The new legislation will impact emergency physicians greatly as newly insured patients find it difficult to find primary care doctors who accept their insurance.
I recently saw a Medicaid patient who received a medical card with the name of a doctor who was to be her primary care physician only to find out that he was not accepting any new patients.
This lack of good primary care for Medicaid patients is a tragedy made more acute by the 16 million plus patients who will join the Medicaid ranks in the years ahead.
Without drastic changes, I will continue to provide emergency care to all, and primary care to those with 'second tier' insurance. This will not only continue to drive up costs but also will push an already overburdened emergency department system to the edge.
The lack of any meaningful tort reform in the bill is also very concerning. Studies in Massachusetts have shown that 25% of imaging tests performed (CT scans, MRI's etc.) are ordered as a direct result of defensive medicine. The same report calculated that such defensive practices added up to $1.4 billion per year in Massachusetts alone.
If one extrapolates this to all 50 states, the savings would be staggering.
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