Doctors and HMOs

Although recent HMO legislation espouses Donna Shalala’s principle that “No patient should have to wonder if their doctor’s decision is based on sound medicine or financial incentives,” the majority of Medicare patients, those in fee-for-service Medicare, are left unprotected (“U.S. Acts to Ease HMOs’ Cost Pressure on Doctors,” Dec. 26).

Published medical studies have proven that physicians are subject to the same human frailties as everyone else with medical behavior being influenced by financial incentives in a fee-for-service environment. The disappearance of the stories of yesteryear about unnecessary surgery and overutilization is not because this no longer occurs but rather that the media no longer consider these newsworthy. Regretfully, physicians running for-profit practices are part of our capitalistic society.

Rather than trying to legislate away human behavior, why doesn’t the government concentrate on working with the medical community to define “sound medicine” before Medicare goes broke and everyone loses.

MARVIN J. GORDON MD

Mission Viejo