In addition to departures, Blake's committee has also found a great deal of turmoil. Doctors are moving from private practice to Presbyterian to the New Mexico Medical Group to St. Joseph's searching for a good place to work. We have a sense of tremendous turnover and of exit from taking care of patients and going into administration. I deal with more overhead, and I have to hire more secretaries. I fight with the companies to pay for what's supposed to be covered and they think of some very inventive ways not to pay, like saying some procedure is not eligible or that I filed incorrectly or that I used the wrong number for a patient, even though they change numbers on patients all the time.
Physicians have to ask permission to practice medicine.
Then there is the issue of salaries. McKernan points to the New Mexico gross receipts tax, added to the state's income tax. Meanwhile, the premium rates are low in New Mexico, so that payments to doctors are smaller than surrounding states. Dr. Martin Hickey, ceo of Lovelace Health Systems, says doctors in Texas, Colorado, Utah and Arizona are getting paid more than physicians here in New Mexico. Meanwhile, it's estimated that approximately one-fourth of the state's population has no insurance.