Home > August 2009 > A Physician’s Perspective on The Issues of National Healthcare #16

A Physician’s Perspective on The Issues of National Healthcare #16
By Dr. Chuck McGowen

Solution-#4: Physician Fees


Physicians, hospitals and ancillary services (radiology, laboratory and medical supply firms) generally receive checks from an HMO amounting to 30 to 50% of what they actually bill. Thus, it stands to reason that they are currently living on that 30 to 50%. At APR we are going to contact every county medical society in Ohio and request three things of our state’s fine physicians:

     #1. Since the HMOs will no longer be telling physicians how, when, where and why you treat their patients, only bill what you are now receiving in remuneration from an insurance company’s HMO.

     #2. Publish a full disclosure document that informs the public what you are charging for your various services. That would include routine office calls, complete physical examinations, EKGs, endoscopies, immunizations, etc. By doing that the market will control the price and people can shop for the best physicians at the lowest cost to their health savings account. It’s what is called free enterprise. Free enterprise, by definition, implies  business governed by the laws of supply and demand, not restrained by government interference, regulation or subsidy; also called the free market. In healthcare the demand side represents the patient and the supply side represents the physicians. This is simple economics 101

     #3. Since many physicians actually lose money in caring for Medicaid patients, some of you have chosen not to accept those people into your practice. We would ask that you physicians refer them to a community healthcare facility (a clinic for the uninsured or indigent that will be discussed in a future article.) ER personnel will likewise be advised to refer their non-emergency cases to the clinic or a physician’s office the following day.


By eliminating the HMO we will have also eliminated a great deal of unnecessary paper work and oversight that has taken up much of the time that the physician’s clerical staff has spent processing forms and preparing for on site visits by HMO nurses. For example, an HMO would call my office and request the staff to sanitize five of the charts of our patients (their clients) currently under their control. To sanitize the chart my staff would have to copy every document that had the patient’s identifying information and black out the name, address, etc. Then the HMO’s nurse would review those records to see if I was in compliance with their standards of care. One of those so called “standards” involved initialing every consultation, laboratory and radiology report. I chose not to do so, but instead preferred to follow up on such information with appropriate actions. I was cited and reprimanded by the CEO of one HMO for not complying with the inane rule to initial. Had that nurse followed up on her surveillance by looking at further laboratory or radiology reports and my office notes, she would have seen that even though I had not initialed the reports, I had responded properly on the information I had received.  One such case involved a chest X-ray that I had ordered on a diabetic smoker with a chronic cough. The report described a suspicious lesion in the left lung and recommended a CT. I did not initial the report but instead called the patient telling him about the suspicious lesion and then ordered a CT scan of his chest. That showed signs that were very convincing for a cancer. I did not initial that CT report either but I did call the patient and asked which thoracic surgeon he preferred. I then spoke personally with the surgeon. When the patient was admitted for surgery I followed him for his diabetes. I did not initial the reports from the hospital but attended to them on a daily basis. When the cancer was removed I set the patient up with an oncologist. These steps were all well documented in the file and every step performed apart from the useless initial.

Sunday, August 30, 2009, 07:30 AM

Email to a Friend  |  Printer Friendly Page  |  Permalink

Bookmark and Share

Dr. Charles McGowen's Bio


Past Posts

What is scientifically natural about same sex marriage? Nothing!
How does diabetes relate to pancreatic cancer? Don’t ask your attorney.
It is time for Washington to take off the blinders and take notice of what really works in Stem Cell therapy
The Pathophysiology of Christ’s Death
Soda Pop May Be Doing More Than Just Adding Calories
The Proof is not to be found in the Pudding

June 2013
May 2013
April 2013
March 2013
February 2013
January 2013
December 2012
November 2012
October 2012
September 2012
August 2012
July 2012
June 2012
May 2012
April 2012
March 2012
February 2012
January 2012
December 2011
November 2011
October 2011
September 2011
August 2011
July 2011
June 2011
May 2011
April 2011
March 2011
February 2011
January 2011
December 2010
November 2010
October 2010
September 2010
August 2010
July 2010
June 2010
May 2010
April 2010
March 2010
February 2010
January 2010
December 2009
November 2009
October 2009
September 2009
August 2009
July 2009
June 2009
May 2009
April 2009
March 2009
February 2009
January 2009
December 2008
November 2008
October 2008
September 2008
August 2008
July 2008
June 2008
May 2008
April 2008
March 2008
February 2008
January 2008
December 2007
November 2007
October 2007
September 2007
August 2007
July 2007
June 2007
May 2007
April 2007
March 2007
February 2007
January 2007
December 2006
November 2006
October 2006
September 2006
August 2006
July 2006
June 2006
May 2006
April 2006
March 2006
February 2006
January 2006
December 2005
November 2005
October 2005

Search this blog: