Page 15 - Boca Club News - April '25

Boca Club News, Page 15
Medical Matters: Primary Care

By Richard Nagler, M.D., a member The cost of ER care is often exorbitant. Premature burnout has resulted in earlier retirement for
of Broken Sound Club and retired Primary care doctors include internists, pediatricians, many of these doctors, adding to the shortage.
physician. After graduating from the ob-gyn, general practitioners and gerontologists. Medical The challenge is how to provide adequate primary care in
University of Pennsylvania and New student graduates are not choosing primary care residency a broken American Health Care System. Concierge doctors
York University’s School of Medicine, programs for a variety of reasons that include the fact that are increasing in numbers. They offer personalized medical
Dr. Nagler served his internship and this specialty is the least financially rewarding. care with adequate time spent with a patient and access to
residency at Baltimore City Hospital Burdened with huge student loan debt at a time when a doctor 24 hours a day. However, there is an annual fee
and Johns Hopkins. He followed that these young doctors are ready to marry, have a family and of between $1,500 to as much as $6,000 or more, which is
with a Fellowship in Gastroenterology own a home drives them into such more financially rewarding beyond the reach of most people.
at Yale University School of Medicine, and was then Chief careers as Dermatology, Ophthalmology, Radiology and Increasing the supply of Nurse Practitioners and
of Gastroenterology at Fitzsimons General Army Hospital various surgical specialties. At one time primary care doctors Physicians’ Assistants who take care of mundane chores and
in Denver. He returned to the Yale Medical School for one were held in high esteem but that has changed, mainly minor ailments would permit the doctor to attend to more
year as an Assistant Professor of Medicine before opening because these doctors no longer are in private practice. serious cases.
his own successful private practice in Internal Medicine They are hired by groups of doctors whose practices have Greater use of Telemedicine would grant access to a
and Gastroenterology. During that time, he also served for been bought up by HMOs, hospital corporations, insurance doctor, especially in rural areas where patients cannot travel
ten years as Chief of Medicine at Huntington Hospital in companies and entrepreneurs. the distance to the doctor’s office. Medical schools could
Huntington, N.Y. They become salaried employees whose income depends offer free tuition to students who are willing to commit to
In a recent article that appeared in the AARP Bulletin on performance. This translates into seeing as many patients primary care for a five-year period, especially in areas of
entitled “Where Have All the Doctors Gone?” the ever- as possible in the least amount of time and avoiding sick greatest need. Student loans could be forgiven for a similar
growing shortage of primary care Physicians is explored. This patients who take up the most time. In addition, because of commitment.
has placed an extraordinary burden on the delivery of health the lack of time spent with a patient and doing little more Thoroughly vetted foreign-trained primary care
care to American citizens, particularly evident in rural areas. than a cursory physical examination, they rely more on costly doctors could be encouraged and welcomed to the medical
Many of these doctors are not seeing new patients and others tests and procedures as well as often unnecessary referrals establishment with opportunities offered in needy areas.
are so overburdened with patients that getting an appointment to specialists within the group, adding more to costs as well Providing health insurance for the remaining millions of
is beset with unacceptable delays. as their own income. Americans who have no, or grossly inadequate, coverage is
Many patients are forced to seek medical care in urgent This kind of medical practice is no way to build a another possibility. This might involve access to expanded
care centers or in an overcrowded Emergency Room with meaningful doctor-patient relationship; it results in poorer Medicare, Medicaid, the Affordable Care Act and private
exposure to contagious illnesses and unacceptable wait times, medical care and the label of “vendor” applied to these insurance, a formidable task in today’s environment.
often resulting in patients leaving without ever being seen. doctors who have sacrificed their once cherished prestige.
Legal: Proposed New Laws

By Michael J. Posner, Esq., a partner property owners to remove trees or shrubs growing on shared that were imposed in light of the Champlain Towers
in Lippes Mathias LLP, a national property lines without permission from their neighbors, after Condominium collapse in 2021. The deadline for compliance
real estate and business-oriented providing written notice. is December 31st, 2025, and assessments as great as thirty
law firm with sixteen locations Property Taxes: Several bills have been filed that would to fifty percent of the unit’s value have been proposed to pay
nationwide. Michael specializes in dramatically affect property taxes in Florida. Governor Ron the cost of unrepaired milestone defects as well as to fully
real estate and association law. He DeSantis urged the Florida Legislature in his recent State of fund structural reserves, which reserves many associations
can be reached at (561) 594-1452 the State address to provide relief from such taxes. The cost have failed to fund for decades.
or at mjposner@lippes.com. to homeowners has increased substantially due to the rising These assessments mean that many owners, especially
Florida’s legislature is now in home values. The total amount of property taxes levied in those on fixed incomes, cannot afford to keep their units.
session and several new bills have been introduced that are Florida has roughly doubled over the past decade. However, unlike a few years ago, demand for condominium
most likely to pass this Spring. The proposed bills would increase the number of units is lower just as the supply increases, and values are
Fallen Tree Act: If a tree falls in the forest, does it make exemptions so as to reduce the taxable value of a property, declining making it hard for many owners to sell their units
a sound? (For science nerds the answer is “no,” only sound especially for homes used as a primary residence. In addition, except at bargain basement prices. A unit that would have
of waves). However, under current Florida law if your there have been some radical calls to totally eliminate property sold for $400,000 in 2021 will likely go for $300,000 today,
neighbor’s tree falls on your lawn you are responsible for taxes even though they provide 18% of county revenue, 17% of and if there is a $50,000 pending assessment the net to the
any removal or clean-up, not the tree’s owner. municipal revenue and 50% to 60% of school-district revenue. owner in just four years has been reduced by $150,000.
A new Florida law has been proposed that would address A constitutional ballot amendment to eliminate the tax could One proposed bill would change the current requirements
this perceived inequity. The law, called the Fallen Tree Act, if be brought to voters as early as 2026. from condos that are three stories or higher to condos that
passed, would impose liability on a tree’s owner for any loss Condominium Assessments: Many condominium are six stories or higher, allowing the smaller buildings to
or damage caused by their tree falling onto your property. owners of older units in condominiums that are taller than opt out of the milestone inspection requirement and to vote
The determination of the ownership would be based on where three stories are facing potentially devastating assessments to waive or reduce contributions to the structural reserve.
the tree is rooted. In addition, the new law would also allow in order to comply with new structural reserves and repairs Another proposed bill would allow Associations to invest
reserve funds; obtain a line of credit in lieu of a required
reserve fund and allow buildings that have completed
a milestone inspection to delay mandated funding until
ARCHIVE GALLERIES reserve study for up to two budget years.
December 31st, 2028 and to delay a structural integrity
Another bill proposed provides up to $2,500 to assist with

special assessments levied to fund the reserve accounts. The
Accessory Dwelling Unit Act: Many municipalities in
grant would be to low-income homeowners ages 60 and over.
PAYS HIGHER PRICES FOR FINE ART AND ANTIQUES Florida prohibit accessory dwelling units to be placed on a
single family lot. A proposed new law would legalize the
right to install accessory dwelling units, such as granny
• Oil Paintings • Sterling Silver • Collectibles apartments, regardless of any local prohibition. One key to
• Oriental Rugs • Objects of Art • Fine Crystal the bill is that homeowners would not lose their homestead
• Tapestries • Sculptures • Orientalia property exemptions if they add such dwelling units. The
proposal does not apply to homes in a PUD (such as most
• Fine Furniture • Bronzes • Tiffany Items homes in a homeowners’ association, and would also restrict
• Service Plates • Porcelain • Clocks use of same for short-term rentals.
Car Laws: Two new laws, if passed, could affect how
you drive in Florida. One law proposes to raise the 70 mph
We Also Purchase Men’s And Ladies’ Items Including: speed limit on major roads to 75 mph. A second law would
require cars to have two license plates, as many other states
• Old Watches • Cufflinks • Smoking Items • Coins • Antique Jewelry already require.
• Designer Handbags • Fine Modern Jewelry • Vintage Costume Jewelry Supporters of this bill say it may help investigators trying
to catch hit-and-run drivers.

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