The recent column implying hospital-based physicians provide more effective or affordable care (“Support hospital-based doctors to help all kinds of patients,” April 14) is not accurate.

Independent primary care practices also see Medicare and Medicaid patients. We are only allowed to charge for the doctor’s time at each visit. Hospital-affiliated practices can charge for the doctor and a hospital facility fee. Therefore, they get a subsidy with every visit. Because independent practioners have to be aware of finances we work to get the most cost-effective care for our patients, outside costly hospital systems if possible.

The small family practices have long provided medical homes for their patients. We do collect medical data, we do notify people of needed preventive care and we do sometimes make home visits. We have a long-term relationship with our patients that hospital-based physicians usually don’t have.

The sad fact is that the United States system of medicine is too expensive. Europe has better access and equal quality at half the price. Doctors, pharmaceutical companies, insurance companies and also hospitals must all reduce costs.

Dr. Michael Szela

Capital Family Practice

Augusta