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A Voice for Private Physicians Since 1943


September 13,
2006CONTACT:  Kathryn Serkes 202 333

FOR IMMEDIATE RELEASE:                                                                                         
        [email protected]


�It�s NOT about the

PHOENIX, AZ — A national physician
association voted today to urge Congress NOT to take any action to stop slashes
in physician payment that are scheduled to go into effect next January, despite
the all-out effort by the American Medical

The vote by the Directors of the
Association of American Physicians and (AAPS) came today during the first
session of the 63rd annual meeting in Phoenix, AZ.  The group sent a letter to Congress
urging them to reject the efforts of the AMA, which launched a national fly-in
to WashingtonDC to convince Congress to stop the
pay cuts.

�They claim that doctors will stop
seeing Medicare patients if the pay cuts go into effect. But that�s ALREADY the
reality, and it has nothing to do with money,� said Kathryn Serkes, Director of
Policy & Public Affairs for AAPS.

�The system is imploding.  Increasing payments is like adding a
third story to a building with a crumbling foundation.  More money isn�t going to fix what�s
wrong with Medicare,� said Serkes

In the Congressional memo AAPS

�Some other medical groups have been
telling you that proposed cuts in physician payments will harm seniors by
creating a crisis in access to physicians. 
But we disagree.  There�s already a problem, and it has
nothing to do with the new rates.�

In ads and website, the AMA claims
that its survey shows that 45% of its members will cut the number of Medicare
patients if the pay cuts go into effect. 
They not only call for a halt to the cuts, but a change in the
Sustainable Growth Rate (SGR) that would provide for pay raises in subsequent

In its memo, AAPS refutes the AMA
conclusions and tells Congress they don�t want a pay raise, but instead lays out
the case for less government interference instead.

�But those numbers are extremely
misleading because it�s not all about the money.

�Surveys conducted by AAPS show many
physicians ALREADY refuse new
Medicare patients.  In fact, about
33%.  But even more alarming is that
40% already restrict services
they�ll perform to current Medicare patients.   (See Disheartened Doctors,
Patient Problems: AAPS Biannual Survey of Physicians on Medicare and Patients�
Access to Care
, Journal of American Physicians & Surgeons, Winter

�But here�s what you need to
know:  the reason they do so is NOT
because of money. When asked, it�s the
government �hassle factor.�
The two leading reasons given were �billing and
regulatory requirements, and hassles and/or threats from Medicare
carriers/government.� Payment rates were down the list.

�So it�s really about FREEDOM, not
the money.

�And what the AMA survey doesn�t
show is that those trends have been in play for about a decade.  We�ve conducted our survey every two
years since 1995 � not just to show a trumped-up �crisis� about current rate
schedules. In fact, our survey shows that doctors would rather treat uninsured patients for
than to treat Medicare patients.

�So it�s clear that tweaking the
reimbursement rates by a few percentage points by taking money away from
hospitals or putting more financial pressure on an already collapsing system
won�t alleviate the other serious problems that are leading to physician
discouragement with Medicare that are directly impacting patients access to


H.R. 580 Seniors�Health Care Freedom
Act of 2005, and

Say �NO� to Government Cookbook

�We oppose the various bills playing
with the Sustainable Growth Rates (SGR), such as HR 3617, HR 2356, HR 1162 and
S. 1574.   Instead of changing
the SGR, we support H.R. 580, the Seniors� Health Care Freedom Act of 2005� that
would allow the use of private contracts under the Medicare program.  This is a win for patients, doctors and
taxpayers as well. 

�Our survey shows that 63% of
doctors would be more willing to treat Medicare patients if unrestricted private
contracts were allowed.  Patients
could pay doctors more than Medicare allows if they think the service is worth
it.  It would be up to the

�Also, we oppose any mandatory �Pay
for Performance� provisions that would tie Medicare payment to physician
compliance with government practice guidelines.  This would be a radical break from
Section 1801 of the Social Security Act that prohibits federal officials from
interfering in the practice of medicine.

�In conclusion, it�s not always
�about the money� for doctors, and it�s too bad other groups are perpetuating
that stereotyped image of �rich, greedy� doctors.  What doctors really need is freedom to
practice medicine in the best interests of their patients.  That will truly serve our seniors and
help preserve access to the best care. 

�Otherwise, the best and the
brightest will continue to leave the program.�   



Disheartened Doctors, Patient Problems: AAPS Biannual
Survey of Physicians on Medicare and Patients� Access to

Journal of American
Physicians & Surgeons



More doctors will bail out of Medicare, while those who remain will
continue to refuse new patients and restrict services, leading to severe
rationing in the next ten years.

Those are the dire predictions of physicians revealed in a new survey
titled �Demoralized Doctors, Disheartened Doctors, Patient Problems: AAPS
Biannual Survey of Physicians on Medicare and Patients� Access to Care�
published in the Journal of American
Physicians and Surgeons (JP&S)
, winter
2004.  (See:  www.jpands.org)

While the future looks bleak, the present isn�t much better, according to
344 physicians responding to the respondents, who are involved in patient care
at least 20 hours and an average of 23 years in practice.

“This study is concrete documentation of the atmosphere of fear and
frustration in which doctors practice today,” said Kathryn Serkes, co-author of
the survey and policy and public affairs counsel for the Association of American
Physicians and Surgeons (AAPS).  
“Money is not the issue � control is. More doctors would rather treat
uninsured patients, possibly for free, than jump through Medicare hoops.�

The results show that increased
government involvement in Medicare is actually responsible for increasing
physician demoralization and practice changes that are making it tougher for
patients to find doctors who are willing to treat them. And the impact is being
felt by all patients, not just seniors, and will get worse if an open-ended,
costly drug benefit is added.

�Tacking on some cosmetic changes
as Congress is now considering in the conference report will only make things
worse,� said Serkes.  �It�s like the
sick patient who was in deep denial. 
He delayed treatment for so long that he became terminally ill, and then
ran out to have expensive plastic surgery – that bankrupted him.  But his friends say he was a
good-looking corpse.�

The survey supports 6

1. Increasing fear of prosecution
or government retaliation has had a negative impact on Medicare patients� access
to physicians, and their ability to receive referrals and certain services such
as surgery.

2. Compliance with Medicare
regulations is costly, takes significant time away from patient care, and is an
increasing cause of reluctance to treat Medicare-eligible

3. Unrestricted private contracting
under Medicare would greatly increase willingness to treat Medicare-eligible

      4. Increased fear
of retaliation and regulatory burden are causing physicians to make changes in
practices that adversely affect patient access and quality.

5. The increasing role of
government in medicine results in more difficulty for all patients to access
care, not just those who are Medicare-eligible.

6. Physicians are becoming
increasingly disheartened and negative about the future of the practice of

The survey examines five areas:
Access by established Medicare patients, acceptance of new Medicare patients,
costs and changes to practices, opting out and private contracts, and assessment
of the future of the practice. 
Further, the survey looks at trends of the past three

Some of the

do not accept new Medicare patients;

  • 40% restrict services to all
    Medicare patients;
  • (Reasons: �billing and regulatory
    requirements� ranked first, followed by �hassles and/or threats from Medicare
    carriers/government, �fees too low� & �fear of prosecution or civil

have had difficulty finding a referral physician;

  • 32% say level of service is less
    than 5 years ago;
  • 22% is the amount of total staff
    & physician time spent on compliance with Medicare
  • 65% would not take part in
    Medicare again;
  • Medicare claims cost offices 50%
    more to process;
  • 63% would be more willing to
    serve Medicare patients with unrestricted private
  • 67% predict more doctors opting
    out of Medicare;
  • 58% predict severely rationed
  • 36% predict a complete
  • 62% plan to retire at an earlier
    age than expected 5 years ago;
  • (Reasons:  �Increased government interference,�
    followed by �increased regulatory burden.� Money ranked number

Physicians have made great changes
to their practices to comply with Medicare regulations, most involving less time
for patient care or additional cost, including spending more time on
documentation, restricting services, hiring more compliance and billing staff,
or just quitting Medicare.

Of particular note is that
physicians prefer uninsured to Medicare patients, turning them away 50% less
frequently than Medicare patients (17% and 33%

�This regulatory roulette is
affecting every patient in the country. 
Doctors have less time to spend with patients, and are retiring earlier
than ever,� said Serkes.  �Medicare
expansion will only bring more of the same.�

Serkes says one respondent�s
comment sums it up: �Unless things change soon, the best and the brightest will
leave Medicare.  It�s simply not
worth it.�

AAPS is a dues-supported, non-partisan, professional
association of physicians in all specialties, dedicated since 1943 to protecting
the sanctity of the patient-physician

Kathryn Serkes                       
[email protected]        
(202) 333 3855

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