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Not Enough Doctors (except in Tucson)

by on Jan. 25, 2010, under Health

There’s an article in today’s Arizona Republic about doctors in Yavapai County turning away Medicare patients.   The reason is said to be a combination of too few doctors and low Medicare payments. The interesting point for Tucson residents appears in the following paragraph from the article:

The ratio of primary-care doctors to population is below the national average in all Arizona counties except Pima, Gila and Coconino counties. The situation is pronounced in Yavapai County, where one out of four residents is enrolled in Medicare, a rate nearly twice the national average. There, the ratio is 5.3 primary-care doctors for every 10,000 residents, below the national average of 10.5 per 10,000, according to a December 2009 St. Luke’s Health Initiatives report on primary care.

Tucson apparently has plenty of doctors and almost all take Medicare. Most doctors are also contracted with the Medicare Advantage HMOs, which have very large lists of primary care physicians and specialists in their networks.

I have heard complaints from a few doctor groups about the HMOs requiring prior authorization for tests. Doctors complain about the paperwork involved and refusals coming from the insurance companies. A recent story I heard was when a doctor requested an MRI for a patient with shoulder pain. The insurance company said “no” to the MRI and recommended physical therapy.  The patient contacted his insurance agent and said, “Get me out of this Medicare Advantage plan!”.

The big news in Benson is that Dr. Barbara Hartley is quitting Medicare Advantage HMO’s and only taking Medicare. The paperwork involved with the Medicare Advantage plans apparently takes up too much time for the doctor and her staff.

Here is the link to the Arizona Republic article: 

http://www.azcentral.com/arizonarepublic/news/articles/2010/01/24/20100124biz-medicaredocs0124.html

This entry was posted on Monday, January 25th, 2010 at 2:50 pm and is filed under Health. Tags for this post: , , , , , , , , , , , . You can follow any responses to this entry through the RSS 2.0 feed. Both comments and pings are currently closed.

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  • karynzoldan

    I have friends who are on Medicare and they lost their University Health Plan coverage and now must find new doctors. They have had the same doctors for many years and the husband has some serious health problems. They are devastated.

  • Matt

    “A recent story I heard was when a doctor requested an MRI for a patient with shoulder pain. The insurance company said “no” to the MRI and recommended physical therapy.  The patient contacted his insurance agent and said, “Get me out of this Medicare Advantage plan!”…
    That course of action is not only true with the medicare plans but also for most if not all AHCCCS plans as well, with the the excuse from the Dr’s being that “the insurance company” deems that anyone who needs one of these procedures is either seeking medications or being a hypochondriac.
    Basically what it boils down to is that the insurance company(ies) AHCCCS plans included, do not want take a preventive course of treatment by allowing Doctors to order these essential and needed diagnostic tests because in the sort run, the tests cost more than it does for a simple X-Ray, which do not show pinched nerves and the like an MRI or CT does either at all or in the same resolution of the latter examples.
    They would rather have the patient or a supposedly cheaper course, which is most of the time a PT session which, when performed without knowing what is actually wrong can worsen a condition and end up costing the patient and the system much more over the long run.
    These actions need to stop and we need to let the doctors make the decision as to whether or not these tests are needed and take it out of the hands of the Bean Counters in Phoenix who are most of the time, not even someone who has proper medical training. Another thing making this whole situation worse is that now with OBAMA! care on the horizon ( not even taking the current political happenings in to account) the companies are starting to pass the buck so to speak, on the misnomer that this, even if it does pass, is going to go into effect immediately and that they either do not have the funds or that they will be going out of business tomorrow. They are banking on the fact that most of the traditional people who are on Medicaid, do not pay attention to news and/or politics and that they don’t want to be bothered with such issues, when in fact they do.
    What we need to do is fight the current so called heathcare reform bill currently in Washington and concentrate more on Common Sense reform such as Tort Reform, legislature on Healthcare provider interstate competition, having Providers remove the Pre-existing conditions clause and a plethora of other measures that would reduce the cost of business in the favor of you and me and would result in lower costs.
     
    To me, this Just Makes Sense(TM) and is just my two cents. Of course, I may be completely wrong… Then again, I’m probably not.
     
    Matt

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