Dear Editor,

Government meddling, not doctors' greed, is the primary reason senior citizens are having trouble finding doctors to treat them. And the problem is much more widespread than reported by USA Today ("Rejections rise for Medicare patients," 2/19/01, Cover story).

A recent survey conducted by the Association of American Physicians and Surgeons reveals that nationally, 20 percent of doctors refuse to accept new Medicare patients. The reason? Not fees, but "hassles and/or threats from Medicare."

Even of those who continue to accept Medicare patients, almost three-fourths (71 percent) say they are making changes in their practice to avoid the threat of prosecution, including greatly restricting services to patients, such as surgery.

There's more trouble if a patient needs a specialist. More than one-third (34 percent) report difficulties in finding a referring physician.

The study is concrete documentation of the atmosphere of fear in which doctors practice today. Money is not the issue --- it's the government in the examining room. Honest physicians are repeatedly investigated and prosecuted because of differences in opinions with government bureaucrats over what constitutes "necessary and appropriate" care for patients. Who knows best --- a government insurance bureaucrat, or your doctor?

When doctors tell us they would rather treat uninsured patients for free rather than risk prosecution as a "Medicare cheat," something is wrong with the system.

The government needs to change policy, simplify regulations and halt capricious crack-downs on so-called "fraudulent" billings. While touted as patient protections, they are actually responsible for severely restricting patients' access to care. Physicians are charged to "do no harm." Perhaps government officials should be held to the same code.

Kathryn A. Serkes
AAPS Public Affairs Counsel
Seattle, WA

Correspondence originally published in the Medical Sentinel 2001;6(2);37-39. Copyright©2001 Association of American Physicians and Surgeons (AAPS).