Saving Private Osteopathic Medicine
Dr. Andrew Taylor Still intended for all DOs to think and treat Osteopathically. After a century of sucess, his fruit is withering on the vine due to the forced intervention of insurance and government which the AOA and its member physicians embraced, as did the AMA and our MD allopathic fellow physicians. Osteopathic manual medicine(OMM) has been marginalized from mainstream family medicine and primary care specialties to PMR/OMM/NMM specialists due to time and economic pressures. They, too, are now doing more reimbursable injection procedures and medications than actual contact OMM.
Osteopathic medicine is dying in DOs offices. In fact, the whole individual private practice of medicine by independent physicians is dying. It is not due to physicians lack of commitment or education but the changing conditions in which we practice, HMOs to ACOs. The AOA has failed to defend freemarket healthcare health freedom for patients and their physicians. Instead they have gone along lock, stock and barrel with the government and insurance matrix stakeholder model, ppaca/Obamacare, ACOs, AMA sponsored coding, insurance billing and denials, EHR tech, data entry and extraction for proposed payment.
The regularly capture of the entire practice of medicine is underway. Electronic health records (EHR) is the Trojan Horse to capture patient data. Insurance companies and government oversight will not pay claims unless they conform to their arbitrary standards, thereby capturing and changing the entire practice of medicine going forward. Physicians will be the slaves for the almighty government and their insurance industry taskmasters. Unfortunately, that leaves patients at highest risk in this terminal experiment.
Osteopathic smart phone apps and AOA approved EHRs and burdensome MOC/OCC maintenance of certification will not save osteopathic medicine from extinction. In fact, to the contrary, technology, insurance administration and government will occupy the entire patient-physician encounter. When will the AOA and its component societies awaken from its beltway narcosis and advocate for the only stakeholders that matter, patients and their physicians?
The only solution to the runaway US healthcare disaster is the restoration of freemarket healthcare healthfreedom for physicians and their patients. Physicians should be free to practice in any setting. Doctors must be able to enter and remain in independent direct patient pay private practice, unfettered by healthinsurance rules and government edicts. The AOA and all physicians must fight for their freedom to ensure their patients the best care choices. This would enable DOs to practice unlimited and further Osteopathic medicine at present and for the future. Patients would be free to choose holistic preventive hands-on DO care for their families as they have done for many decades. The AOA must achieve independence from government and insurance in order to survive and not be annexed, and if not, its principles and practice will be destroyed.
Government Medicare and Medicaid, as well as, private health insurance demands physician charity to the government and insurance industry by denied claims and hold harmless clauses in participation contracts. Medicare law makes it illegal to do pure charity for its members if the physician participates in Medicare. Physicians should be in charge of, and responsible for, the care they provide and the charity they freely elect to do. It cannot be forced by insurance participation, or worse, government law.
Health insurance in the last century was useful to reimburse patient directly for major out of pocket expenses, like the auto insurance model. People are free to maintain their cars as they see fit for their benefit and risk consequences based on their own individual value system. They may drive as much as they want and are free to purchase gas and make repairs and seek preventive maintenance anywhere they want. Auto insurance is reasonably priced through competition and only covers major repairs or damage, not routine maintenance or small repairs.
Now health insurance directs all aspects of care from offices checking patient eligibility to determining and collecting visit copays, prior authorization of tests, precertification of medications, coding, billing and denial appeals. Health insurance procedures and processing wastes a huge amount of patient, physician and staff time and money. The AOA and its physicians needs to redevelop inexpensive major medical indemnity patient reimbursement plans to free physicians and their patients to seek the best care together.
The healthcare equation for success:
Freemarket + competition + transparency + direct patient pay + indemnity insurance +/- voluntary charity = empowered healthy patients + efficient healthcare + reasonable cost
The AOA and its physicians must seek reimbursement from patients not insurance or government. Direct participation in insurance and government programs has led all down the garden path to the death of private independent practice and patient care rationing. Patients must choose, invest in and participate in their care at will. This is the only solution to improve care and outcomes.
Osteopathic uniqueness in thought and deed is too vital to humanity than to be allowed to be bludgeoned to death by insurance and government money stakeholders. The AOA advocating for freemarket healthcare individual health freedom for its physicians and their patients is our only hope for survival of Osteopathic medicine against computer algorithm based population medicine and the government-insurance stakeholder model.
DOs COMITT – DOs Committed to Osteopathic Medicine Integrity Today & Tomorrow
Craig M. Wax DO corresponding author
Carlisle Holland DO
Dane Shepherd DO
Richard Koss DO
David Zeiger DO
George Watson, DO
Steven Horvitz DO
David Dornfeld, DO
Charles J. Smutny III DO