It is possible to find good physicians and get good care in an HMO, but only if you demand it. An HMO prefers to have only healthy, young adults in their care. If you have a medical problem, trouble can be ahead. Each physician gets a report card periodically about how many tests they have ordered and how many referrals to specialists they have made. Their salaries are affected if they order too many. Most HMOs also have a limit on the amount of time to be spent with each patient. I would last in an HMO about 10 minutes. There is no way I would tolerate these rules. Some patients take a while to really get to the bottom of their problems. Getting to know your patients as a physician is one of the true joys of practicing medicine. You become a very important part of a patient's life and a long term relationship brings many rewards, not financial, but very special.
Before you enroll in an HMO it is important to answer a lot of questions and also carefully read anything you are given to sign. You want to be sure of which tests are allowed for you and your children. You also want to know if they will pay for emergency care in another hospital if you are traveling. For your children, does the plan pay for immunizations, yearly physicals, lab work and ER care? Also, who will see your children? Will it be a pediatrician or a nurse practitioner? I saw a two- year-old one day with a severe degenerating disorder. The parents said their child was seen at the local big Kaiser.I asked the name of their pediatrician, so I could send him or her a report of my examination. The parents said they had never had a pediatrician or M.D. but the child was seen by a nurse practitioner. The little boy had a progressive, life threatening disorder and I was appalled. I met the CEO of a large Kaiser on an airplane and told him about the boy. He said not having an M.D.was impossible. He gave me his card and when the child died a few months later I tried to locate him, but he had moved. I will never forget that little boy.
Comments