technical support) that increase PCP adoption of health information technology (HIT) as part of a broader effort to promote the Patient Centered Medical Home.

The DMCB understands why its ACP colleagues believe that a key ingredient for health reform is physician payment reform. It’s uncomfortable, however, with the mercenary tone of the letter. While primary care physician income has serious problems, the ACP letter above is muddling the patients’ well being with its physician-members’ economic interests. A cynic would argue that the otherwise laudable advocacy for the unemployed, expansion of government subsidized insurance, bonus payments and incentives are really attempts to preserve their members’ income levels.

The DMCB also thinks the request for a 10% bonus is bordering on nervy. Compared to the pain from the widespread mortgage foreclosures, lay-offs and vaporizing retirement funds, even the worst-off primary care physicians have little to complain about.

Is there no limit to the willingness of those in positions of privilege to seek government hand-outs, based on pleas that it’s really all about the little guy? Maybe the DMCB is being overly sensitive but a word count reveals the word ‘patient’ appears 8 times in the letter, while the word 'physician' appears 15 times and the word 'payment' appears 11 times. Conflict of interest anyone? Or is this just a case of tone deafness?

Maybe there is an element of truth to the notion about losing their way.

No comments: