Private healthcare is a patient-centered mode of physician practice based on patient expectations. These expectations reflect the desire for autonomy over one's own healthcare. Autonomy is the basis for the following three Freedoms which comprise our

PRINCIPLES OF PRIVATE HEALTHCARE:

1. FREEDOM TO CHOOSE MY OWN PHYSICIAN AND HEALTHCARE PROVIDERS. No government agency, no employer, no managed care entity should limit my freedom to choose my own doctor, hospital or other healthcare provider. 2. FREEDOM TO MAKE MY OWN HEALTHCARE DECISIONS WITH MY FAMILY AND PHYSICIAN. No government agency, no employer, no managed care entity should limit my freedom to choose what is best for my own healthcare. 3. FREEDOM TO PLAN, SAVE, AND PAY FOR THE COST OF MY OWN HEALTHCARE IN ANY WAY I CHOOSE. No government agency, no employer, no managed care entity should limit my freedom to access any means of financing my own healthcare

What You Should Expect from Your Private Physician

When people are looking for better healthcare and are prepared to pay somewhat more for it, they have specific expectations about a physician's practice. Surveys show that the most important expectations concern the character of the physician and how the practice deals with patient interactions. Competence is not a primary concern. Consumers assume almost all doctors are well-trained and competent, whether doing managed care or private healthcare. Expectations can be divided into four areas which in increasing order of importance are: access, responsiveness, respect, and a personal relationship

Access: Consumers expect easier access to a private physician than to a managed care doctor. Easier access can mean the availability of urgent appointments, early new patient appointments or direct telephone contact with familiar employees rather than a voice mail system. It can mean physician availability on-call, after hours and on weekends. At the hospital, it can mean care from your private physician and not transfer of care to a hospitalist

Responsiveness: Consumers expect more action and answers from a private physician than a managed care doctor. Responsiveness can mean enough time during an office visit to ask all questions and direct answers to those questions. It can mean same-day returned phone calls or willingness to communicate with family members. It definitely means taking charge of your problems and not passing them on for other doctors to evaluate and manage.

Respect: Consumers expect to be seen as a person first and treated as a patient second by a private physician, something they would not expect from a managed care doctor. Respect means not being treated like a number in a huge managed care system. Respect is reflected in the manner you are dealt with when you telephone the office, how you are treated by office technicians, the billing service, or even the answering service. Most importantly, it means the manner in which the physician conducts himself or herself when interacting with you and your family.

A Personal Relationship: Consumers expect a committed, personal relationship with their private physician, something they would not expect from a managed care doctor. A personal relationship means a commitment on the part of the physician to you as a person who is vulnerable and at risk. It means the assurance that the physician always has your best interest at heart and can be relied upon to guide you in making the best healthcare decisions. This sense of commitment is the most valued expectation on the part of those seeking private healthcare.

Paying for Private Healthcare

Private healthcare is not about where you live or how wealthy you are. It is potentially available to everyone. There are physicians in the Watts neighborhood of South Central Los Angeles practicing private healthcare among the poorest patients in that city. People there are fully capable of choosing better care when it is available and recognize immediately that this manner of physician practice is much better than the HMOs and Medicaid clinics which are the alternatives.

Private healthcare is not about paying cash or any particular mode of payment. Most private physicians do not participate in any HMO or PPO managed care contracts because they limit choices of treatment and referral and reimburse for services poorly. Private physicians set reasonable fees and help their patients deal with managed care plans which partially reimburse these fees.

Private healthcare is available to Seniors. Most private physicians are still enrolled in the Medicare program. Medicare limits all physician fees, and Medicare supplements do not pay for any extra services not approved by the government. Physician participation in the Medicare program comes with a large burden of government regulation, audits and risk of prosecution. (See A Chronology of Federal Regulation of Healthcare and Its Consequences: The Physician's Perspective.) Private physicians do not want to stop caring for their patients who turn 65 and are forced into the only government healthcare program that is available. Unfortunately, Seniors can expect increasing numbers of physicians to withdraw from Medicare over the next decade.