What happened to private practice?

[Art_Vandelay]

As a nurse, I can see where patients become frustrated with "the system." I can honestly say that I absolutely hate being a patient. Just calling to set up an appointment frustrates me...when I get an automated system immediately, and sometimes have to leave a message to even get an appointment. Once you do have someone on the phone line, the first question asked is not, "What is your name?", it's "Who is your insurance provider?" Will someone please clue me in? Why are doctors nowadays in these large practice groups? Who even needs names, just call me BCBS patient 54321. And the amt of time the doctor spends with me, awful.

[Rose_Queen, BSN, MSN, RN]

Short answer: Money.

Long answer: Docs have to see more patients in order to make ends meet. Insurance providers are reimbursing less and less. Heck, many physicians won't accept or strictly limit Medicare/Medicaid patients because it's actually a loss for them. Many physicians are joining with hospital corporations just to stay afloat. The hospital I work with has bought out many physician practices in the last few years, and now they are working on buying up surgeon practices as well. It's all about the bottom line.

[wish_me_luck, BSN, RN]

I agree, OP. I used to have a family physician that was by himself and not in a group and I loved that. My family and him had a falling out, unfortunately (not including me, I adored him). But, that's what I loved about him. He is a great physician (would love to go back if that falling out didn't happen), by himself, and his office was small but comfortable (not this huge waiting room that you feel like your at the doctor's), paper charts (yay! no computer charts), and you knew everyone in the office and got the same people every time. I refuse to go to the doctor's anymore (unless I have to go get a form filled out) because I HATE groups. I hate having a new person everytime I go because it's inconsistent care in my opinion. I feel like I am filling them in on whatever is going on with me everytime I go (I know they review the charts, but come on, they weren't there the last time).

I know I am so old fashioned and this was way before my time; but, I wish I could find a family doc that's not in a group that still does house calls. Even cozier than a small, comfortable office is a house call on my own turf. Oh, and would pay more.

[BlueDevil,DNP, DNP, RN]

Money. My company is looking at dumping anyone using medicare and medicaid, Cigna, and possibly even BCBS! They poor poorly and they pay late. We need people who pay correctly, and within 90 days. We just signed an exclusive contract to be the provider of choice for all the covered specialties and primary care with the two largest employers in the state. There is no advantage for us to keep patients with those payers. We don't need or want them.

I'm sick and tired of trying to figure out what so and so's insurance will cover. It's getting to the point that I order the right things and if they won't pay, the patient is just SOL. I am not going to keep spending hours of my time trying to fix it for them. They are ungrateful anyway.