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September 11, 1981

Reimbursement Problems Encountered by Private PhysiciansAn Example From a Family Practice in New York City

JAMA. 1981;246(11):1203-1206. doi:10.1001/jama.1981.03320110015017

MY HUSBAND and I have shared a family medicine practice in the Bronx for many years. Five years ago I reduced my private practice and became the director of a family medicine residency program. As a result of my academic affiliation I began to consider some of the problems of the payment system used in the private practice of family medicine in New York City. Private family physicians receive the rewards of helping people, of problem solving, and of the positive feedback from patients, but they also have to earn a living, and I believe that there are inequities in the payment system.

The payment systems we use are payment either by patients directly or by third-party payors: Workers' Compensation, Blue Shield (the largest supplier of medical insurance in the area), Medicare, and Medicaid.

Although third-party payors have different reimbursement schedules for the various geographic localities of the country, I