COMMENTARY
A cry for help
BY MIGUEL A. GUTIERREZ, MD After being a professor at the Universidad de Medicina in Mexico and a neurologist for 13 years, I, along with my wife, made the difficult decision to leave our home in a nation whose government had no idea how to best manage the country’s health care — a country that left us powerless to help patients and often facing the mor- al dilemma of how to help patients without having to pay for their health care out of our own pockets. My wife, a U.S. citizen, convinced me to move here and start a new life with our three children. Our idea was that this country had better resources. I would have to pass exams to con- tinue to practice medicine, but my efforts would be rewarded by being able to practice medicine in a country where I could help the community by providing better diagnostics and med- ications. Once I passed the required exams, we moved to Arkansas, where I did a one-year residency in internal medicine and three in neurology. Af- ter that, we moved closer to my wife’s family.
I established my practice as a neu-
rologist in the Rio Grande Valley from the ground up. I opened my practice in McAllen, an area with high inci- dences of Medicare and Medicaid patients. The area is home to many retired individuals who have worked all of their lives and now have Medicare. It also is home to a large population living in poverty and relying on Medicaid for health care. With great sadness, however, we now find history repeating itself. Our government dictates what medications I can prescribe, without taking into account what is best for the patients. Our government has reached a point where health care is not determined by the necessities of patients; rather, it prefers to save money by demanding the use of cheaper pharmaceuticals, lowering payments for services rendered,
It seems our government is fixated on punishing those who choose higher education and work the hardest.
and yet endlessly requiring documentation supporting estab- lished health care practices. This has, in turn, increased our overhead and decreased our revenue to a point where we find ourselves having to cut benefits and personnel. Now, we have contributed to a vicious cycle, where our own employees in the health care field do not have health care coverage or will be unemployed if we are forced to close our doors. This bureaucracy has caused area physicians to either close their doors or move their practices to communi- ties with lower volumes of Medicare and Medicaid patients. At 61, I find myself constantly evaluating my practice. How am I to continue to provide medical care to a community, when I find myself regularly taking out loans to support my practice? Our area has a shortage of neurologists, and logically, no one wants to come to a poorly paid area. In the billing department, there are more obstacles for reimbursement for services already rendered. I find myself working more for less. I am a physician, a specialist, whose biggest worries should be to provide the best possible care to my patients. I should focus on keeping up with the latest innovations in patient care. Yet, at the end of the day, my biggest worry and focus is keeping up with our coun-
try’s cuts to health care. It seems our government is fixated on punishing those who choose higher education and work the hardest. Our govern- ment’s focus should be on identifying and reducing health care fraud, not limiting honest and hardworking physicians. I ask our representatives to take our cry for help to Con-
gress and provide viable solutions before we reach a greater crisis. If we continue at this pace, health care provider short- ages will continue to be catastrophic to our communities. n
March 2013 TEXAS MEDICINE 53
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