Huge changes have occurred in the medical profession, and the old-time personal family doctor is getting harder to find. The biggest change is in HMO’s. Designed to lower health care costs, they have reduced the efficacy of the care that patients receive. One of our local well-known doctors feels that he has paid his dues and done his stint with this form of medical practice.

Dr. Steven Fales, who has been practicing medicine in Las Vegas for 26 years, says that there are many wonderful people who have joined HMO’s and many fine doctors doing their best to render good care under this model. However, as an HMO doctor Dr. Fales was feeling more and more pressure to do “cook book” medicine and was losing his personal freedom to obtain the best and most timely care for his patients.

Dr. Fales has relocated his practice to the Mountain View Hospital office building and rejoined some of his old associates in a group practice that is based on the traditional fee for service model. There are still many restrictions and complications in dealing with current insurance companies but both he and his patients now have much more freedom in diagnosis and treatment.