Reduced Medicare payments to physicians will render the program useless to millions of elderly and disabled Americans because it means many doctors will no longer accept these patients.
That's the message family physicians and others sent to Washington in testimonials delivered to Congress during a Nov. 9 - 10 fly-in event co-sponsored by the AAFP, American College of Physicians and American Osteopathic Association. The fly-in and testimonials were part of the organizations' effort to impress on Congress the need to provide a positive Medicare update in 2006.
Family physicians expressed virtually unanimous agreement that the 4.4 percent cut in Medicare payment CMS has scheduled for 2006 would force them to stop accepting new Medicare patients, relocate or close their practices. Survival, not avarice, would drive that decision because Medicare payments have failed to keep up with practice costs, FPs said.
"For example, I did multiple cancer lesions on a patient with documented squamous cell carcinoma," said Wayne Hodges, M.D., of Savannah, Ga., in his message to federal legislators "By the low end of the 'book,' the charges were $1,250. I got paid $150! And the greatest insult, after getting essentially nothing for my services, there is the risk of an 'audit' to try to get back some of the sum they paid originally."
Ultimately, continued reductions in Medicare payment will drive physicians away from Medicare, and millions of elderly and disabled patients will lose access to health care.
"I am the only physician in a rural county in western Kansas," wrote Mary Beth Miller, M.D., of St. Francis in one of dozens of testimonials submitted. "My clientele is almost completely Medicare. I am happy to serve this very special population of patients, and I feel that is a sacrifice I can make. However, if the sustainable growth formula is not repealed by Congress, I will not be able to continue to provide the care that these American citizens deserve and that I am happy to provide."
Philip Kaplan, M.D., of Manlius, N.Y., predicted Medicare cuts would force his practice to close. "A cut in Medicare reimbursement will be the final straw," he wrote in his testimonial. "We will be closed in less than one year after this takes place, leaving about 7,000 folks in our suburb without care, because there are no nearby family medicine practices taking new patients."
Others, such as Grady King Snyder Jr., M.D., of Colorado City, Colo., would be forced to relocate. "I stay out here because if I left, there would be no doctor to care for these elderly people," he said. "If reimbursement cuts continue without some relief, I will be forced to leave so I can make a living. Eleven primary care doctors have left the nearby city of Pueblo, Colo., in the past two years because of declining reimbursements and increased unfunded governmental mandates.
"We need some help from Congress if primary care doctors are going to be able to continue coordinating the care of our nation's citizens," he continued. "Otherwise, health care will become fragmented, with cardiologists treating urinary infections and gynecologists stabilizing heart attack victims."
Moreover, family physicians who do continue to serve a large Medicare census struggle to ensure their patients have access to subspecialists.
"I may have a more difficult time finding a specialist to do surgery on my Medicare patients or to accept them for referrals," said Ashwani Garg, M.D., of Lombard, Ill.
