From Brienne

The Impact of Health Insurance and Liability Insurance on Physician Autonomy

Although the book does not focus too much on the impacts of insurance on physician sovereignty, it is an important issue that has direct impacts on physicians’ practice. I know one physician who, in the course of his 40 year career, spent more and more time completing paperwork for health insurance companies, trying to meet the differing requirements of both health insurance and government regulations within Medicare and Medicaid. He experienced frustration over concerns about being audited by government agencies or of not receiving payment due to some bureaucratic requirement that he was not aware of. In the final year of his practice in 2010, as he attempted to cut back on patients, the chief determinant of the final day his office remained open was the annual cost of liability insurance. While he would have loved to care for his longtime older patients, the volume could not justify the insurance expense.

The book focuses mainly on direct medical decision making, but there is a vast array of issues that impact a physician’s autonomy.