Insurers must be forced to grant privileges to all specialists who graduate from these accredited residencies.
By: Débora H. Silva MD, FAAP, MEd.
Recently, Senate Project 1134 has circulated, which, among other measures, provides that the Board of Licensing and Medical Discipline can grant certifications of experts a doctors generalists for years of service, as well as opening state residences not accredited by the Accreditation Council of Graduate Medical Education (ACGME). This, in my opinion, the only thing that will achieve is a dual health system divided between rich and poor. Puerto Rico needs expertsof course, but it cannot be at the expense of the people who are already being run over.
It is widely known that the current health system is at the mercy of insurers. These deny privileges to graduates of accredited residencies resulting in all those graduates having to leave Puerto Rico. Also, they maintain rates below the norm for experts that are already within your network, causing them to also migrate or stop accepting the medical plans.
As the only alternative to increase the number of experts let them stay in Puerto Rico is by granting them privileges for the insurers and increasing pay rates. One wonders, then, how is it that the graduates of accredited residencies are not currently provided with privileges, but those who are given a specialty degree for years of service or for graduating from a state residence are going to be granted them? Doesn’t make sense does it?
Unless it’s because the insurers they know that the experts without formal training or graduates of state residences will not be recognized in any other jurisdiction of the United States, thus reducing the possibility that they emigrate from Puerto Rico. This would make them a group of new experts kidnapped at the mercy of the rates that the insurers wish to put, whether they are equal to or lower than those that exist today. We must remember that the raison d’être of the insurersas a business, is to make money.
It is my opinion, this is going to result in a dual health system, where those who can directly pay for health care will be treated with experts graduates of ACGME-accredited residencies, while those who are not will be served by graduates of state residencies or those who were awarded a degree without formal training.
To prevent this, it is necessary to maintain and expand the number of accredited residences, which are the only ones with a transparent quality guarantee process and, concomitantly; you have to force the insurers to grant privileges to all experts who graduate from these accredited residencies. Lowering the quality standards that accredited residency programs have will only lead us to injustice.
It is imperative that the government oversees the insurers and forces them to give privileges to experts graduates of accredited residencies and raise premiums for all physicians. This is the only way to increase the number of expertsassuring both quality of medical care and justice for all patients regardless of their ability to pay.