American College of Physicians: Internal Medicine — Doctors for Adults ®

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From the June 1996 ACP Observer, copyright 1996 by the American College of Physicians.

More restrictive plans gaining ground

In 1995 only 4% of the enrollment in commercial health insurance plans was in "conventional fee-for-service health plans without pre-certification restrictions," according to a recent survey.

Another 27% of enrollment was in conventional fee-for-service plans that require pre-certification for inpatient services, according to the "KPMG Survey of Employer Sponsored Health Benefits." KPMG is a national consulting firm.

Meanwhile, nationwide enrollment in preferred provider organization-based plans (PPO plans) decreased since 1994, to 22% of enrollees, although in parts of the country—particularly the Midwest—PPO enrollment has been increasing.

The rest of insured U.S. workers were enrolled last year in more restrictive managed care plans. Point-of-service plans now cover 18% of enrollees (up 3% from 1994), and HMO plans encompass 29% of enrollees (a 4% increase).

Does physician gender affect patient interaction?

Female physicians spend more of their time with patients performing preventive services and giving patients information while their male colleagues spend significantly more time taking medical histories, according to a study by researchers at the University of California, Davis. The study was sponsored by the federal Agency for Health Care Policy and Research (AHCPR).

The researchers were trying to determine why female doctors tend to earn higher patient satisfaction ratings. According to AHCPR, conventional wisdom has been that they spend more time with their patients. The researchers, who videotaped 250 new patient visits, instead they found that women and men doctors spent their time with patients differently.

Professional courtesy lives

According to a report in The Physician's Advisory newsletter, nearly all doctors extend professional courtesy to other doctors: 12% write off the entire charge and 75% accept insurance reimbursement as full payment.

Physicians surveyed reported extending some professional courtesy to their office staff (30% give full write-offs and 62% accept insurance as full payment), to staff's family (18% give full write-offs and 63% accept insurance as full payment), to doctors' grown children (18% give full write-offs; 47% accept insurance as full payment), and even to clergy of the physician's church or synagogue (10% give full write-offs; 45% accept insurance as full payment).

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