A regular ER stint in the life of a TV doctor is fraught with emotional cliff-hangers, disease of stupefying complexity and legal conundrums.
But nowhere in shows like Grey’s Anatomy do you see the drama that keeps real-life providers, patients, and payers up at night: the life-altering policy dilemmas that determine the business model behind the provision of care.
One such dilemma is the antitrust lawsuit between Saint Alphonsus Health System, St. Luke’s Health System, and the Federal Trade Commission, which was resolved in Saint Al’s favor last month. Another is the Affordable Care Act, a giant rewrite of health policy created by President Obama and his advisors and produced by Congress and still, after becoming law four years ago, providing a large helping of drama.
Those two big episodes of medical lawyering – and the twists and turns that lie ahead in each case – are just part of the excitement. On a day-to-day level, patients experience true adventure in health care all the time. Many have turned up for their appointments in recent years to discover that they are under the care of a hospital system, not a physician. The art of demystifying medical bills and letters from insurance has become a science. It long ago became unremarkable for health insurance to serve as the sole determining factor in taking a job.
All this change has left health consumers, and employers who pay for health care, scrambling to understand the health care landscape.
Now a group of independent Treasure Valley doctors has joined forces to bring more clarity to what they do.
To dispel the notion that all doctors now work for one hospital or another, Independent Doctors of Idaho has signed up 180 doctors in the Treasure Valley and hired a public relations firm to spread the word about the group.
Independent doctors’ organizations have been established in several other states. They’re aimed at promoting the work of independent doctors, who often fear being left out of hospitals’ referral chains.
IDID wants patients to know that they have choices beyond the hospital referrals. The group is also aiming at providers, hoping to show medical students and others that it’s still possible to run a solo practice.
Jeff Hessing, an orthopedic surgeon in a four-man practice in Boise, is chairman of IDID’s board.
“I stay independent because my relationship with my patient is probably the most sacred thing in my business,” Hessing said. “There are outside forces, whether that be the federal government, policymakers at the state level, CEOs at businesses, insurance companies, hospitals, that are trying to come between me and my relationship with my patient.”
Medical care isn’t a one-size-fits-all proposition, says IDID board member Vicki Wooll, a family practice physician with a practice in Eagle.
“We live in a free country, and patients need to have opportunity to choose. We give patients a choice,” Wooll said.
IDID’s founders also say that independent doctors are less expensive than doctors who are employed by hospitals, because hospitals have many overhead costs that they must recoup through patient charges. It’s unclear if that’s true, though Medicare does allow physicians to charge a fee for hospital outpatient care, raising the reimbursement rate from that payer for hospital-employed physicians.
Blue Cross, Idaho’s largest insurer, doesn’t pay more for visits to hospital-employed physicians, said spokeswoman Karen Early. But Wooll said recent studies show that it costs up to 50 percent less to visit an independent physician than a hospital-employed physician.
The new group is similar to a smaller independent physicians’ organization in Twin Falls. IDID has members in northern and Eastern Idaho, Hessing said, and expects to work with the Twin Falls group.
IDID won’t compete with the Idaho Medical Association, said that groups’ executive director, Susie Pouliot.
“We’re not in the business of providing referrals,” Pouliot said.
Some of Idaho’s independent physicians work in solo practices; others work in groups. Some, like Wooll, have admitting privileges at local hospitals. IDID is for physicians who aren’t employed by hospitals.
“You’d be surprised how many people don’t know that we exist,” said Wooll, who is on the board of trustees of the Idaho Medical Association and is one of two doctors who represent Idaho as an alternate delegate at the American Medical Association.
“We want patients to know that private practice is still alive and well,” she said. “We want medical residents to know that private practice is alive and well. And we want doctors to know.”
Anne Wallace Allen is managing editor of the Idaho Business Review.