My dad was not a prepaid group practice patient

Abstract

The author's father was a psychiatrist, a concerned citizen, and a Medicare patient. He died recently after a prolonged illness during which a panoply of physicians cared for him in ways that were sometimes redundant, inefficient, and poorly coordinated. He was definitively not a prepaid group practice patient. The author reviews the growing body of evidence that suggests that physician density is associated with greater costs but not improved outcomes. He reflects on his father's concerns with equity in health care and how prepaid managed care might have provided more efficient and less expensive medical coverage for his father's final sickness.