The AMA should back movement to collect liability surcharges

Regarding "AMA to study liability surcharges" (Article, July 5): My practice's bottom line dropped 35% last year, largely due to a doubling of my malpractice premium, and fixed reimbursements from Medicare and insurers.

The AMA must take action to assure that physicians can continue to serve their patients without going bankrupt.

It is clear that Medicare and insurers don't care that their reimbursements don't cover our real costs. Congress certainly doesn't seem to care that the physician reimbursement formula remains broken. We must have some mechanism by which costs can be passed on to consumers, as in any other business.

The AMA must not conclude somehow that it is unethical to pass these costs on. We can't serve patients if we are out of business.

It would be unethical for the AMA to fail to take all necessary actions to prevent the collapse of physician practices, which would lead to terrible access problems.

Unless the AMA can compel Congress to increase not only relative value units but also the conversion factors to adequately keep pace with these true costs, the AMA must advocate ways that allow doctors to legally pass these costs on to consumers.

There are real economic costs associated with taking call, returning phone calls, arguing with insurance companies on behalf of our patients, writing prescriptions and simply being there for our patients.

Attorneys, accountants, financial planners, and all other professionals don't give their services out gratis like physicians have been expected to. Now that the third-party payer system has bled the profits completely out of medical practices, we simply can't afford to continue as we have and be expected to keep the "open" sign in the window.

Benjamin T. Hu, MD, Coupeville, Wash.

Note: This item originally appeared at http://www.ama-assn.org/amednews/2004/07/26/edlt0726.htm.