The individual who developed the concept of HMOs later said he regretted doing so. There are some excellent doctors in HMOs, but I do not understand how any physician could tolerate their rules. HMOs have rules about everything, including how much time can be spent with a patient, how many referrals to specialists can be made and many others rules. I would last about 10 minutes in an HMO. Thus, I have great respect for physicians who decide HMOs are not for them and move to their own or a group private practice. One of the other problems with HMOs is they allow nurse practitioners to see patients without a physician being involved. A good nurse is worth his or her weight in gold, but nurse practitioners do not have the years of training that medical doctors do and should not see patients without supervision. I have seen some real tragedies occur when this takes place. One tragedy was my own mother's medical care. My parents loved their HMO doctor, even though he was greatly incompetent. He would ask me what tests to order for my mother. As a pediatrician, I was certainly not the doctor to consult.
I am always puzzled when people who can afford private insurance stay in an HMO. I realize that sometimes the people with the most money are the ones who hold on to their money the tightest. Having great wealth wealth does not make them smart about medical care. Sadly, they may pay a high price for not having private medical care and an excellent private physician.
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