The Virginian-Pilot
                             THE VIRGINIAN-PILOT 
              Copyright (c) 1994, Landmark Communications, Inc.

DATE: Saturday, August 27, 1994              TAG: 9408270007
SECTION: FRONT                    PAGE: A14  EDITION: FINAL 
TYPE: Letter 
                                             LENGTH: Short :   42 lines

DOCTORS' DILEMMA: PATIENT CARE VS. COSTS

Upon reading ``Medicare doctors hard to find here'' (news, Aug. 21), I was struck by the statistics relating to the number of Medicare patients in the area relative to the number of available providers.

I am a fourth-year medical student at Eastern Virginia Medical School, preparing to graduate in May. During our training, my classmates and I have had the luxury of caring for patients without the burden of concern regarding cost and reimbursements.

All that will change with graduation, and many of us realize that we do not understand the business aspects of medicine.

What we do know is that we will have trained for more than 10 years, and accrued thousands and thousands of dollars of debt, in order to be able to care for people who need us.

We get to be idealistic while we are in school, assuming that we can care for anyone who walks through the door of our office.

Reality hits when we finally begin a practice and realize we have to weigh paying others, paying ourselves, paying back loans, etc., against caring for certain patients (e.g., Medicare patients). It is distressing to me to think that one day I may be forced to turn a patient away because his government-provided insurance won't reimburse me well enough to cover my costs.

I did not choose to become a doctor to become rich. Rather I chose to become a doctor because I care about the health and welfare of others.

Unfortunately, today's health-care system seems to be in direct opposition to my reasons for entering medicine, and many of my colleagues feel the same. I fear for the future of health care in the United States, and I wonder if things could get any worse.

KIMBERLY WELTY

Norfolk, Aug. 21, 1994 by CNB