PHYSICIANS: OPTING FOR “LUCRATIVE” SPECIALTIES
"Thousands of doctors, frustrated by the price controls, redThis is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
tape and sometimes intrusive oversight of managed care," have
switched to "lucrative" areas such as cosmetic surgery and
infertility treatment where patients pay directly for services,
NEW YORK TIMES reports. A growing number of Americans are
willing to pay handsomely for elective procedures that insurers
will not cover. Fees for these procedures are often "far higher"
than what doctors can obtain "under managed care for work
requiring comparable skill and time." The TIMES reports that the
switch to elective procedures is not "surprising," given that
managed care "has been cutting the flow of patients and sharply
reducing fees for many specialists."
GOLD RUSH: A California plastic surgeon, Dr. Randal
Haworth, said that by "concentrating on cosmetic surgery,"
doctors "are not held fiscal and emotional hostage by these
people in managed care; secondly, by refusing to join their plan,
you are not obligated to accept what they pay." Dr. Frank
O'Donnell, a St. Louis ophthalmologist, added, "It's pretty hard
to scramble to replace a 50 percent reduction in reimbursement."
THE BENEFICIARIES: Physicians practicing cosmetic surgery,
ophthalmology, gynecology, urology and ear, nose and throat
specialties have benefitted by leaving managed care. The
American Academy of Cosmetic Surgery reported that "the number of
commonly performed cosmetic procedures doubled" between 1990 and
1994. According to the American Society of Plastic and
Reconstructive Surgeons, in 1995, 40% of plastic surgeons
reported cosmetic work as their main business compared with 32%
percent in 1991 (Freudenheim, 8/24).