Health reform stories should include private-practice docs

July 13, 2009

I read with interest IBJ’s [June 29 story] focusing on health care reform. I was not surprised by the exclusion of opinions from “real” private-practice physicians. No offense to the “doctors” who were interviewed but they were not physicians that currently work in private practice and I doubt that they ever did.

I would suggest that IBJ contact at least five-10 private-practice physicians in the area to get a better perspective on the real workings of health care. To borrow a phrase from one of my partners, we are the “trench workers” of medicine. Not to mention small-business owners that are on the front line of the health care debate. I would think that any debate on health care should involve the opinions of these private practitioners and would be of great interest to IBJ and the business community.

It’s not IBJ’s fault that we are overlooked. I certainly didn’t read that any of the directors, CEOs and administrators interviewed mentioned us either. We are constantly being squeezed by the government (Medicare, Medicaid), private insurance and the hospital systems in the quest for making health care more “affordable,” controlling costs and improving quality.

In reality, it is more about profit. Profit for the insurers and hospitals, not the physicians. On a patient-by-patient basis, we are forced to take less and less every year, despite the escalating costs of doing business. This means that we have to have more patient contacts on a daily basis just to cover our costs, let alone make our income.

We don’t get a raise every year or a bonus when we treat patients more efficiently, treat an illness or even save a life. Indeed, we are constantly being told which procedures or treatments can or more likely cannot be done because it is too expensive or not profitable. These mandates are even required by these so-called “non-profit” entities.

Eventually the private practitioner will go by the wayside. It is the goal of all area hospital systems to have all of its physicians employed by that system in some form or fashion. It is happening at an alarming rate as physicians eventually tire of the struggle of being business owners and employers and gladly welcome the “freedom” of letting the hospital run their practice. However, there will be a price to pay for both the physician and, more important, the patient.

I therefore invite IBJ to get the real scoop on health care and what proposed reforms will mean to the practice of medicine and the patients we serve.

Dr. Jonathan P. Gentile
Indiana Spine Group

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