Flow of funds is not endless
Primary care is squeezed by lack of reimbursements, slow payment, and inadequate Medicare/Medicaid compensation. Something
has to give. You simply can't give salary offers to new front-desk personnel that stay competitive and reasonable, or offer
increasing bonuses and benefits to retain good personnel ["Does your front-desk staff draw patients in—or turn them off?" July 21, 2006].
The answer is to drop lousy, slow, or no paying health plans, along with Medicare and Medicaid. Or for those plans and the
government to step in and make sure we get paid better.
Better pay, better recruitment of sufficient and quality individuals to staff offices, and overall better care experience.
It is a vicious cycle. Alan T. Falkoff, MD
Stamford, CT
Should you use hospitalists?
I sympathize with Dr. George Wolff's unfortunate experience regarding his acute illness and care under a hospitalist group
["Readers React," Mar. 2].
Seeing multiple providers certainly undermines continuity of care and quality patient outcomes. But this situation could happen
regardless of who admitted and cared for him. I doubt he would have seen his primary care physician from start to finish if
his PCP practiced inpatient medicine.
His conclusion that it's best for PCPs to follow their patients in the hospital does not address the problem, which is a
poorly conceived model of inpatient care. A structured and well-run hospitalist program would manage continuity and quality-of-care
issues from the onset.
Kenneth G. Simone, DO
Veazie, ME
The pressure to settle a lawsuit
My hat's off to general surgeon Anna Maria Voltura! She is a fine example of a dedicated physician who stuck to her guns because
she knew she was right ["Don't settle if you're right," Feb. 16]. Too bad she didn't—or couldn't—sue the plaintiff's attorney for defamation of character.
Jack W. Stage, MD
San Rafael, CA
I think "Don't settle if you're right" points out exactly what it is like to practice medicine today. I can not think of a
single colleague who enjoys practicing medicine due to the fear of litigation.
Lawyers are only too aware that they don't need to be correct but to have just enough information to convince a jury of laypeople.
Why is there rarely a case brought against a lawyer for a frivolous lawsuit? Why isn't it automatic for the loser to pay the
legal costs of both parties?
Why do doctors treat anyone who practices malpractice law? Because physicians have a deeply rooted moral code of ethics.
Jay Duxin, MD
Avon, CT
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