Dr. Susman’s editorial, “Is your practice truly patient-centric” (J Fam Pract. 2012;61:70) struck a nerve with me and, I’m sure, with many other family physicians. I fear that we have allowed too much third-party encroachment into the doctor-patient relationship.
Instead of working directly for (by which I mean being paid by) our patients, we are often working for a third-party payer. The result? In a world of increasing overhead costs and declining reimbursements, our offices have had to achieve industrial-type efficiencies just to make ends meet. This is not conducive to warm, mutually respectful doctor-patient relationships.
The truth is, many physicians do use a Web-based appointment and/or preregistration system. Many physicians have championed greater access for their patients. Some have jettisoned the third-party payment model and work directly for their patients, while others have found ways of being more patient-centric while continuing to practice within the third-party payment model. I’ve benefited greatly from hearing from such innovative physicians.
I would encourage your readers to visit to learn more about the Ideal Medical Practices Organization. The ideas being developed by this nonprofit group may well help us create truly patient-centric practices.
Jack Shepherd, MD
Matthews, NC
Why aren’t we more patient-centric? The short answer is that patients are not our customers—insurance companies and the government are. Keeping them happy is the primary focus of health care today, from medical records to IT to protocols and social services. Third-party payers have so many requirements and expectations that they crowd out whatever time, energy, and resources might otherwise be focused on patient care.
Sadly, in most settings, taking care of patients is a low priority. That reality is accentuated by the fact that fewer and fewer physicians practice independently; for many physicians, medical practice is just a job.
I still own my own practice, but I’m barely hanging on amid the onslaught of requirements.
But what options are there? Those annoying questions Dr. Susman wrote about, that patients are hit with as they walk into a medical office, are mandated. Even electronic medical records, which once seemed so promising, have been turned into data-gathering tools since the government—and the Certification Commission for Health Information Technology—got involved.
Our health care system is imploding from an overwhelming (top down) burden while our leaders sit by.
Keith Stafford, MD
Greer, SC