RESHAPING HEALTH CARE: Managed Care’s Impact On Doctors
Starting Sunday and ending yesterday, the Bergen Record ran a series of articles investigating the impact of the managed care revolution on patient-physician interactions. Reporter Lindy Washburn based the series in part on a "survey of physicians in Bergen and Passaic counties conducted by the Record with the cooperation of the Bergen County Medical Society and the Passaic County Medical Society" (7/12). Click on the story headlines below to read the full text of each article:
- "A World Turned Upside Down" -- Lead paragraph: "Dr. David Butler received the 'Dear Provider' letter last summer. CIGNA HealthCare, a big national health plan, was cutting its rates 'to remain competitive.' From now on, the busy Englewood obstetrician and gynecologist would receive $222 less each time he delivered a CIGNA baby, a 9 percent cut from the insurer's previously announced fee. No discussion, no negotiation" (7/12).
- "HMOs Establishing Barriers with Patients" -- Excerpt: "The bonds once forged between doctor and patient as patients received good news and bad, disclosed intimate problems, survived harrowing emergencies, and endured difficult passages through pain and illness, are being shaken. A third party -- the managed care company -- is becoming an active, and often unwelcome, presence in the relationship" (7/13).
- "Solo Practitioners Lack Leverage" -- Excerpt: "Dr. Michael Ardito flips on the lights in the exam rooms, grabs a chart, and opens the waiting-room door to invite his first patient in. It's 1 p.m. on a Wednesday afternoon -- a time when many doctors are off golfing. These are Ardito's busiest hours, but the appointment book shows just five more patients scheduled for visits. ... Now, like many doctors who've surveyed the new medical landscape and don't like what they see, Ardito is convinced that there's no room anymore for solo practitioners like him. On June 1, he sold the practice to St. Joseph's Hospital and Medical Center in Paterson" (7/14).
- "Specialists Hit Hardest by HMOs" -- Excerpt: "Sam Snyder, a Westwood orthopedic surgeon, worked his way through medical school selling scrimshaw. ... Nowadays, the 40-year-old Ivy League graduate figures he might earn as much from carving as he does replacing hip joints. While his surgeon's fees have been plummeting due to managed care's cost-containment policies, a palm-sized oval rendering of a square-rigged schooner can fetch $2,000. So, for the first time, Snyder, who has been in practice for eight years, is preparing magazine ads to sell some of his artwork" (7/14).