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A growing medical menace

Patients in Maryland and across the U.S. are losing access to primary care as practices 'go boutique'

December 05, 2008|By Peter Beilenson

What are the solutions? Two entities must respond: private insurers and Medicare.

Private insurers in many parts of the country are already starting to feel the consequences of the trend toward boutique medicine in terms of shrinking numbers of primary care physicians available to join their groups. Without sufficient providers, insurers will be unable to offer participants access to appropriate care. To counter this problem, insurers must do two things: increase reimbursement rates to primary care doctors and drastically streamline their administrative requirements.

Medicare also must address the problem. Because most private insurance reimbursement rates are tagged to what Medicare pays for that service, Medicare can help push private insurers by increasing primary care reimbursement rates too. In addition, because the residency programs that train medical school graduates in whatever field they desire to enter have historically been funded by Medicare, the Medicare program must work to increase the number of primary care residency training programs in the country, in order to increase the supply of primary care providers to necessary levels.

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Only by addressing the dwindling supply of primary care physicians can we curtail the trend of boutique medicine and - more important - maintain Americans' ability to access the primary care services that are vital to our nation's health.

Dr. Peter Beilenson is the health officer for Howard County and the founder of Maryland's Health Care for All initiative. His e-mail is pbeilenson@

howardcountymd.gov.

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