1401 Ochsner Blvd. Suite A
Covington, Louisiana 70433


toplogoAs published in the New Orleans Advocate and Baton Rouge Advocate – September 16, 2014

Louisiana’s doctors are protesting the government’s intrusion into health care. These protests aren’t taking place in the streets, however. They’re taking place behind the scenes — and they’re affecting how Louisianans receive health care.

I have personally witnessed this protest develop. When I graduated medical school in 1986, medical decisions were made predominantly between doctor and patient. Today, however, many are made before patients even come through the door. Decision-makers today are government bureaucrats 1,000 miles away inserting themselves into every issue.

Many of Louisiana’s 9,800 physicians are protesting this intrusion into the doctor-patient relationship by shielding our practices from bureaucratic overreach.

Witness the number of physicians having to refuse new Medicare and Medicaid patients. A recent survey found 26 percent of physicians have stopped accepting Medicaid patients. Another 52 percent reported having or planning to limit the number of Medicare patients they see.

Thousands more physicians are dropping Medicare altogether — nearly 10,000 of them in 2012 alone. That’s a 160 percent increase over three years earlier, when the Affordable Care Act was passed. With nearly 900,000 Louisianans over the age of 60, we need a system that encourages physician participation, not one that pushes them out.

Many physicians are instead seeking practices that limit government interference. The emergence of “concierge” and “third-party-free” practices provides perfect examples.

Concierge practices charge patients membership fees to be included in their practice. Third-party-free practices have no insurance contracts and directly charge the patient for services rendered. These practices avoid the hassle of dealing with government programs like Medicare and government meddling in private insurance.

Last year, fully 10 percent of practice owners reported plans to convert to concierge medicine over the next three years. Of all physicians, 7 percent said they were planning to stop accepting insurance altogether. This makes sense: Eliminating insurance payments saves, on average, 40 percent in billing-related overhead expenses.

I, for one, took my practice third-party-free. More important than the cost savings, eliminating the additional paperwork of government-entangled insurance allows me to spend more time with my patients. It also removes the government and insurers from health care decisions, allowing them to be made exclusively between doctor and patient.

Still other physicians are protesting by leaving private practice altogether and seeking shelter in hospital-owned networks. Just 10 years ago, roughly two-thirds of medical practices were physician-owned; today, that number has dwindled to around half and is shrinking each year. While this allows doctors to remain financially viable, it adds a layer of bureaucracy from their corporate employers.

Physicians are tired of the government intruding upon the doctor-patient relationship. Our practice decisions are our collective protest — and we won’t stop until bureaucrats and politicians get out of the treatment room.

Gerard Gianoli, M.D.


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1401 Ochsner Blvd.
Suite A
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