Saturday, May 17, 2008

Medical Ethics

The current issue of Medical Economics magazine has an interesting article about medical ethics:
A consequence of fewer physicians accepting Medicare and Medicaid recipients, of course, is that those who continue to treat these patients will be forced to see a disproportionate share of them, and suffer the economic consequences.
FP Patricia Roy of Muskegon, MI, proposes a middle ground. "Nobody can make a living caring for these folks exclusively," she says. "But I think ethically, and in the interest of fairness, we all have to takesome." Turton agrees. "Physicians work within a system," he says, "and, ethically speaking, the burden of caring for uninsured and underinsured patients must be distributed evenly throughout the physician population."

Medicare and Medicaid reimbursement will continue to decline in inflation-adjusted dollars, and possibly also in nominal dollars as well. As a sleep specialist, I will continue to see most patients referred to me by my primary care colleagues, including patients with Medicare and Medicaid.
I disagree that primary care patients have an obligation to work within a broken system and take Medicare and Medicaid. Until PCP's show some backbone, Medicare reimbursement will continue to decline.


mchebert said...

Well, I don't think PCPs lack of backbone is the entire problem. We know what is happening in Mississippi with Medicaid. The governor won't fund it, won't raise taxes on cigarettes to fund it, so the federal money won't come.

Also, I could turn Medicaid patients away on principle, but Medicaid patients are poor and have fewer and fewer options. It doesn't seem fair to punish poor people for the foolishness of public officials. There has to be a better way.

You'd think that, as the poorest state in the nation, Mississippi would have enough poor people to vote for politicians who would help them. Why do the poor constantly vote against their own interest? I don't get it.

Michael Rack, MD said...
This comment has been removed by the author.
Michael Rack, MD said...

thanks for the comments, Dr. Hebert

K said...

Thanks for the information on medical ethics.

We recently wrote an article on doctor ethics Brain Blogger. Doctors face so many different ethical questions that sometimes have no clear-cut answer. What if a doctor was out at dinner and got a call that a patient that wasn't in a life-threating situation needed his help? Should he go or should he stay?

We would like to read your comments on our article. Thank you.


Anonymous said...

I don't know if this is true everywhere but I know that in some places your medicare reimbursement goes up based on the percentage of medicare patients that you see.

So perhaps it is better to allow some people to see exclusively medicare patients.

Regarding the backbone issue, it is difficult. I had a resident comment to me once that how can the healthcare system in the US complain when the hospitals here look like 5 star hotels. We have to do our part as well.

Overall however, I do agree with M Herbert and voting but the poor are usually poor because of lack of education and the horrific news in this country (i dont just mean Fox either).

-A Poor Sleep Fellow taking a break from studying EEGs!

Herbert said...

Well, I do not actually imagine it is likely to have success.
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