Wednesday, January 30, 2008

WHAT YOU DON'T KNOW ABOUT YOUR DOCTOR


I am your doctor, and I need your help. The New York State Superintendent of Insurance has approved a $50,000 surcharge over and above a 15 to 25% rate hike on my medical malpractice insurance, effective July 1, 2008. I cannot afford to pay such an increase, and if I don’t I will have to shut down my practice.

I have been practicing Colon and Rectal Surgery in this area since October 2000. In that time I’ve done thousands of colonoscopies and anorectal operations and hundreds of major colon surgeries. Maybe I’ve taken care of your mother, your husband, or you. I get along well with nurses and staff at the hospital. My colleagues trust me with their patients. I am famous for my “bedside manner.” I read all the time, study and go to conferences to keep up with the latest developments in my field. I teach once a week at the medical school. I’ve never been sued.

I thought for a while I was alone. I knew I had higher premiums than doctors who are in primary care. When my own primary care physician left New York, to practice medicine in Kentucky, I thought she was homesick. When my patients told me their other doctors were not taking certain insurance plans, I thought it was greed. When I lost my job with another practice, I thought it was just poor business sense. Then the AMA named New York State one of its “crisis” states. Even President Bush pushed for medical liability reform, supporting federal legislation favoring caps on non-economic damages and frivolous lawsuits.

When I started my own practice, I got a break, a stepped discount on premiums for my first couple of years. Now out of this protected period, I was shocked to write out checks for thousands, then tens of thousands every three months to keep my policy in force. Shocked last July at a 14% rate increase, and shocked again this January to hear of the 15-25% increase and $50,000 surcharge in store for this July. I made some drastic changes at the office, joined an ad-hoc committee on my medical staff, wrote a check for over $13,000 for the next three months, and held my breath. My payroll service called today to ask why I haven’t written a paycheck, even to myself, for almost two months.

I am a surgical subspecialist. My colleagues and I are some of the highest paid doctors in the world. Yet I am struggling. I can’t imagine how your other doctors, your family practitioner, your pediatrician, your gynecologist are surviving.

I am your doctor, but more than that, I am your sister, your neighbor, your friend. I’ve seen you at the library, at BJ’s, at Kohl’s. My children go to school with yours. My daughter is in Girl Scouts with your daughter. My husband coaches your son’s little league team. This health care crisis affects all of us.

I don’t live in a big house. I don’t drive a fancy car. But, you know, I take good care of my patients. Some of you have said, “I wish you were my doctor for everything!” If this crisis continues, and malpractice rates continue to rise, I will be your doctor for nothing.

Wednesday, January 23, 2008

HOW TO HELP YOUR DOCTOR


To learn more about the Malpractice Insurance Crisis, click HERE.
To contact your local representative to support legislation favoring reform, click HERE.

CLOSING THE OFFICE


On March 4, 2008, my office will be closed. I will not see patients. I will not operate or do colonoscopies. I will not make rounds. I will not write, sign, or read any medical records. I will not teach medical students. I will not open mail, check my email, or return phone calls. All calls to my office will be directed, by an answering machine, to call 911 or report to the nearest emergency room with any true medical emergencies.

I am joining a state-wide coordinated effort to demonstrate physician support for Medical Liability Reform. March 4, 2008, I will join busloads of my colleagues on a trip to Albany for the Medical Society of the State of New York’s annual Legislative Day. Representative physicians will meet with their local representatives to the New York State Senate and with the senators and assemblymen in charge of healthcare.

A medical malpractice crisis exists in New York State and without real reform of existing laws and policies, it will result in limited access to health care. In plain English, YOUR DOCTOR IS STRUGGLING.

In the past year I have taken all of the following drastic measures to meet the rising premiums on my Malpractice Insurance policy, while accommodating heavily discounted reimbursements paid by Medicare and managed care plans:



  • Restricted my practice to Colon and Rectal Surgery (in which I have advanced, fellowship training), performing little to no surgery that could be considered general surgery.

  • Refrained from taking General Surgery Emergency Room call.

  • Terminated my relationship with the lowest paying managed care plans.

  • Decreased the number of hours devoted to direct patient care.

  • Lost a medical assistant due to our decreased hours.

  • Worked without a medical assistant for over seven months.

  • Hired my husband as my office manager.

  • Typed my own consultation letters.

  • Switched billing companies.

  • Stopped my answering service.

  • Borrowed from family.

  • Borrowed from friends.

  • Borrowed from credit cards.

  • Defaulted on credit cards.

  • Defaulted on medical school loans.

  • Defaulted on my mortgage.

The check for my most recent premium payment, over $13,000, was posted yesterday at 2p.m., just ten hours before my policy was scheduled to be cancelled. I was overjoyed to care for an office full of patients today, as I will be for the next three months, except, of course, for March 4th.