MANAGED CARE: Doctors Flee State for Greener Pastures
California physicians are leaving the state in droves, according to state and county medical associations, the East Bay Business Times reports. Many blame the doctor drain on managed care and point out that doctors are leaving for areas where the money they make can buy a better quality of life. According to the U.S. Census Bureau, over the last decade, California has fallen from eighth in the nation in per capita ratio of doctors to 12th, with 244 physicians per 100,000 residents. "Unlike ... high-tech businesses ... there's no particular reason for a physician to [stay] here; you can earn the same living and own a nice home somewhere else," pediatrician Elliot Lepler, a member of the Camino Medical Group, said. Physicians are also fleeing the state because low managed care reimbursement rates "make it more difficult for doctors to cut a profitable business." William Parrish, executive director and CEO of the Santa Clara County Medical Association, said, "A lot of people think that when they buy coverage, the money goes to support their primary care physician. Often, eight to 12 cents (for every dollar) goes to the primary care doctor; that's gross, before expenses." Based on a PricewaterhouseCoopers report prepared for the California Medical Association, the average capitation rate in the state reached its pinnacle in 1993 at $45 per month. Last year, the rate sunk to $29, while the cost of living jumped 25.2%. In addition, the report concluded that "many of California's physician practices are on the verge of financial collapse." Noting that only four HMOs cover 80% of the state's managed care patients, Lepler said, "[A] single physician cannot afford to refuse a contract or he loses access to a large number of his patients" (Shepard, 7/24).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.