Big business dominates health care...health care bows to big business

Pretty good article telling it like it is...the healthcare business...where doctors no longer get their patients from referrals, but rather directed to them by managed care...and then have to see as many patients as possible to pay the rent..BD

In a health care system run by businessmen, patients should expect to be harmed and doctors should expect to be sued. What's unforgivable is that we (doctors, hospitals, plan-members and the uninsured) go along with it.

To recoup their loss, doctors treat more patients in less time. "More patients in less time" is a toxic recipe for substandard care. Some PPO doctors treat a remarkable 30 to 35 patients a day. In a letter to The New York Times, Dr. Michael Harel comments: "Practicing under price controls, as most physicians do today under Medicare and managed care, does not leave us much choice when malpractice insurance premiums rise. In order to balance the books, one has to increase one's daily office visits by reducing the allotted time per patient, which sooner or later will negatively affect quality of care and result in more malpractice suits." It's astonishing there aren't more lawsuits.
Like you, doctors don't have much choice. A patient can use only doctors on the PPO provider list, and doctors can see only patients who subscribe to the same managed care organization the doctors contract with. In a climate where managed care organizations decide which doctors will be on the PPO provider lists, doctors can't build and maintain a practice based on referrals. Their reputation is not their primary source of patients. Their primary source is managed care organizations, and in the same manner managed care organizations can funnel patients to doctors by signing them to PPO contracts, so too they can funnel patients away by declining to renew PPO contracts, and there is nothing the doctors can do about it.
Though managed care executives work doctors hard and shave them with steeply discounted reimbursement rates, they pay themselves extraordinarily well.