Washington area residents generally receive quality medical care at less expensive prices through the area's five health maintenance organizations (HMOs) than with private physicians, but they may not be as happy with HMO physican services as with the traditional doctor system.
That is the essence of a survey of patients published yesterday in the latest issue of Washington Consumers' Checkbook, a nonprofit magazine directed by Robert Krughoff, president. The issue costs $4.95 and will be available on magazine racks beginning Jan. 2 or from the Checkbook office at 1518 K St. NW.
Included in the magazine is a report on how 10,000 Washington-area residents rated individual physicians and medical groups here. That survey and the HMO patient survey were based on comments obtained from local subscribers to Checkbook and to Consumer Reports magazine.
After compiling information from 824 local residents who belong to HMOs -- which typically are prepaid group health programs -- the magazine concluded that some of the programs are better than others, that the HMOs may be good for some people but not for everyone and that problems that do occur tend to grow out of the patient-doctor relationship in the HMO plans.
For example, the survey asked patients to rate their doctors for "arranging to see you quickly when you request." The results reported by the magazine showed that 34 percent of the patients at the Group Health Association, the area's largest HMO with 111,000 members, rated their physicians "superior." But when that question was asked of the patients of private physicians, 64 percent of those surveyed rated their doctors as "superior."
Patient satisfaction on that one point was higher in the other HMO programs, with 38 percent rating physicians "superior" for quick appointments at George Washington University Health Plan and 43 percent at Kaiser-Georgetown Community Health Plan.
The one exception to the trend showing private physician patients more satisfied than HMO patients on quick appointments was in the Columbia Medical Plan, which is among the smaller HMO programs here. Seventy percent of the Columbia patients responding to the survey rated their physicians as "superior" -- a higher rate than the private patient rating of 64 percent.
John Ott, executive director of the George Washington HMO plan, questioned the survey method used. Rather than a random sampling of opinion, he said, the surveyers relied on patients to respond -- "those with a point to make."
Ott also said that other national surveys show that HMO patient access to their doctors is as speedy as the private patient's access to the physician. t
No data was available on patient ratings of Health Plus, the newest and smallest of the five HMOs. The magazine does have some details on the cost of the Health Plus plan, however.
Among the advantages of the HMO prepaid group practice prorams are the generally lower annual cost of medical care, the magazine said. In one case, the HMO plan was about $400 lower than a representative insurance plan. However, some federal employes may be better served by insurance programs available to them through their work.
The magazine said that HMO doctors are slightly better trained on the average than are physicians in the traditional fee-for-service systems. The HMO doctors also generally use some of the area's better hospitals and are unlikely to put patients through the discomfort and risk of unnecessary surgery, the magazine said.
Disadvantages of HMO cited by the magazine included the less satisfactory relationships with doctors and the HMO locations, which may not be convenient for some patients.