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HMO Brand of Medicine

August 22, 1986

Dr. Bronow's letter on the new breed of health organizations was an ace. I terminated my membership in one when it became apparent that only reasonably healthy older persons benefit from HMO participation. I'm back with my former private physician, relieved to be restored to competent, concerned and available consistent medical services.

HMOs claim that members may choose their own personal physician from their staff. They do not indicate that one must wait two to three weeks minimum for an appointment, simply because the physician has his own, usually distant, office practice. He is available only during the scant periods he leaves his own practice and travels to the HMO facility as a subcontractor.

Sometimes my need to see my personal physician can't wait. The HMO provider facility has "in-house" personnel to accommodate you in the interim. You are seen by a medical stranger completely unconversant with your health records. I guess he does his job. If you are not in "extremis" he maintains your health, but he does nothing to improve it.

That action is on hold until an appointment with the commuting subcontractor can be scheduled for weeks ahead. These professionals are not only over-scheduled, they switch allegiances from one HMO to another. It is an uncertain trap for them as well as for their "unhealthy" HMO patients.

The lure of the freebies offered by HMOs is potent. But the best things in life are not free, and the costs of medical care are appalling. Is it not ironic that physicians who do not accept Medicare "assignment" are actually nurturing their slick competition, the HMO?

For the shortsighted medical professional who endangers his own future by not accepting Medicare assignment, there is only one prescription--"physician, heal thyself." Dr. Bronow seems to have the formula.


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