Medicare cuts impacting Ob.gyn. practice: seeing more patients that others turn away. (Some Limit Medicare Exposure).

Ob.gyn. practices are being affected as physicians nationwide are rethinking treating Medicare patients.

Internists and family physicians have begun limiting the number of Medicare patients they take on, have dosed their practices to new Medicare patients, or--in some cases--have stopped caring for Medicare patients entirely.

The exact number of ob.gyns. who've recently made similar moves is not known. While some ob.gyns. are turning away Medicare patients, others maybe seeing an increase as Medicare patients lose access to their family physicians and internists.

For instance, in Pasadena, Calif., female Medicare patients are migrating to Dr. James Macer, an ob.gyn., for their regular checkups now that internists in the community are restricting their Medicare practices, he said. Dr. Macer also chairs the California district of the American College of Obstetricians and Gynecologists.

Adults of Medicare eligibility age make up 5%-12% of the average ob.gyn.'s practice, said Dr. Thomas F. Purdon, immediate past president of the American College of Obstetricians and Gynecologists.

A 1998 survey of ACOG members showed that 89% of them take Medicare patients. ACOG just mailed another Medicare participation survey to its members; those survey results are expected this spring.

The Medicare participation issue is yet another "nail in the coffin" of ob.gyns. who are already dealing with skyrocketing malpractice rates and low reimbursement rates from commercial insurers, who use Medicare rates to set their own.