Reimbursement: Medicine's Achilles' heel?

AMA Leader Commentary. By William G. Plested III, MD, Feb. 2, 2004.

AMA LEADER COMMENTARY

A few words about current events in medical practice

SEE ARCHIVES

A message to all physicians from the chair of the AMA Board of Trustees, William G. Plested III, MD.

This is the first of a two-part column on the problems of physician reimbursement. The second part will appear in the March 1 issue.

Not long ago, I wrote about how physician payments have progressively and inexorably decreased over the past decades (See column, Oct. 6, 2003). I likened this to the "limbo" dance where the inescapable result is that the bar is finally placed so low that the dancer collapses. I still feel that the analogy is an apt one, and I'm going to continue to write about reimbursement intermittently because I feel that this issue represents one of the -- if not the most -- important threats to our profession today.

I am certain all will agree that our medical liability crisis is our most important immediate threat, and I certainly do not intend to diminish in any way the importance of this problem. I am convinced, however, that this will be corrected. This travesty has grown so tremendously that the only way that American medicine will ever survive is to drive a stake through the heart of this tort evil. The alternative to destroying the medical liability system is simply to destroy medical care, which won't be the American public's ultimate choice. Unfortunately, in some areas of the country, there will be grave damage done to access before people wake up to that reality, but it will happen.

The problem with payment is much more dangerous because it is much more insidious.