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<body topmargin=0 leftmargin=0 marginheight=0 marginwidth=0> <table cellpadding=0 cellspacing=0 border=0><tr> <td valign="top" colspan=2 height=82 BGCOLOR="#666699" TEXT="#080000" bgproperties="fixed" background="1e328283.gif"> <div> <FONT SIZE="4" COLOR="#FFFFFF" FACE="Garamond" ><B>PRIMARY CARE PARTNERSHIP</B></FONT><FONT SIZE="1" COLOR="#FFFFCC" FACE="Garamond" ><B>  </B></FONT><B>   |     </B><A HREF="index.htm" TARGET="_top" TITLE="PRIMARY CARE PARTNERSHIP"><B>home</B></A></div> <div> <A HREF="about.htm" TARGET="_top" TITLE="About PCP">About PCP</A>   |   <A HREF="practice.htm" TARGET="_top" TITLE="Practice">Practice</A>   |   <A HREF="patients.htm" TARGET="_top" TITLE="Patients">Patients</A>   |   <B>News</B>   |   <A HREF="contact.htm" TARGET="_top" TITLE="Contacts">Contacts</A>   |   <A HREF="links.htm" TARGET="_top" TITLE="Links">Links</A>   |   <A HREF="search.htm" TARGET="_top" TITLE="Search">Search</A></div> <div> </div> </td> </tr><tr> <td valign="top" width=210 BGCOLOR="#C0DCC0" TEXT="#080000"> <div> Add your name to our</div> <div> <A HREF="mail_list.htm" TARGET="_top" TITLE="eMail List">e-mail list</A></div> <bR> <bR> <div> <IMG SRC="1a7c6c90.png" border=0 width="198" height="201" ALT="Microsoft Photo Editor 3.0 Photo" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></div> </td> <td valign="top" height=398 width="100%" BGCOLOR="#FFFFFF" TEXT="#080000"> <div> News</div> <div> <B>Commonwealth Choice</B></div> <div> Under the Massachusetts Health Care reform law, insurance companies now offer specific insurance plans for affordable health insurance for uninsured individuals. These plans are offered under the name of Commonwealth Choice. Each insurance company has instituted Commonwealth Choice plans and selected the providers who may accept the plans. Low income individuals may be eligible for the subsidized Commonwealth Care plans. <A HREF="insurance_com_choice.htm" TARGET="_top" TITLE="Insurance Accepted">Additional Information</A>.</div> <bR> <div> <B>Dr Smigel Resigns</B></div> <div> PCP is sad to report that we are losing Dr Karen Smigel to the Naval base ambulatory care clinic in Newport, as of November 1st. Her last day with us will be in mid-October. Dr Smigel has been with us for four years and will be sorely missed. She has given the "financial insecurities and administrative work that the insurance companies have placed on us" as predominant reasons for leaving private practice. For those patients who have seen her exclusively, it is unfortunately not an option to follow her, as the naval base sees military families exclusively. We will endeavor to provide the same high standard of care after her departure, with Dr. Hood and Maria Flanders remaining. The search is on for Dr Smigel's replacement. Her shoes will be hard to fill. Please follow our progress in hiring a new provider by watching this page. We will announce a new addition to our provider staff soon!</div> <bR> <div> <B>Beware of Tiering!</B></div> <div> It is not a coincidence that Dr Smigel's departure from Primary Care Partnership has come close on the heels of the implementation this Summer of Unicare/GIC's tiering program for physicians in Massachusetts. As you may know, this is one of the insurance products we do not contract with, but have submitted electronic claims as a courtesy to our patients with this coverage. Unfortunately, despite a warning by the Mass Medical Society to allow physicians an opportunity to provide feedback before implementation, Unicare nevertheless went forward with their plan to establish tiers for doctors, tying the patient's copay to the doctor's tier. They took the confidential claims and billing data, without our permission, and gave it to an agency that used a software program to determine a physician's relative standing with respect to money reimbursed, and called it a quality assessment. Tier 2 was assigned as "average."</div> <div> Tier 1 would demand the lowest copay, tier 3 the highest. They marketed this program as evidence of their cost-consciousness, and published the names and tiers of all the physicians, again without our permission They encouraged patients to seek out the top tier doctors - the reward being the lesser copay. </div> <div> <I>The problem is that the tier tells us nothing about the quality of care that doctor provides, just how much money he/she cost the insurance company!</I></div> <div> And the more serious problem for our healthcare system is that this misappropriation of claims data has the effect of impugning the reputations and livelihoods of excellent physicians who either work under the auspices of another physician's practice (Dr. Smigel was defaulted to tier 2 because Unicare neglected to import her name from her claims) or happen to take care of a sicker-than-average patient population, like the pediatricians here in Fall River who have an inordinate number of children with cerebral palsy, cystic fibrosis, seizure disorders, and the like. </div> <div> The bottom line: Tiering is intentional manipulation of confidential claims data for purposeful deception of the patient population and commercial gain in the marketplace, NOT a true indication of quality. They are trying to steer patients into the offices of the doctors who cost them the least, with no care whatever for that patient's well-being, contrary to the content of their glossy brochures.</div> <div> Buyers and beneficiaries of health insurance beware!</div> <div> There is every indication that other insurers are following suit.</div> <bR> <div> <B>HPV testing</B></div> <div> You may have seen recent advertisements on television about testing for Human Papilloma Virus. There are also kiosks at the mall and orange rubber bracelets with the logo "right to know" on them referring to the same thing. HPV is the causative agent of cervical cancer, and there is now a patented DNA test that can be done at the time of your Pap smear, to detect the presence of the virus. At Primary Care Partnership we  perform the Thin Prep Pap smear, processed at Southcoast Hospital. If an abnormal smear is discovered, the HPV test is performed automatically. Results are always called to the patient if positive. If negative, we inform our patients by letter, with any recommendation for follow-up care. An abnormal Pap smear, HPV positive, may signify precancerous or cancerous changes of the cervix. A referral to a gynecologist is made at that time, and a culposcopy is usually done there to determine whether treatment to eradicate the virus and restore normal cellularity is needed. The company that markets the HPV test is urging all women over the age of 30 years to demand that HPV testing be done at the time of their pelvic exam/Pap smear. The reason for the age recommendation is that, under the age of 30, many spontaneous remissions of HPV positivity to negative occur without intervention. The American College of Obstetrics and Gynecology has yet to issue a consensus statement on the advisability of universal testing over 30. Until it does, we are making the test available to all of our patients, and will continue our current practice of receiving HPV tests on all abnormal Paps as before. </div> <div> Please familiarize yourself with the complex issues surrounding the discovery of HPV and its potential implications for your health. A good initial resource is the US Government Center for Disease Control in Atlanta. Go to www.cdc.gov. There you will also find current information on the newly approved vaccine against HPV, Gardasil, now recommended for girls and women aged 9-26.</div> </td> </tr></table></body>