Alex Blaze

Health insurance industry shuts down pioneering HIV/AIDS practice

Filed By Alex Blaze | June 22, 2010 9:30 AM | comments

Filed in: Living
Tags: health care reform, HIV/AIDS, Marcus Conant

Dr. Marcus Conant, one of the first doctors to identify Karposi's Sarcoma and to receive the first grants to study HIV. Conant-and-Volberding_1981.jpgNow he's shutting down his San Francisco practice because the insurance industry's paperwork requirements are getting out of hand:

He has been a physician for nearly 50 years, but like many doctors, in the past decade he has become increasingly frustrated with insurance challenges that made running a private practice unnecessarily complicated and a financial nightmare, he said. He tried to run his practice part time, using his personal savings to keep the clinic open.

"The bottom line is, you cannot make a living practicing medicine unless you work at least 50 to 60 hours a week," he said. "I'm not the only doctor who's getting to the point where it's not worth it."

Health care reform was about real problems that are actually making people's health worse, not moving numbers around and looking like they're "doing something." And instead of any real reform, the same industry that's promised for years to reform the way it does paperwork and hasn't has been given millions more clients and huge subsidies that'll just end up being used to prevent further change.

"He was definitely one of the driving forces in San Francisco's earliest response to the AIDS epidemic," said Dr. Mitch Katz, director of the city's Public Health Department.

"He had a large gay practice at a time when many people didn't want to care for gay people, period," Katz said. "He saw before most people the devastation of the epidemic. And then he went about his Dr. Conant way of insisting that funding be provided for research and services."

In the 1980s and '90s, Conant's name was widely known throughout the Castro. He wasn't just a well-regarded physician, but also an important spokesman for the AIDS research community, said Michael Siever, director of behavioral health services for the San Francisco AIDS Foundation.

Conant held community forums after major research announcements to explain the science to patients. He was a leading researcher himself, involving his practice in some of the largest national clinical studies on protease inhibitors.

"He's always been about keeping people informed. When Marcus speaks up, people listen," Siever said. "He's been a really strong voice advocating for gay men living with HIV. It's a loss for us that he's moving to New York."

Sounds like a great doctor who should be in the business of treating people as long as he's willing and able to.

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He can't make enough money to live off of as a doctor unless he works 50 to 60 hour weeks? What are his bills? That sounds like a lot more going on than just slow insurance payouts.

Given that he makes a loss on Medicare patients - costs exceed revenues - this is not unusual.

Bil, you should read more MedBlogs. This situation is not unusual. There's too many fixed costs - malpractice insurance is the same per year whether you see one patient or a thousand. Similar for rent, reception, accountancy... Work 50 hrs a week, you go broke. 60, you break even. 70, you make out like a bandit.

Work 80 for ten years, then you retire. Or become a paid employee of a large medbiz, so you get holidays, health insurance, workers compensation, reasonable hours...

The docs aren't the bad guys in this. Non-interventionalist cardiologists (that is, non-surgeons) like my partner are facing 21% Medicare cuts and scrambling to do "assembly-line-medicine" (here a test, there a scan, everywhere a billable procedure) just to make the minimum of their "expected" money for the clinic/hospital/whatever in order to get paid or have a job AT ALL.

A 60-hr week would be a slow week here in our household.