I don’t think there are many Medicare patients out there who, if asked to comment on their primary doctor, would report, “The problem is, he spends too much time with me, he has this annoying way of really listening to what I’m saying, he explains so much that he makes me know what’s going on with me, and he doesn’t shoot me off to enough specialists who treat me the same way.”
Doctors who take care of Medicare patients don’t act rushed and harassed because they are bad people, or even bad doctors. They are, in fact, rushed and harassed. They are paid by the visit, and the price of visits is not keeping up with the increases in overhead. They feel as if they are working harder and faster to just keep up, and the government requirements for electronic health records and billing and paperwork have added to their burden.
Medicare patients should have the option of going outside of Medicare to get better care, but this is really hard. A doctor who takes any money from Medicare at all cannot open a cash-for-service practice for Medicare patients who want more time, access, and attention. If Warren Buffett, 84 years old and worth $66.2 billion dollars, came to me and offered me $100 for a one hour office visit, I would have to turn him down. He can well afford it, I want to offer the service, but the government would jump on me with both feet if I took this deal.
There are “concierge” practices that do offer better services to Medicare patients, by very carefully charging subscription fees for services that Medicare doesn’t cover. If there were enough demand for this, I might start one, because I think it is ridiculous that everyone covered by Medicare has to accept the same mediocre level of service. I enjoy not acting as if I’m rushed and harassed, because I’m not. I’d like to share this experience with Medicare patients.