As a practicing physician (not a "provider") for more than 56 years, I know what works - and what doesn't work - for my patients and for me.
That is what has kept me eager and effective in my work. Obamacare is just the latest challenge to that work. It is a monstrosity that will fall of its own stupidities within the next three years: a gaudy Christmas tree of wants with no attention paid to the true reforms needed in the U.S. delivery of health care.
But we must survive the next three miserable years. Herewith, my personal plan for survival in practice.
My greatest value to my patients is my time. Decades ago I decided to maximize my professional time by integrating my work with that of highly trained registered nurses. This has allowed me to accept all insurance programs, regardless of the often insulting levels of payment, except for those programs that require a prior referral from a less qualified physician, impinging on the patient's right of choice of physician.
This approach has also allowed me never to have "closed my practice" to new patients. The only condition I place on patients in return for my continued interest and efforts on their behalf is that they be equally interested in their own care. I work with patients, not for patients; and those who are not equally engaged, cooperative and compliant with my instructions find themselves discharged from my care.
While I offer my best efforts and personal devotion, I never guarantee my work or the outcome of that work. And I never take personal or financial risk for the outcome of that work, a stance that would put me in a conflict of interest with the patient and would be unethical.
Some of the coming demands of medical practice under the new health care law will place the above approaches under great strain. But that approach will not change. Contrary to the posture of too many of my medical colleagues who, in the last two decades when ordered to "jump" have supinely responded, "How high?", my response will continue to be, "Says who?"
And so, I will continue to offer my professional time, my best efforts and my devotion to patients who appreciate that commitment. That is my plan, while those around me stagger through Obamacare.
Dr. George Sprecace lives in New London.