Health care reform and
the increasing cost of medical care have been widely discussed
for years, but recent reports point to a fundamental flaw that
could overshadow the political rhetoric - the doctors who
perform the majority of checkups and everyday care in this
country are rapidly disappearing.
According to a study released by the Physicians' Foundation in
November, nearly half of the nation's primary care physicians,
including pediatricians, plan to stop practicing or reduce the
number of patients they see over the next three years. The
reasons include "increased time dealing with non-clinical
paperwork, difficulty receiving reimbursement and burdensome
government regulations."
Not only are PCPs leaving the profession, fewer U.S. medical
students are pursuing primary care as a specialty today. The
American College of Physicians reported last month that from
1997 to 2005, the number of U.S. medical school graduates
entering family medicine residencies dropped by 50 percent. An
August 2006 commentary in the New England Journal of Medicine
notes that "the fortunes of primary care are dictated not by the
health care needs of the country but by a specialty-rich,
quantity-based reimbursement system."
Even the effort to help correct this growing primary care
shortage in our area, with the recent formation of a medical
school at
Hofstra University, is, in my view, quite unlikely to
succeed. Time has proven that no medical school, no matter how
excellent it may be, is any match for the powerful economic
forces that lead doctors into the better reimbursed medical and
surgical specialty fields such as dermatology and plastic
surgery.
Many PCPs are making cut-backs. Patients are finding it
difficult to get an appointment. Some may also find they now
have fewer treatment options. A survey published in the journal
Pediatrics found one in 10 doctors who vaccinate privately
insured children are considering dropping that service because
they are paying more for the vaccines than the private insurance
companies will reimburse.
I've seen it in my own practice. While the cost of malpractice
insurance and the expenses of running a practice have risen
considerably, especially in our area, reimbursement rates from
New York area health plans for the services that make up the
bulk of primary care practices have been virtually stagnant for
nearly seven years.
In fact, national studies have found that the income of PCPs,
adjusted for inflation, dropped by 10.2 percent from 1995 to
2003, while the amount of work increased.
Primary care providers play a central role in improving the
overall health of patients as well as reducing the costs of
medical care. Numerous studies continue to demonstrate that
those patients whose personal physician is a primary care
provider have lower health care costs, fewer hospitalizations
and live a healthier life - even after accounting for age, risk
of disease, etc.
All of these reports confirm what I've been seeing as a
pediatrician in private practice on
Long Island for several years. Most of us chose private
medical practice because we want to work one-on-one with
families. We want to spend our time on the gratifying task of
caring for them. We are the primary line of defense against
dangerous communicable diseases such as measles, whooping cough
and meningitis as well as chronic illnesses like heart disease,
cancer and stroke. For those complex cases that require the care
of specialists, we serve as the "conductor," orchestrating
health care so that it is delivered in an efficient,
coordinated, timely and caring manner.
Can we ever get back to a time when doctors spent the majority
of their time doctoring, rather than pushing paper in an
increasingly futile effort to deliver that care and to cover our
burgeoning overhead?
While turning back the clock may be impossible, some PCPs are
working toward a more patient-centered approach. My group has
taken some initial steps. First, by integrating the business
practices of 70 pediatricians on Long Island, we have reduced
the administrative burdens of primary care and freed up more
time for good quality, old-fashioned patient care. We also
recently joined the Patient-Centered Primary Care Collaborative,
a coalition of major employer and physician groups, representing
more than 300,000 PCPs across the country. Through this
organization, we are approaching groups as diverse as Congress,
AARP and employers to begin to transform how primary care is
organized and financed.
The public debate over health care coverage will continue,
probably well after my generation retires. But, we can't wait
any longer to make the kinds of changes necessary to hold on to
our primary care doctors and pediatricians, while also
encouraging the best and brightest new doctors to seriously
consider a career in primary care. After all, if there aren't
enough doctors to care for our families, it won't matter how
good our insurance coverage is. We need the personal primary
care doctor to ensure the quality of our health care and to
responsibly reduce the expense of providing that top-notch care
for our patients.
PRWEB, March 9, 2010
Long Island Pediatric Group Announces Policy Changes That Will Help More New Yorkers
Allied Pediatrics of New York, PLLC (APNY), a group of 18 established and highly regarded pediatrics practices in Queens, Nassau and Suffolk counties in New York, announced today exciting policy changes that will allow the reach of their care to extend to thousands more New York children than in the past.
To cater to working parents and to prevent long wait times at the Emergency Room, APNY opened an After Hours Center in Jericho, New York in 2008. In response to a growing need for readily available, affordable pediatric care, APNY announced today changes to the After Hours Center that include the extension of their weekday (Monday through Friday) hours from 6:00 p.m. to 11:00 p.m., and the addition of Sunday office hours from 12:00 to 5:00 p.m.
APNY will also extend the reach of care available to any child - regardless of whether that patient regularly sees a doctor in the APNY system. This means that any patient with insurance coverage accepted by APNY, as well as any patient interested in paying out-of-pocket for their appointment and associated services, now has the ability to call the Center for an appointment to be seen during evening hours rather than make an expensive (and often unnecessary) trip to the emergency room. In addition to this change in policy, which opens the Center doors to thousands of children previously not eligible for after hours care, APNY also announced acceptance of several new insurances at both the Center and in all their practices' offices, including Blue Cross, Blue Shield and United Healthcare. Patients with either of these insurance plans, as well as the many others accepted by APNY, will now benefit from having a convenient, in-network resource for their children's medical services not previously available on Long Island.
"As we enter what is expected to be a tough flu season, these announcements are incredibly exciting for both us and the public at large," noted Gary Mirkin, MD, CEO of APNY. "Working parents have long-sought affordable, convenient care for their children that do not require them to make major sacrifices at work. With the change in our acceptance policy, and our ability to now accept the most widely-popular insurance plans on Long Island, we are able to provide exactly what the working parent so desperately needs."
Dr. Mirkin noted that if the Center sees a substantial increase in patients, a decision to offer even lengthier hours or open other centers will be imminent. "Our mission is clear - we aim to provide the highest quality of care to our patients. If our patients now include every child on Long Island, we will take the necessary measures to ensure each and every child can be treated. We will not turn anyone away."
With healthcare reform a major national issue, APNY's change in policy is a refreshing patient-first answer in what has become a policy-driven industry. Parents interested in visiting the Center to have their child seen need only call during office hours. Doctors affiliated with the Center caution that it serves the same functions as a primary care pediatric office, and that any cases requiring emergency care should still be referred to an Emergency Room.
To learn more about the APNY After Hours Center, including hours of operation, location, insurance plans accepted and directions, visit www.APNYafterhours.com. For more information about Allied Pediatrics of New York, visit www.alliedpeds.com.
About Allied Pediatrics of New York, PLLC:
Allied Pediatrics of New York, PLLC is a single-specialty "mega" pediatrics group created when eighteen established and highly-regarded practices in Queens, Nassau and Suffolk Counties came together to improve the quality of pediatric care. Each practice became a Division of APNY and retains clinical control over their offices. Their collective mission is to provide the highest quality care to their patients. To achieve this goal, the group supports increased clinical research, evaluation of new techniques and technologies in healthcare, and the promotion of an enterprise - wide continuous quality improvement program based on evidence-based clinical guidelines.