Physicians feeling Medicare strain

Nearly one in four senior citizens new to the Medicare program report having difficulty finding a physician to provide primary care, according to a government-sponsored survey.

Other senior citizens will also have trouble finding physician care if slated Medicare-payment cuts go into effect Jan. 1. That warning was issued Tuesday by the president of the American Medical Association and his Utah counterparts in a "house call" to the Wasatch Front.

Dr. William G. Plested III, a thoracic and cardiovascular surgeon from California when he's not wearing his AMA hat, said a survey of physicians found that 60 percent will limit the number of Medicare patients they see if they must take a 10 percent cut in what they're paid at a time when their overhead keeps increasing. Projected payment cuts will total 40 percent and physician overhead will increase by 20 percent in the next nine years.

The Medicare reimbursement cut applies only to physicians, not to others involved in health care, including hospitals, and that's another area of contention, Plested said.

Hardest hit will be patients who have recently turned 65 and are trying to establish a physician-patient relationship using their new Medicare coverage, or those who move and need to find a new physician.

Dr. Catherine J. Wheeler, immediate past president of the Utah Medical Association and a Salt Lake gynecologist, said many primary-care physicians are struggling because of the cost associated with running a medical practice. Each year, fewer doctors choose to be primary care, which will create even more problems in the future. And it all comes, she added, at a time when baby boomers are poised to enroll in Medicare.

Dr. Mark N. Bair, president-elect of the UMA, said he and colleagues in a Utah County emergency department already see more senior citizens and people with disabilities who have Medicare come in because they don't have primary-care physicians. Or they stop taking their medications and get so sick they end up in the emergency room. That, he added, is the most expensive option for health care.

An estimated 216,000 Utahns are on Medicare and another 63,000 patients have the military's insurance, TriCare, which matches its reimbursement rates to that paid by Medicare. Because so many insurance companies base reimbursement for services on Medicare, the effect will be even greater, said Plested.