In a guest column in the November 5, 2017 edition of the Asheville Citizen Times by Marsha Fretwell, M.D., she has concluded that she might be the last happy doctor. This is because she had practiced as a geriatrician and thus had only Medicare to interact with as more than 96% of her patients were covered by Medicare. This allowed Dr. Fretwell to spend the 30 minutes per patient that she feels she needs to properly listen to and care for her patients. The predictable [compared to for profit insurance companies?] reimbursements from Medicare allowed her to reduce her staff as they did not need to spend longer periods of time with for profit insurance companies to get reimbursed for her services.
Dr. Fretwell also indicated that our country's Surgeon General reported that second only to the opioid addiction crisis, physician burnout is the next most critical issue in health care. Even though Family Practice, Psychiatry and Internal Medicine are typically paid 50% of what other medical specialties are paid, the most often cited factor in burnout was not inequality of pay but the paperwork demands of insurers that took them away from direct patient care. The ability to form relationships with their patients was felt to be critical to providing quality health care and critical to the satisfaction of patients and physicians.
I firmly believe and have seen in my practice how important spending time with my patients is. That is why I do not accept payment from insurance companies. I have maintained a minimum of 30 minutes with my patients and will often spend 60 to 75 minutes depending on the needs of each patient. Without a relationship with my patients it is much harder to help them to recover from their anxiety, depression, flashbacks, difficulty concentrating, etc. and experience an improved quality of life that they desire.
Dr. Fretwell goes on to advocate for universal health care as she notes that since for profit health insurance providers have been on the scene, overall health care has declined in the United States. Dr. Fretwell believes that universal health care will lead to less expensive care, better outcomes, and happier patients and physicians.
What do you think?