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Medicine Needs CPR

Had Trouble Finding a Doctor Lately?
We, the physicians of Humboldt and Del Norte County, want you, our patients, know that the state of medicine in this area has deteriorated greatly over the past years, and is in danger of falling into dire straits right now. There are many reasons why that is so, and we cannot claim to understand them all, but the fact remains that local medical care is falling apart.
This is what we know:
1. People are having trouble finding a doctor. The local medical society had to drop its physician referral program because the number of calls from people wanting help finding a doctor became unmanageable, and the medical society didn’t have anyone to send them to anyway.
2. Hospitals are providing more services for ever-decreasing reimbursements. The region’s largest hospital, St Joseph’s, managed to pull itself back from the brink of financial insolvency, but not by much. Recently St. Joseph’s rehabilitation program came very close to having to be shut down for lack of funding. To avoid bankruptcy, all hospitals have been forced to run at maximum efficiency which results in fewer open hospital beds with less staffing when hospitalization is needed.
3. The availability of subspecialists is at an all time low. The area has gone from having three or four Ear, Nose and Throat specialists to just one. We previously had 3 neurosurgeons—now there is one. All the local hospitals used to cover orthopedics. Now only St. Joseph’s has 24/7 orthopedic coverage, which is maintained at great cost to the hospital (thank you St Joe’s!). According to a survey done by SJH, there is a 4 month wait to see a neurosurgeon, a three month wait to see and Ear, Nose and Throat specialist, a two month wait to see a neurologist, and a one month wait to see an orthopedist—IF you can get an appointment. 43% of primary care offices do not accept MediCal, and 26% of non primary care practices do not accept MediCal. 18% of offices do not accept MediCare. Many offices are closed to any new patients regardless of coverage.
4. We, your doctors, are getting older; recruiting new doctors is increasingly difficult. (insert graph) When we age and retire, no one is coming to take our place. Selling a private practice to a younger physician is not only impossible, it’s a joke. The income to be made here is not enough to attract young physicians, even with a salary guarantee. Most new graduates are going to work at HMO’s like Kaiser where they have regular hours, limited on-call time, and a guaranteed income.

We, your doctors, care about the health of Humboldt and Del Norte Counties, and we want to see excellent medical care provided to all its denizens. Many of us believe that a single payer solution would be the best way to improve access to care, eliminate waste and duplication, and allow for the co-ordination of the various participants in the medical care system. (What system? There is no system now; that is a large part of the problem!)
However, we know what gets in the way of us taking care of you:
We get stuck in reams of paperwork with numerous different insurance companies who require us to study and debate numerous different contracts. We fill out volumes of forms to try and get you the medication and the treatments you need because insurance companies have denied the treatments we recommend or the drugs we prescribe. These companies also, at times, delay payment of claims or refuse to pay claims at all. We have to hire full time staff to help us overcome the obstacles put forth by insurance companies just so we can get paid. It’s not fun, and it is very expensive.
Reimbursement from most government programs is inadequate, and at times the reimbursement from insurance companies is too, if we get gulled into signing a disadvantageous insurance contract (we went to medical school, not business school). The standard reimbursement for a MediCal visit does not cover our overhead costs,, much less leave any payment for the physician. No business can maintain itself that way.
Inane regulations pull us away from patient care and require us to spend time doing less important work in order to meet legal requirements.
Insufficient numbers of doctors work here, and there is no good way to recruit them
We all need to work together to solve this health care crisis. We wanted to let you know that we, your doctors, are worried, and are dealing with an unprecedented scarcity of resources and working under poorer conditions than we ever anticipated. We are watching as the structure we work in disintegrates around us. We don’t have all the answers, but we want to be part of the solution, and the first step is voicing the problem. We did not feel that it would be right to stand by as things fall apart and not communicate anything. We did not want you to find out about the problems by not being able to get medical care when you need it. We want you know of our concern.

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