YOUR MARCH 20 editorial, "Curbing the power of HMOs," contained a number of factual errors. The most blatant one was your assertion that "medical decisions are made not by physicians . . . but by bean-counters. . . ."
I have been a sole practitioner for 25 years in Columbia. My specialty is family practice and I belong to several HMOs (over two-thirds of my patients are members of HMOs).
I have never been told how to practice medicine by any HMO.
I have been given practice guidelines on selected diseases (like asthma and heart failure) and continuously encouraged to practice preventive medicine, including counseling patients to have mammograms, PAP tests and the like. As a result, the quality of medicine is improving because medical decisions are made by physicians who are encouraged to act in the best interest of patients by HMOs.
There is much data to show that HMOs have lowered the cost of medical care.
There is no data showing that quality of care has suffered. In fact, many more people are obtaining preventive care than in the past because HMOs are not only encouraging this care but are paying for it as well.
Frank Bruno, M.D.