CHANGING IN MEDICAL RESPONSIBILITIES
In addition to the change in medical responsibilities, many insurance plans will require physicians to be paid on a capitation basis, under which a physician is paid a monthly service fee by the insurance company for all the patients the HMO assigns to him or her, regardless of the number of visits each patient makes. For instance, Dr. Smith, a primary care physician, may be assigned a caseload of 220 patients per month and receive $10 per patient no matter how many times each patient visits. However, to prevent the possibility of abuse by both patients and physicians, financial incentives are built into this type of plan to encourage the primary care physician to limit repeat visits, utilize the support of fewer specialists, and order fewer tests. So while this will result in improved medical access for patients, it also means they will need to become more familiar with their Body Signals and to learn why certain medical tests they had under the old method of health care are now not appropriate.
Clearly, the way we receive our medical care is changing. In this decade, we may pay less for treatment, but we will also see fewer sub-specialists and will undergo fewer unnecessary diagnostic tests than before. Patients may find that their doctors are reluctant to schedule appointments, especially if they’re being paid so much less for each patient encounter. In addition, examinations may seem shorter and more focused on the specific health problem, and the doctor may appear to be more rushed. Your new insurance plan may actually force you to switch to a new primary care physician who is unfamiliar with your medical history or face paying higher premiums to see a physician who’s not in the HMO. As a result, most people will make the switch whether they like it or not. Without a doubt, the health care consumer of the 1990s and beyond will have to learn to make the most of each office visit.
Since patients will need to accept more of the burden of their own health care, from being screened by a nurse practitioner before ganing access to a physician to paying a larger share of medical expenses, it’s imperative that you learn how to recognize the signals your body is sending you and how to relay this information to your doctor in an efficient manner.
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