After reading "Critical Mass." [July 10, 2009] and learning about the universal healthcare "experiment" that has been going on in Massachusetts since 2006, I find it incredible that all physicians have not left the state. It is only common sense that universal coverage does not guarantee universal access, but it is apparent that common sense does not apply here.
What's really disturbing is that the state has the highest per-capita ratio of primary care physicians to residents in America, yet the average wait time for a new patient to see a primary care internist is eight weeks!
On reimbursement: "While I didn't go into medicine to get rich . . . I never thought I would have to struggle so hard to pay the bills if I was a good doctor who was willing to work hard."
And this from a physician who is seeing 30 patients a day, with a seven-page waiting list of new ones? I'm sorry, but I challenge any physician to provide truly compassionate, top-tier medical care by seeing 30 patients per day. Unfortunately, that is the world of primary care docs in Massachusetts. No wonder so many are leaving.
The good news is, for you 75 percent of physicians who voted for President Obama, you will soon be sharing Dr. Atkinson's frustrations. Of course, the Congressional Budget Office predicts that even with "universal" coverage, 10 million out of the nearly 50 million uninsured in America will still lack coverage (details, details!), and the costs will skyrocket to more than $1 trillion over the next 10 years.
Your reimbursement will be cut to pay for the program, you will be overwhelmed with crushing demand for new patients, your paperwork will increase, and your quality of care will diminish as you see your 30th patient of the day.
The Massachusetts program sure sounds like a model for healthcare delivery on a national scale. I don't know about you, but I can't wait!
JOE BADOLATO, DO
"Critical Mass." should be required reading for all the socialist physicians who support state-run insurance on a national scale. My only hope is that when the policymakers realize that no doc with half a brain will accept the public option because it pays so badly, and then they try to make licensure contingent on such acceptance, we still have a Supreme Court that respects the doctrine of uncompensated takings above "empathy."
JOHN WILLIAMS, MD
A new locum
I read cover-to-cover several medical magazines per month, Medical Economics being one of them.
Elizabeth Pector's article ["Top-down, bottom-up, and medicine in the middle," July 10, 2009] was fantastic, right to the point, and extremely well-written. Now how can we get all of the legislators to read your article and heed its message?
After 27 years of struggling as a solo FP in a small-town practice and giving compassionate care to my patients and friends, I have decided to close my practice and go on the road as a locum physician. Thank you, government intervention. You've won again.
Keep up the articles, Dr. Pector. You've got my support 100 percent.
CHARLES L. COSTER, DO
An overdose of logic
The article by Dr. Pector was very well-written and exactly on target. Because it is so on target, I doubt if anything like this will be done in Washington. It is far too logical for the policy wonks to accept.
DOUGLAS MORRELL, MD
Between the generations
In response to "Bridging the generation gap" [March 6, 2009], I am living this as the administrator of a seven-physician family practice in Arizona. I have four mature physicians from the "old" school and three younger physicians. One of my physicians will be retiring in a year, and I am recruiting another younger physician. Two of my younger physicians, both female, job-share via part-time schedules to raise their families.
I am in the generation between the mature and younger physicians, and enjoy working with both schools of thought. There are pros and cons for each generation. The one thing that is obvious is that healthcare will be changing on so many different levels that, with the retirement of older physicians, the dynamics of the provision of healthcare services will be fundamentally different.
MS-HCM, CMA, CPC, CCP, CMSCS, CPM