Desperate measures: Frustrated physicians leave Medicare

AUSTIN, TX – As the administrative burdens associated with Medicare pile up, some doctors are growing frustrated and walking away from the program or limiting the number of Medicare patients they see.

While the number of physicians withdrawing from Medicare isn't a mass exodus, said Susan Bailey, MD, president of the Texas Medical Association, it's definitely a trend.

 

"We had upwards of 200 physicians resign from Medicare in 2010 as opposed to perhaps one or two a year back in the '90s," she said. "The curve is skyrocketing upward, and although 200 physicians out of a state of some 60,000 physicians may not sound like much, it's the trend that is disturbing to me. Anyone that's in practice knows that it's a very drastic move to actually drop out of Medicare altogether."

 

Bailey said the Texas Medical Association is seeing more doctors who are either not accepting new Medicare patients or spreading out how often they'll see Medicare patients, rather than opting out entirely.

Lee Gross, MD, a family care physician in Florida, stopped seeing new Medicare patients last year.

 

"The rules keep changing in the middle of the game and it's hard to keep up with them," he said.

He cited issues with Medicare reimbursement, the continuing threat of payment reductions, mushrooming

paperwork and regulations and looming budget cuts.

 

"The main thing besides, obviously, the cash flow issues is the fact that this is a looming disaster that's never been properly addressed," he said. "I don't see it as something that's able to be properly fixed."

Whether Medicare can be fixed or not, it's a big financial player that most doctors can't avoid dealing with to some extent, said Wayne Lipton, managing partner at Concierge Choice Physicians in New York.

 

"The monopoly on seniors is called Medicare, and because there's a monopoly, there's only one game in town, so I don't think you can readily cut that off and still remain in practice," he said.

 

But doctors have survived when they've reduced or eliminated Medicare patients from their practices. One of those doctors is Ezriel Kornel, a neurosurgeon at Brain and Spine Surgeons of New York. He dropped out of Medicare about four years ago.

 

"I realized it was about 20 percent of my business, but income-wise it was below 5 percent," he said. "If I was relying on Medicare reimbursements, I wouldn't be able to stay in practice."

 

Kornel offers seniors a reduced rate that they negotiate. If they can't pay, he either refers them elsewhere or takes them on at no cost.

 

"I never want it to be a burden for them," he said. "I personally want it to be fair and honest and to me it's more fair and honest when they understand that the fee that Medicare is giving me is way below what I need to break even."