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| U.S. Sen. Kelly Ayotte discusses the impacts of health care reform with Dr. Ted Brooks and other local physiciansatDerryMedical Center in Derry Thursday, as part of her week-long tour of Granite State medical facilities. |
By CHELSEY POLLOCK
Union Leader Correspondent
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| U.S. Sen. Kelly Ayotte, left, chats with Derry Medical Center lobbyist Maura Weston and center CEO Tom Buchanan. |
DERRY -- Marking the one-year anniversary of the new health care reform law, U.S. Sen. Kelly Ayotte, R.-N.H., spent this week touring New Hampshire medical facilities to discuss Medicare reimbursements, a new medical device tax and the lack of incentives for incoming primary care doctors.
Ayotte’s final stop Thursday was at the Derry Medical Center, a family practice founded 47 years ago by a Scottish doctor looking to escape a volume-based, nationalized health care system.
“Things have changed tremendously over the years and now we sort of micromanage people’s lives, but we’re doing a lot more for chronic disease identification and management,” said Dr. Ted Brooks, a physician at the Derry center. “We are very concerned that that’s being directly threatened by what is essentially a national health care system that we don’t have any control over.”
Dr. Albert Northcutt, of the group’s Londonderry Family Practice Center, highlighted decreasing reimbursements for Medicare and Medicaid patients as one of the main concerns for smaller, community- based practices.
“The reality is that if our pay drops by more than 30 percent, as a business decision not necessarily an ethical or moral decision, we can’t stay viable if we lose that kind of money,” Northcutt told Ayotte. “Then we can’t take those patients even though we would want to see those patients and we’ve always seen those patients. You just can’t do it because then I can’t pay my staff every two weeks.”
It’s not just about what’s in the new law, they said, but also what’s been overlooked.
Derry Medical Center CEO Tom Buchanan said he wanted to see more incentives to draw students into primary care as opposed to higher-paying specialties.
“There’s really nothing in that 2,700-page law that did anything to create or improve access in primary care,” Buchanan said. “... There’s no debt repayment or other things that would change these medical students to say, no, I will go into primary care. There was no real acknowledgement.”
Tufts University students often spend six-week rotations at the Derry Medical Center each year, but Brooks said fewer and fewer students are considering primary care.
“It’s a minority of students who are going into primary care,” said Brooks. “Reimbursements are going down; the future is uncertain. They are graduating with $200,000 or $300,000 in debt and it doesn’t make sense for them logistically or economically to go into a field where they don’t know if they can pay their bills.”
After touring the facility, Ayotte applauded the group for their approach to patient care.
“You’re a model for the types of organizations that we should be fostering in terms of cost effectiveness and quality care,” Ayotte said. “But when you tell me you’re not sure how your model will thrive under the new health care reform bill, obviously that’s a deep concern.”
This week Ayotte also visited iCad, Inc., a Nashua-based manufacturer of computerized detection systems, Next Step Orthotics and Prosthetics in Manchester and Salient Surgical Technologies in Portsmouth.
She said those companies were especially concerned about a 2.3-percent excise tax on medical devices included as part of the year-old law.
Ayotte said she is co-sponsoring a bipartisan bill that would repeal the medical devices tax.
“It’s a tax on innovation and it’s going to hurt those companies that are developing new medical products and generating new ideas,” said Ayotte in an interview after the tour. “I heard from a company just this afternoon that said it could force them to ship jobs out of the country.”
In New Hampshire, she said, 50 companies and some 3,800 employees could be affected by the tax.
Ayotte’s final stop Thursday was at the Derry Medical Center, a family practice founded 47 years ago by a Scottish doctor looking to escape a volume-based, nationalized health care system.
“Things have changed tremendously over the years and now we sort of micromanage people’s lives, but we’re doing a lot more for chronic disease identification and management,” said Dr. Ted Brooks, a physician at the Derry center. “We are very concerned that that’s being directly threatened by what is essentially a national health care system that we don’t have any control over.”
Dr. Albert Northcutt, of the group’s Londonderry Family Practice Center, highlighted decreasing reimbursements for Medicare and Medicaid patients as one of the main concerns for smaller, community- based practices.
“The reality is that if our pay drops by more than 30 percent, as a business decision not necessarily an ethical or moral decision, we can’t stay viable if we lose that kind of money,” Northcutt told Ayotte. “Then we can’t take those patients even though we would want to see those patients and we’ve always seen those patients. You just can’t do it because then I can’t pay my staff every two weeks.”
It’s not just about what’s in the new law, they said, but also what’s been overlooked.
Derry Medical Center CEO Tom Buchanan said he wanted to see more incentives to draw students into primary care as opposed to higher-paying specialties.
“There’s really nothing in that 2,700-page law that did anything to create or improve access in primary care,” Buchanan said. “... There’s no debt repayment or other things that would change these medical students to say, no, I will go into primary care. There was no real acknowledgement.”
Tufts University students often spend six-week rotations at the Derry Medical Center each year, but Brooks said fewer and fewer students are considering primary care.
“It’s a minority of students who are going into primary care,” said Brooks. “Reimbursements are going down; the future is uncertain. They are graduating with $200,000 or $300,000 in debt and it doesn’t make sense for them logistically or economically to go into a field where they don’t know if they can pay their bills.”
After touring the facility, Ayotte applauded the group for their approach to patient care.
“You’re a model for the types of organizations that we should be fostering in terms of cost effectiveness and quality care,” Ayotte said. “But when you tell me you’re not sure how your model will thrive under the new health care reform bill, obviously that’s a deep concern.”
This week Ayotte also visited iCad, Inc., a Nashua-based manufacturer of computerized detection systems, Next Step Orthotics and Prosthetics in Manchester and Salient Surgical Technologies in Portsmouth.
She said those companies were especially concerned about a 2.3-percent excise tax on medical devices included as part of the year-old law.
Ayotte said she is co-sponsoring a bipartisan bill that would repeal the medical devices tax.
“It’s a tax on innovation and it’s going to hurt those companies that are developing new medical products and generating new ideas,” said Ayotte in an interview after the tour. “I heard from a company just this afternoon that said it could force them to ship jobs out of the country.”
In New Hampshire, she said, 50 companies and some 3,800 employees could be affected by the tax.
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