From an eye doctor. Read the whole thing.
The way HMOs make money is by charging patients a yearly fee for medical care, and then trying to keep the utilization of medical care as low as possible. They do this by denying certain treatments, medications, and tests. And, they usually pay physicians what is called “discounted fee for service”, which means they only pay a percentage of the physicans charges, rather than their actual bill. What this basically means is that physicians get shafted, not just because their bills don’t get fully paid, but because this giant bureacracy, which is geared towards denying as much care as it can, is between the doctor and the patient, preventing the doctor from caring for the patient the way they believe the patient should be cared for.
Trust me, it’s very frustrating to not be able to give someone the medication you want to, or to have to fill out a bunch of paperwork to justify a CAT scan or a consultation with another doctor because the HMO doesn’t want to have to pay for these things. So, that in a nutshell is why the trend is for doctors to avoid HMOs if possible, and I’d expect that trend to continue. And, as as unfortunate result of that, patients will find it more difficult as time goes on to find physicians willing to care for them. When you add in all the physicians who are dropping out of the Medicare program, there’s a real potential for some serious doctor shortages in certain regions of the country.
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