Just to show I don't stick my head in the sand, here is a link I imagine a few of you are going to enjoy quite a bit http://news.investors.com/blogs-capital-hill/082715-768522-obamacare-co-op-in-nevada-is-the-third-to-fail.htm This may actually have an impact on me as my current preceptor, whom I plan to work for, has had a rather large influx of patients to his practice through this co-op. Sadly, a lot of these people who came in through this plan have a lot of issues that are quite manageable with very affordable medications. Prior to coming to his office, however, they went to ERs or urgent care where they received about five minutes of attention and quite often, inappropriate care.
As I compare my experience to that of my classmates, I am finding that the norm in most offices that are ruled by HMOs is to spend literally no more than 15 minutes with a patient, limit them to 1-2 issues at most, and refer them out to "specialists" even though a vast majority of what specialists do can also be done in primary care. In our office, my preceptor will manage quite a bit and take responsibility for managing as much as a patient feels comfortable with him managing. This saves a lot of money for the system and time for the patient. But, it takes an investment of time up front by the doctor that they will not be paid for, or at the least, they will not be paid as well for that one visit versus three, treat em and street em visits.
A lot of patients who have come in have been very grateful and have been very compliant once they received education about their conditions and why they have been taking certain medications.