Doctors also see costs rise

BY KAREN KARASZKIEWICZ, TIMES STAFF WRITER
http://www.carrollcountytimes.com

When Dr. John E. Steers began practicing medicine in 1971, his malpractice insurance premium cost him $1,471 a year.

By the time he retired in 2005, the Westminster general surgeon was paying close to $75,000 for insurance to protect himself against potential lawsuits. Other overhead costs, such as employee salaries and equipment, also had steadily increased over the years.

“The cost of maintaining a private practice has skyrocketed; it has gone through the roof,” said Steers, who now volunteers twice a week at the county’s free health clinic, Access Carroll.

Nonprofit health organizations that serve the uninsured also are facing these rising overhead costs. Mission of Mercy, a mobile health clinic that travels to nine sites in Maryland and Pennsylvania, pays $50,000 a year for medical malpractice insurance, according to chief medical director Dr. Michael Sullivan. The coverage cost $8,000 when the organization was founded in 1994, he said.

While doctors continue to pay more for malpractice insurance and for the salaries they pay their employees, they also are receiving less reimbursement from insurance companies for the services they provide, according to Dr. Mark Mashburn, a local ear, nose and throat surgeon.

Because insurance companies determine the rates of the services they will cover, doctors cannot just charge patients more to make up the difference, he said.

“Medicine isn’t like owning a grocery store, where you can increase the cost of bananas if something goes up,” Mashburn said. “It is subject to a lot of rules and regulations.”

He said doctors tend to be paid less per procedure now than 10 or 15 years ago.

To keep their practices sustainable, many are learning to be more efficient and see more patients in a day, Mashburn said.

According to Sullivan, who has been practicing internal medicine for more than 30 years, insurance companies assumed control of many aspects of health care in the 1990s.

Dr. Choon Kim, a gastroenterologist in Westminster, said the process to get procedures and services covered by insurance companies is much more involved now than it was several years ago.

He said the doctor’s office, not the patient, typically is responsible for making the phone calls to get procedures, visits and prescriptions approved, which takes more time and therefore requires additional staff.

When he started his practice in 1990, Kim had just one secretary. Now he has nine administrative staff members to handle the high volume of calls from 30 to 40 different insurance companies.

“It discourages the usage of resources,” Kim said. “[Insurance companies] do not want to pay the money, and they’re passing the burden on to us.”

Steers said one of the ways to lower the cost of health care for both patients and doctors is to intervene early and treat diseases before complications arise.

“If you can pick up an illness early and treat it, not only is it the humane thing to do but you can save the system tremendous expenses,” he said.
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