City hearing addresses health care disparities
"Doctors in Baltimore are not paid enough," Monti said. "Specialists make more money than general physicians, so [doctors] feel the need to specialize."
According to Joseph Zebley, a family physician in Baltimore, the majority of all medical services have a fixed price for patients, but insurance companies can decide how much they will reimburse doctors for these services.
Zebley also noted that levels of physician pay in Maryland are low, and that Baltimore is the lowest payment jurisdiction for insurance companies in the nation.
The market for insurance in Maryland is dominated by two companies: United Health Care and the Blue Cross Blue Shield companies. According to Zebley, these two companies own so much of the market that no other insurance companies have been able to gain a foothold in Maryland. They have been able to lower the reimbursement payments to doctors with no competition.
As a result, most doctors in Baltimore choose to specialize in order to earn more pay. In addition, many doctors who train in Baltimore move to other areas to practice, where they will receive better payment.
Zebley also explained that teaching institutions limit the number of doctors they train in general medicine because it not as financially viable as training specialists. Residency slots at medical schools like Hopkins are funded by the federal government and Medicare, and institutions make more money by offering residency positions for specialized medicine than they do for general practice.
According to Zebley, Hopkins does not have a department of family medicine. Although the University of Maryland School of Medicine does have a residency program in family care, Zebley explained that it only graduates about 12 people per year.
"There are not an adequate number of family physicians trained to supply for the generation of physicians who are retiring," Zebley said. "Most practicing physicians are part of the baby boomer age group, and they are going to retire soon."
According to Joseph Zebley, a family physician in Baltimore, the majority of all medical services have a fixed price for patients, but insurance companies can decide how much they will reimburse doctors for these services.
Zebley also noted that levels of physician pay in Maryland are low, and that Baltimore is the lowest payment jurisdiction for insurance companies in the nation.
The market for insurance in Maryland is dominated by two companies: United Health Care and the Blue Cross Blue Shield companies. According to Zebley, these two companies own so much of the market that no other insurance companies have been able to gain a foothold in Maryland. They have been able to lower the reimbursement payments to doctors with no competition.
As a result, most doctors in Baltimore choose to specialize in order to earn more pay. In addition, many doctors who train in Baltimore move to other areas to practice, where they will receive better payment.
Zebley also explained that teaching institutions limit the number of doctors they train in general medicine because it not as financially viable as training specialists. Residency slots at medical schools like Hopkins are funded by the federal government and Medicare, and institutions make more money by offering residency positions for specialized medicine than they do for general practice.
According to Zebley, Hopkins does not have a department of family medicine. Although the University of Maryland School of Medicine does have a residency program in family care, Zebley explained that it only graduates about 12 people per year.
"There are not an adequate number of family physicians trained to supply for the generation of physicians who are retiring," Zebley said. "Most practicing physicians are part of the baby boomer age group, and they are going to retire soon."
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Baltimore Movers
posted 7/17/09 @ 2:26 PM EST
It's really unfortunate that there is a shortage of primary care doctors. A shortage of 150,000 visits per year is a very significant problem.
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