Janus, the ancient Roman god of beginnings and transitions, doorways, endings, and time, was depicted as having two faces: one looking backward to the past and one looking forward to the future, writes Marilyn Singleton, M.D., J.D., in the spring issue of in the Journal of American Physicians and Surgeons. “Janus was sometimes used to symbolize the progression of one vision to another and of one universe to another. Medicine is in one such transition.”
One vision is confidential communication between the patient and a trusted personal physician. The other is “the healthcare factory, where patients see a physician who sits behind a computer screen transmitting information to the Office of the National Coordinator for Health Information Technology,” Dr. Singleton writes.
Fewer than half of physicians now own their own practices, Dr. Singleton reports. Physicians are selling out to hospitals as the regulatory burdens and compliance costs escalate. She points to the 2009 Health Information Technology for Economic and Clinical Health (HITECH) Act that was tucked into the American Recovery and Reinvestment Act (the “Stimulus Act”), the 2010 Affordable Care Act (ACA), the 2013 Medicare Improvements for Patients and Providers Act, the 2014 Protecting Access to Medicare Act, and the 2015 Medicare Access and CHIP Reauthorization Act (MACRA).
In addition, hospitals are suffering from “merger mania,” she notes, and only two insurers (Anthem and UnitedHealthcare) control 70 percent of the health insurance market.
“Insurance companies have moved from reimbursing your physician to becoming your physician,” Dr. Singleton observes. “In the dystopian vision of medicine, independent physicians are devolving from trusted confidants to automatons.”
Overwhelmingly, patients prefer a personal physician. “The new face of medicine must have one voice taking the lessons and the best from the past and creating a bright future…. As physicians we must declare that we are not insurance company or government tools.”
She concludes that the Association of American Physicians and Surgeons (AAPS) “will continue to promote and provide tools to have a successful third-party-free practice and to fight the perils of vertical mergers at each opportunity.”
Dr. Singleton is an anesthesiologist residing in California. She serves as president of AAPS.
The Journal of American Physicians and Surgeons is published by the Association of American Physicians and Surgeons (AAPS), a national organization representing physicians in all specialties since 1943.
Full PDF of article: http://www.jpands.org/vol24no1/singleton.pdf