Blog | Wednesday, January 20, 2010

The doctor will see you shortly--by law

California debuted new rules that specify patients in health maintenance organizations (HMO) see a doctor within 10 days of asking for an appointment. Calls must be return within a half-hour, and health professionals must be available 24/7. Urgent care must be seen in 48 hours.

Richard Frankenstein, FACP, former president of the California Medical Association, told the Los Angeles Times that this places pressure on the HMOs to have a big enough network to deliver what they promise. Critics contend this will force doctors to rush patient care even more, or be especially damaging to rural areas already facing a shortage.

The law was passed in 2002. It took state officials seven years of negotiations with HMOs, doctors and hospitals to draft the final regulations. Now, HMOs have a year to figure out how to implement the goals, or face consumer complaints to the state and possible penalties.

Physician recruiters Merritt Hawkins & Associates found that patients in San Diego wait an average of 24 days for a routine physical and those in Los Angeles wait 59 days on average. (The results were part of a national survey for major metro areas, comparing results from 2004 to 2009.)

This might be old hat to those who've chosen to adopt the patient-centered medical home model, and can offer such care. But could you practice internal medicine through an HMO contract in California now?