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Crowd of Whidbey patients demands doctors

A vocal crowd of more than 100 people sat through a forum at the Whidbey General Hospital Tuesday night to find out why it is nearly impossible for new Medicare patients to find doctors on Whidbey Island.

The panel of doctors and health care professionals delivered some unwelcome news: There is a national health care crisis that is affecting rural areas like Whidbey first, and it's a problem that will only get worse unless some real changes are made.

The basic issue is that doctors can't make a living in areas like Whidbey Island and are moving out.

"I gotta tell you, I think hospitals and physicians in the state are threatened," said Len Eddinger of the Washington State Medical Association. "They're threatened with bankruptcy."

There are three basic reasons for the crisis, according to the professionals. First of all, physicians say Medicare and Medicaid reimbursements don't come close to covering the costs of medical procedures. And in the case of Medicare, reimbursements rates vary throughout the nation. Doctors in states like Washington receive half of what a doctor in Florida, for example, receives for performing the exact same procedure on a Medicare patient.

This year, Medicare reimbursements were cut by more than 5 percent, and President Bush has proposed additional 5 percent cuts in each of the next two years.

Another part of the problem is medical insurance. Physicians have a plethora of concerns about managed care, from the amount of time they waste dealing with insurance companies, paperwork and referrals, to the fact that the companies dictate how much doctors will be reimbursed for medical procedures.

Also, doctors' malpractice insurance has skyrocketed in the last few years. Dr. Jerald Sanders of Whidbey Community Physicians, Oak Harbor, said malpractice insurance for his group doubled this year. Dr. Byron Skubi of Whidbey Orthopedic Surgeons said he'll have to stop working at the emergency room because of the high cost of insurance. That will leave the hospital without a bone surgeon several days a week.

Finally, there are the overwhelming regulations imposed by the government. Medicaid and Medicare forms have a complicated set of codes and forms. While nobody seems to understand the coding system completely, Sanders said doctors can face giant fines and even prison if they make mistakes on the forms.

The rigid regulations also mean that doctors have to hire more support staff and spend more time with paperwork, both of which makes practicing medicine less profitable for the physicians.

"Filling out forms is the job we hate the most," Sanders said. "They're increasing at a rate that is hard to believe."

Complicating all aspects of medical affordability is the rapid advancement in technology and drugs. While medical treatment becomes better, it also becomes more expensive.

"The gap between science and who's able to afford it is getting wider and wider," Eddinger said. "A medical breakthrough means absolutely nothing if you can't get access to it."

The effects of the doctor shortage are already being felt on Whidbey Island. Trish Rose, a spokesperson for Whidbey General, said it would be "just about impossible" for an elderly person moving to the island to find a doctor.

Whidbey General is already seeing an increase in ER visits, which is a sure sign that people aren't getting in to see doctors.

Peter Borden, the president of the board of commissioners for the hospital district, said at the forum that Whidbey is short two internal medicine specialists, two family practitioners, one obstetrics and gynecology specialist, and an ear, nose and throat doctor.

The solution, according to forum panel members, is a grassroots show of concern. People need to get worked up over the crisis and write letters to their elected officials asking for things like more and fairer Medicare and Medicaid funding, tort reform for medical malpractice and less cumbersome regulations.

Sen. Patty Murray has proposed a "Medifair" bill that would level Medicare reimbursements to physicians throughout the nation.

Rachelle Hein, an aide to Murray, said Tom Scully, administrator for the Center for Medicare and Medicare Services, recently told a Senate committee that he wasn't aware of any problems with patients' access to physician, to the senator's disbelief.

"Bring Tom Scully to Freeland," a woman in the audience said, "and let him break his leg here."

The crowd applauded.

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