“AS USES WIDEN FOR INTRAUTERINE CONTRACEPTION, WHY HAVEN’T OBGYNS BECOME ADVOCATES?” ROBERT L. BARBIERI, MD (EDITORIAL; NOVEMBER 2009)
I have been in solo practice for almost 10 years. During that time, I have had patient requests for intrauterine contraception. After researching the cost of the devices, and the various reimbursements for placement, I never found it to be a feasible business move. I am dedicated to women’s health, but not to the exclusion of my practice’s financial health. A high volume of patients allows me to maintain a financially healthy business. Placement of an intrauterine device (IUD) takes more time and yields little—or ends up costing the physician when the price of the device exceeds reimbursement. I send patients who request an IUD to Planned Parenthood, an organization that operates on a different business model than I do. I have done so with full disclosure and explanation.
Ruth Schleifer, MD
South Windsor, Conn
Dr. Barbieri responds: Practice patterns are not always conducive to IUD advocacy
In the United States, we are fortunate to have a cadre of highly trained and deeply committed ObGyns, as evidenced by the thoughtful and concise letters from Dr. Schleifer and Dr. Tolley. Their experiences demonstrate how the unique situations of each physician (and patient) influence practice patterns. As we evolve our health system, I hope that financial barriers to patient care will be identified and resolved.