Dade County Medical Association grapples with health reform act issues
By Marilyn Bowden
Excessive paperwork and tort reform are among issues the Dade County Medical Association is grappling with as elements of the federal Patient Protection and Affordable Care Act begin to take effect, said Frank Maderal, president of the association's Board of Directors.
"The priority for any medical organization is to try to reduce the hassles of practicing medicine — the phone calls, the paperwork and the hoops we have to jump through," he said. "Doctors want to take care of patients and not have to do all the other stuff we have to deal with. Unfortunately, every time there is reform it usually leads to more hassle and more hoops. Doctors yearn for a simpler time where they would answer patients' calls and quickly take care of things."
The demands of insurance companies are major impediments to that simpler vision, Dr. Maderal said.
"Now we have to call for permission to take an X-ray, permission to prescribe medication, permission to admit them to a hospital — permission for everything, even a walking cane. And every insurance company has a different formulary."
One difficulty compounding the massive administrative duties of practicing medicine today, he said, is that physicians aren't businessmen.
"There are no business courses in medical school," he said. "Physicians now have to have very sophisticated business offices, which we were not trained to run. Billing and collections alone is very complicated."
Dr. Maderal said the Dade County Medical Association works closely with the Florida Medical Association on insurance matters and other issues regulated by the state.
"We lobby the state legislature to try to improve the practice of medicine," he said, "or at least not worsen it in any aspect."
Malpractice suits are another area where Dr. Maderal said reform is necessary.
Litigious states such as Florida — where Medicaid, which is administered by the state, is also made more difficult for physicians than in others places — will continue to suffer more than other parts of the country from an inability to attract primary-care physicians.
"There are many issues we need to work on with the American Medical Association at the federal level," he said. "For example, Medicare is a federal issue, and any changes in that or in private plans that insure Medicare patients are all handed at the federal level.
"But in general, I would say that organized medicine is just looking to help physicians practice medicine and reduce the hassles."
Miami-Dade County faces problems of its own, Dr. Maderal said, which are different from the upper part of the state — issues such as the high number of uninsured patients, Medicaid patients and illegal residents.
"But the big issues for everybody are going to continue to be tort reform and streamlining the entire billing and reimbursement process.
"Unfortunately, to control costs is to make things more difficult for doctors. The more difficult you make the process, the more you control it.
"So there are multiple issues, but the thrust is to try to lessen the hassles of practicing medicine — having doctor doing doctor stuff, not clerical stuff."