Pauline W. Chen, M.D., and author of The New York Times column, Doctor and Patient, writes about doctors and their growing anger at health plans.

While the topic is old, the emotion is reaching new levels.  Physicians’ assertions about health plan administrative burdens are supported by several studies which document the cost to doctors to comply with what they consider often needless bureaucracy and paperwork.

As her column says, primary care doctors “spend as much as one-third of their annual average income (including benefits) to these interactions with the various health plans.”

However, the even bigger losers are patients. This is yet another look at why medical students don’t choose primary care. Why would anyone willingly submit to this and handle the responsibilities of patient care at the same time?

However, in the end, it may turn out that the health plans out-foxed themselves with all of their requirements, which cost doctors out of their own pockets to meet—leaving us  chickens to scratch around for doctors on our own. A health plan can’t charge premiums to people when it does not have enough doctors for a plan network.

Medical manpower (and woman power) shortages in primary care already are serious. These shortages will only worsen as more people have insurance and seek doctors and as the population ages.

The New York Times

“As a primary care doctor posted recently on Sermo, the nation’s largest online community of physicians: “We are our own worst enemies, as we have allowed insurance companies and Medicare to set the value of our services. Clearly those values they impose have nothing to do with our contribution to the health of our patients or the cost savings we bring about.” (Emphasis added)

“The fraught nature of the relationship became clear again last month when Sermo and athenahealth, a provider of Internet-based business services for medical offices, released the results of a national survey of 1,000 physicians. Nearly two-thirds of doctors felt that the current health care environment was detrimental to the delivery of care, and more than half believed that the care quality would only decline over the next five years. Less than a fifth of doctors felt they could make clinical decisions based on what was best for the patient rather than on what payers were willing to cover. And an overwhelming majority believed that getting reimbursed was becoming increasingly complex and burdensome.” (Emphasis added)

…”These canaries (doctors speaking up about these problems) may be right. Last year, a study published in the health policy journal Health Affairs found that physicians in private practice on average spent nearly three weeks in time and $68,000 in staffing per year dealing with the particular administrative constraints of third-party payers. Doctors who were specialists could better afford to support these costs; but primary care physicians devoted as much as a third of their average yearly income (including benefits) to these interactions with the various health plans.”

Source: New York Times, April 29, 2010