My Doctor Just Fired Me

Yesterday I was reeling from the news that my bank refused to modify my mortgage. That must not have been humbling enough for the fates, because today brought yet another blow: the doctor I have seen for the past 12 years handed me a letter saying she will no longer accept Medicare as insurance, effective April 1, 2010!

My first reaction was sheer anger. How could this practice turn its back on such a long-term patient who presented her Medicare card today for the very first time? So much for the noble motives of primary care physicians. But after I dried my tears -- yes, I was crying again -- and took a few deep breaths, I expressed to the doctor how unfair I feel this decision is. And that's when today's lesson in reality began.

I assumed, like many of us have, that since my doctor is in private practice with her husband, she and her family were living it up, raking in the bucks. When I first started seeing this doctor, she and her family were in the habit of taking exciting vacations every year and she admitted that they were financially comfortable then. But twelve years later, they are skipping vacations, cannot afford to live inside the city limits, near their office, and are scaling back on their monthly expenses, just like everybody else.

The doctor explained that it wasn't supposed to be this way. She said that back during the Clinton administration, provisions were established that would shift the power away from the insurance companies and essentially neutralize the powerful insurance lobby in Washington.
However, when the time would come to pass the legislation to actually make that shift happen, our illustrious members of Congress, always fearful of the repercussions leveled by the insurance lobbyists, would decide to table it until the next non-election year. As a result, those measures never happened.

I asked her why doctors haven't been more vocal in their support of health care reform, since she said she had been looking forward to the public option component of any reform, because it would provide competition for the entrenched insurance industry. Her response was that the American Medical Association is dominated by specialists, and specialists outnumber primary care physicians by a large margin. And specialists have done quite well under the present arrangement and they are opposed to changing it.

When my doctor and her partner/husband learned that their Medicare payments would be cut in 2010 by a whopping 17%, they had no choice but to cut their ties with Medicare. They will be implementing a quasi-concierge-type medical practice, with their patients paying a negotiated price for the level of access they choose. I don't think I will be able to stay with her, but the details have yet to be completed.

I had no idea that doctors were suffering as much as they are. As I told her, I understand completely the business basis for her decision, but I still think it sucks. She agrees.