It was recently reported in the news that Dr. Marcus Conant, a veteran HIV specialist working in San Francisco, has decided to quite his practice over hassles with insurance billing in his private practice. Though he has been practicing for over fifty years, and would like to continue to practice until physically or mentally unable to do so, he feels that he can’t practice the type of medicine that he wants to.
This is very concerning for a couple reasons. For one, there will likely be greater demand for the medical services that HIV/AIDS specialists provide over the coming decades as the number of new HIV infections is remaining constant, or actually increasing, and as HIV/AIDS patients live longer. In addition as HIV/AIDS patients live longer lives, new medical challenges associated with their care will become apparent, and the long term side effects of HAART will require more specialized knowledge than some physicians treating HIV/AIDS patients have today.
Secondly, it is sad to see such an experienced infectious disease expert hang up his hat over bureaucratic difficulties. Not many medical students these days would want to devote themselves to the care of HIV/AIDS patients, or to work exclusively with socio-economically disadvantaged patients. Hopefully, the recently enacted health care reform law will help address some of these issues, such as helping private practice doctors in underserved areas keep their practices afloat.
When I was in medical school topics such as caring for HIV/AIDS patients and learning to see patients as individuals dealing with their own socioeconomic obstacles was rarely addressed. Neither was there an emphasis on learning how best to contribute to your community after the completion of training. Rather, medical education is a brutal process which is dominated by politics in which consideration of the patient comes last. This, sadly, may be a sign of the times when a doctor’s displeasure with their practice is transferred into apathy for medical education, such that students absorb the callous nature of their would-be mentors.
This may be the greatest lost with Dr. Conant’s involuntary retirement from full time practice, the loss of a dedicated physician who strived to be the best in his field and to care for some of the nation’s most vulnerable patients.
Will an equally caring and expert doctor replace Dr. Marcus Conant? There are plenty of young doctors who would be capable of doing so, but changes in billing practices are needed to help the community oriented health care center survive. At the very least, distractions caused by complicated paperwork, and excessive arm wrestling with insurance companies, should be eliminated to prevent caring doctors from becoming burnt out.