Why would doctors leave the profession because of the passage of the bill? Despite what the proponents of the bill are saying, specifically: “If you like your doctor, there is nothing in the bill that will change that, or make you lose your ability to choose”; the reality may be completely different. While it is true there is nothing in the bill that forces doctors and patients to change their relationship, the eventual outcome of the bill will be that doctors may not be able to afford to treat patients as they would like. Some doctors will not let the government (or insurance companies following government mandates) tell them how to treat their patients and will retire from medicine.

What will this mean to doctors who remain in the medical field? If only 10% of the doctors leave the profession, that will mean a heavier patient load for those doctors remaining in medicine. Heavier patient loads may be welcomed by some practitioners and will increase their income, but lower Medicare and Medicaid reimbursement will make the income increase minimal at best. More work for the same pay is not a good long term arrangement.

The more onerous implication of the bill is how many future doctors will choose another career path. It is entirely possible that many young adults will see the writing on the wall (or in the bill) and reasonably decide that their talents will be better rewarded in another profession. It will only take a few years before this decrease in students applying for medical school and ultimately graduating to become medical doctors, will be felt by patients as a doctor shortage.

The authors of the healthcare reform bill have anticipated this impending doctor shortage and have written several provisions into the bill to address this situation.

1) The only area of medical reimbursement through Medicare that is slated to increase is payments to primary care doctors in areas that are currently being medically underserved.

2) Student loans will be forgiven for doctors, nurses, and other medical professionals who work in primary care in areas of doctor shortages.

3) Student loans will come directly from the government, not just private loans guaranteed by the government. In the future students may only be available in areas of study that the government approves of, or to students the government deems in financial need.

So, even though the healthcare reform bill does not directly tell doctors where or what to practice, it clearly will define what type of practice and location of practice will be financially viable. The implications of the healthcare reform bill will not affect older doctors much, but for younger doctors or future doctors it will have a great impact. Patients will eventually see a shortage of doctors, especially in some specialty fields, and clamor for the government to do something about it. That may be the trigger point for the government to make their move toward socialized medicine.

 

COMMENTS:

Excuse me, but I lived in Europe for 30 years, working in hospitals, and there are plenty of very dedicated, happy doctors there. And they do fine financially as well. I think what you have written is nonsense.
Andrea
05/25/2010

 
“Some doctors will not let the government (or insurance companies following government mandates) tell them how to treat their patients and will retire from medicine.”

I had to comment when I read the above statement. I find that this statement pokes holes in the entire argument being presented. This is why: All doctors currently practice medicine and treat patients according to the laws and mandates of the government. There are literally hundreds of requirements and system checks in place that make it impossible to practice medicine without government involvement.

If we want to discuss the fact that doctors (particularly specialists) will not be as prevelant due to budget cuts and therefore payment reductions (SGR fix) then that’s a different story. It has nothing to do with not wanting to practice medicine under the watchful eye of “Big Brother”.
Jane Loxley
05/25/2010

 
Insurance reimbursements are so bad now I can’t imagine it getting any worse. If it does I think it will definitely affect the quality of healthcare in the future. Why would you go into a career where you have no control of your income and very little control over how you treat your patients!
To make matters worse insurance companies are now coming after money they have already paid the doctor.
This healthcare scene is not pretty. It’s actually very sad…
Ray
05/25/2010

Everything in the article is correct, unfortunately, and I will be among those who will decide to stop practicing. I feel sorry for my children and grandchildren. I and my generation have paid into the system for our entire career,and because of bad politicians and poor management, our money has been dribbled away, and now there is not enough. Even the providers are responsible, as they have committed fraudulent acts out of greed. the other issue is the lack of tort reform, which is totally out of control. Thank the lawyers for that.
Arthur N. Vecchiotti, MD
05/26/2010

It is getting harder and harder to get paid by insurance and medicare is a joke. Its all falling on the Dr’s more service demanded for less money, more documentation, with more risk with all of the new HIPPA laws. The Gov. will want less services and studies done but the Dr’s are being exposed to increasing risk of failure to diagnose, and poor treatment out come. Due to failure to enact adequate tort reform. More medical dollars going to the attorneys. Many law suits over medical conditions not treatable 20 years ago. Medicare threatening to sue every one, who wants to take the risk.
Douglas Peffer D.C.
05/26/2010

 
We have a podiatric medical office in Houston. A patient of ours actually lives in Scotland. He works as a professional soccer player. He got an ingrown toenail and was put on a six month waiting list to get it treated. In order to continue working, he flew here to Houston to get his ingrown toenail removed. He has done it multiple times. Is that the kind of situation we want for people here in the US? Where will people go for treatment when it can’t be obtained here? We will leave the business because we cannot survive under the new healthcare system. That is the bottom line. It is a sad statement in a country where we have always been proud of our free market system.
Rae
05/26/2010

All your statement here about how all these docs will quit is a good thing. We don’t need them that are only there for the money anyway. Second, the health care system with the HMO’S and PPO’s is very bad and very ccontrolling. Many doctors now that want to treat cannot get on the lists. ONLY the sacred few are allowed on FOREVER! This whole system needs to fall. So, be it about those 10% that will leave there will be thosand more that will be willing to have a good paying job when they are no longer force off the lists and can see the patients they want to see. WHY don’t you print my statement here. I have been in practice for 25 years and it became hell with these controling big corporate managage care organizations making their own laws. Government may show to prove it self to be also bad, but I am willing to take the chance from what we have now.
Dr. Wiese
06/02/2010

 
All statements to the fact that: waiting lists, patient increase, riembursment decreases, doctor fallout, loss of autonomy, regulation fines and the list goes on and on are all true. the question I have to all my doctors that are going to stay in PRIVATE PRACTICE is what are you doing in your practice to position yourself for this?

Sherry L. Krueger
06/07/2010

This was a very informative article. It just tells us about how the Bill is going to affect physicians in a quick, simple, concise manner. No hogwash. I’m a physician planning to attend med school in Spring 2012. I wanted to ask two questions, how is a private practice affected, and how will the departure of medical school students change the demand for doctors, or more specifically, how much less difficult will it be to attend medical school.

Thanks,
John
Oshii Knight
06/14/2010

It’s no secret that widespread dissatisfaction with insurance practices is driving practitioners toward alternative ways of being paid for their services. With the devastating 21% cut to Medicare reimbursement rates, many physicians are even less sure that they can continue to do business as usual.

Restoring profitability to private practices is going to be a challenge. Physicians will have to become thought leaders in creating a patchwork of solutions.