Many doctors are tired of the difficulties, paperwork, and unreliability that come with Medicare, therefore these doctors (one in every ten doctors practicing in the United States) expect to eventually leave Medicare completely. Instead they will let their patients pay for their care directly.
In 2010 the American Medical Association reported that 17 percent of doctors contacted had already begun restricting the number of Medicare patients in their practices. The reasons for these restrictions were that the Medicare payment rates were too low or that threats of further budget cuts to Medicare made it an “unreliable” payer. Almost two-thirds of the doctors contacted also said that they were considering opting out of Medicare completely and instead using some type of private agreement that would be directly between the patient and the doctor.
As the federal government’s involvement in healthcare grows, the number of reasons to leave “mass medicine” has also increased. Such reasons include the red tape and delays in receiving payment, the low payments and the uncertainty of how much they will receive, excessive overhead, and the pressure to see enough patients in a day to keep their practice viable. If the number of patients a doctor sees is too high then the quality of care could be impacted. Also, due to the pressure to see so many patients there is also pressure to refer patients out to expensive specialists to relieve their workload. Additionally, the fear of medical malpractice suits leads doctors to order unneeded tests.
Doctors who have patients who pay them directly have fewer patients and can give the patients they do have higher quality care. So the idea of “direct primary care” (DPC) evolved. DPC allows physicians to group together to share overhead while at the same time staying out of Medicare. This type of care can cost patients much less than “concierge medicine”, just between $50 and $60 a month. For this monthly fee patients can receive personalized care, lab tests, basic x-rays, and stitches. There are no co-pays and no deductibles. DPC is seen as a way out for patients and doctors from the complicated requirements of the government. Instead it is just a simple transaction between doctor and patient.
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