Comments on: Another Doctor Ponders Group Exams Under ObamaCare

By: Eric Gates

Eric Gates — Tue, 20 Apr 2010 18:11:27 +0000

I only know what I’ve heard: Dr. Sterling is the best of the best at Internal Medicine and Pain Management in Orange County. that’s why I am switching over to him. Better care on the front end (for more money, but getting more time and more careful analysis) means less cost overall to the patient AND to the health care system, including the taxpayer.

By: Dan S

Dan S — Mon, 21 Dec 2009 20:39:48 +0000

artk’s comment about price discrimination reveals a lack of understanding of the effects of the “Health Reform” bill. Insurance companies will no longer be able to practice price discrimination. All comers will be charged a single “community rate” and people with chronic diseases will be charged the same as people with no health problems.Physicians are not allowed to practice price discrimination which is one reason the uninsured get shafted.

By: David Loiterman MD

David Loiterman MD — Sun, 20 Dec 2009 16:13:43 +0000

I agree with the sentiments expressed by Dr. Sterling.

By: A Kar

A Kar — Sun, 20 Dec 2009 15:00:48 +0000

Dr.Sterling is one of the most respected internists in the area.I know of no other profession where experienced people get paid less on a per hour basis.Looks at senior attorneys (usually 500-1000 per hour),basketball players and golfers.Great article.

By: John Goodman

John Goodman — Sun, 20 Dec 2009 13:48:13 +0000

This has been a good exchange. I especially want to thank Dr. Sterling for explaining as much as he did.

By: Mel Sterling

Mel Sterling — Sun, 20 Dec 2009 06:34:11 +0000

I agree, you clearly do not understand.

By: pat

pat — Sun, 20 Dec 2009 03:38:41 +0000

Biggest beneficiaries of US Medical system are doctors, insurance and drug companies, malpractice
lawyers. Patients enjoy least benefits. Most doctors dont spend more than 15 min with the patients. Most of the notes is preprinted from previous visits or EMR systems. Physicians stoped doing good clinical exams and nutrition counciling. I do not understand why a doctor needs 150 dollors for the physical exam. US medical system is most expensive and least efficient. It is a money making and profit driven system.

By: Mel Sterlng

Mel Sterlng — Sun, 20 Dec 2009 02:42:36 +0000

No contracts with any insurance company. The radiologist usually deals with the authorization for the MRI and my patients are rarely hospitalized (because I do not do 10 minute physicals and because they understand why they should not smoke and why they should take their statin, Byetta, ARB etc, etc). When they are hospitalized the hospital fights with the insurance company. I do get called by pharmacists. If the patient will do well on a different drug within the same class of drug I usually agree with the pharmacist if it saves the patient money. If the patient will not do as well with the pharmacist’s recommendation I do not agree. There are instances when the patient will be safer or more comfortable (better control of pain or other symptom) if they ppay for the better drug. That is up to the patient.

By: artk

artk — Sun, 20 Dec 2009 02:25:54 +0000

No insurance companies? Never? Your patients write checks when they need an MRI or does your admin fight with the insurance company for a preauthorization. The same goes for hospitalization. You never get called by a pharmacist because their drug plan has a different idea of the correct prescription then you do?

By: Mel Sterling

Mel Sterling — Sun, 20 Dec 2009 00:14:22 +0000

The only “insurance company” that I deal with is the government, I do not have any contracts with any insurance companies or health plans. My overhead is my rent, janitorial service, office staff salaries (I pay them a decent wage, pay for their health and dental insurance, retirement plan, uniform allowance and other benefits), malpractice insurance, office premises liability insurance, a long list of taxes and other assessments, payroll service fees, accountant’s fees, electricity, telephone, office supplies, computers and their software, internet access, hospital staff membership fees, county, state and national medical association membership fees, 2 specialty society (American College of Physicians and American Academy of Hospice and Palliative Medicine) dues, publications, attendance at medical education meetings; a long list of expenses and I am probably forgetting some of the expenses.
You are correct, some doctors may take 10 minutes with a patient. If you mean that they provide a comprehensive preventive care evaluation for a Medicare patient in 10 minutes, more power to them. I would be surprised if they could do what should be done in that time, or much more time.
Regarding the medium sized multispecialty group, I prefer, and my patients have been willing to pay the fees that I charge for my mode of practice which is solo private practice, fees that are certainly higher than the usual multispecialty group. My clientele is largely professionals; physicians and their families, nurses, stockbrokers, bankers, attorneys, judges, corporation executives but it also includes truck drivers, clerical workers in health care, teachers and, well paid waiters.
Currently all my patients have the option of paying me for the amount of time that we mutually agree is appropriate for their evaluation.
The proposed Preventive Evaluation With No Copay embodied in the Senate bill will take away that freedom. Welcome to your 10 minute Preventive Care Evaluation. Perhaps Senator Reid will opt for that very efficient exam.