AUSTIN: GREAT! and sometimes NOT so much….

I’ve been visiting Austin since the 70’s, because I’ve had family here. I’ve had so many great experiences here! I do want to share one story that’s not so great. I moved here a number of years ago from out of state.

I’m retired, and on Medicare. I looked for a primary care doctor for MONTHS, and couldn’t find one who took Medicare. After 6 months, I FINALLY found a doctor who would see me. I made an appointment, went to see him, and was quite pleased with our initial visit. Soon after, however, a clerk from the medical practice called me. She said, “I’m terribly sorry, but we made a mistake—we’re not accepting Medicare patients anymore.”

”Well,” I said, “I guess Dr. X will have to decide whether he is willing to continue to see me, or not.” He did decide to continue to see me. I have had access to medical care ever since—due to a clerical error!

Medical practice is regulated by the States. In many states, it is considered unethical to refuse to see a patient, once you’ve accepted them as a patient. It’s termed “patient abandonment.” It can be done, but there are stipulations as to how it must be done. I don’t know the laws of Texas on this.

I mentioned this to a friend who lives in another town in Texas later, and she agreed it is a problem.

“What do people DO?” I asked her. Well-off financially, herself, she’s never had to deal with this. She hesitated for a moment, thinking, and said:

”Well… they move!”

Is that really an acceptable way to deal with people, once they qualify for medical care? Is Texas going to continue to force elderly people out of Texas, unless they are wealthy and can pay out-of-pocket for medical care?

Many states require that all medical practices to see patients on Medicare or Medicaid.

It is a significant issue for many medical practices, because reimbursement from Medicaid and Medicare is often not sufficient to cover the costs of a patient visit. Lab work and imaging reimbursement is generally insufficient to cover costs, as well. In many areas, patients with better insurance are in the majority, especially in cities. In rural areas, though, the majority of patients are either on Medicare or Medicaid.

I don’t know the answer to this problem, but I do know that for the past decade or so, fewer students—especially men—choose to apply for medical school, as a result. In primary care, physician incomes have dropped significantly as a result of inadequate reimbursement. A move toward corporate models of medical care has also been a cause of plummeting physician income; administrators’ salaries come out of income generated by those in direct patient care, which includes physicians.