Hard times for doctors mean less access for poor

With reimbursements low and expenses tight, more than a third of U.S. physicians have discontinued accepting new Medicaid patients into their practices, while more than a quarter see no Medicaid patients at all, according to the preliminary results of a national survey from Jackson Healthcare.

Given that Medicaid enrollment is expected to surge by 22.8 million by 2019 under the Affordable Care Act, access will become even more difficult for low-income patients, according to Richard L. Jackson, chairman and CEO of Atlanta-based staffing firm Jackson Healthcare. More than half (51 percent) of primary care physicians--often patients' first point of contact in the healthcare system--said they were not accepting new Medicaid patients.

"This is creating the perfect storm that will make it very difficult for the poor and elderly to access a doctor," Jackson said. "Physicians say they just can't afford to be part of a system that generates so many patients for so little compensation."

The same survey of 2,232 physicians across all specialties found that 17 percent of all physicians and 26 percent of PCPs said they could no longer afford to see new Medicare patients, while 10 percent overall reported not seeing Medicare patients at all.

Physicians' frustration with declining reimbursements and increased pressure to see more patients in less time fueled a lively panel discussion about concierge medicine at the American Association of Clinical Endocrinologists 21st Annual Meeting and Clinical Congress in Philadelphia, Medscape Medical News reported. While doctors who had made the switch to a retainer-based model that capped their patient load around 600 raved about their ability to once again enjoy practicing medicine, other physicians criticized the approach.

"I really believe these people doing these concierge practices are cherry picking," physician Richard Guthrie told Medscape. "They're taking patients who can and will pay. There are some people who simply can't. Somebody's got to take care of them; I'm the guy who takes care of them."

To learn more:
- see the statement from Jackson Healthcare
- read the preliminary results of the survey
- see the post from the Daily Caller
- read the story from Medscape Medical News