Health Care thoughts: Hysterical Reporting
by Tom aka Rusty
Health Care: Hysterical Reporting
Fox News ran a screaming intro and a scary bottom summary line on a story on some survey of physicians, claiming a majority of physician will quit, retire or work part-time.
Link via Yahoo: http://news.yahoo.com/video/health-15749655/23362511
This is further proof that Fox News does not do journalism. The conversation eventually winds around and the expert really contradicts the story headline.
I have been spending a lot of time talking to people at the national level, and the one trend that is certain is the merger/sale of physician groups to hospitals and integrated networks, effectively making the physicians employees of a larger entity. The ownership of a private practice will fade like Marcus Welby MD (some of you may be too young to understand this popular culture reference).
PS: if you leave the link open you will see a story about Miley Cyrus puffing on a bong. Oh the horror.
Tom aka Rusty Rustbelt
2010 Survey: Physicians and Health Reform
This survey was conducted as part of The Physicians Foundation’s ongoing mission to incorporate the physicians’ perspective into national healthcare policy discussions. It is the second national survey of physicians.
The Physicians Foundation has conducted to learn how physicians on the front lines of medical care view the current medical practice environment. The Physician Foundation’s initial survey, Medical Practice in 2008: The Physicians’ Perspective, examined the state of physician morale and physicians’ attitudes towards the practice of medicine. The survey concluded that many physicians are dissatisfied with the conditions under which they are compelled to practice, and that many plan to retire, transition out of patient care roles, or take steps that will result in reduced patient access to their practices.
Some 4,000 of approximately 12,000 physicians who responded to the 2008 survey provided written comments appraising the current state of the medical profession. These comments formed the basis of a book published by The Physicians Foundation entitled, In Their Own Words: 12,000 Physicians Reveal Their Thoughts on Medical Practice in America.
The 2010 Physicians and Health Reform Survey continues The Physicians Foundation’s ongoing dialogue with doctors on the front lines of care, with a specific focus on how physicians perceive the Patient Protection and Affordable Care Act (“health reform”) will affect their practices. The survey is intended to gauge physicians’ initial reaction to health reform and to learn the ways in which they plan to respond to it.
A Continuing Erosion
Conducted in June, July and August of 2010 by Merrit Hawkins, a national physician search and consulting firm, the survey offers a snapshot of how physicians responded to the health reform bill some three to four months after it became law. As health reform is implemented, physician attitudes may change. However, the survey suggests that physicians’ assessment of health reform in its early stages is predominantly negative, perhaps in part because they do not believe they had sufficient input into the new law. A great majority of physicians indicated that the physician’s perspective was not adequately represented to policy makers during the run-up to health reform.
The survey makes clear that physicians are dubious about how health reform will affect the quality of care they are able to provide to patients, the financial viability of their practices, and the long-term future of the traditional independent private practice model. In response to health reform, many physicians indicate they will take steps that will reduce patient access to medical services, accelerating a trend observed in The Physicians Foundation’s 2008 survey.
The survey suggests that physicians will adopt a variety of practice styles — including hospital employment, part-time practice, locum tenens and concierge practice—further driving a trend toward a heterogeneous physician workforce no longer composed primarily of full-time, private practitioners. Rather than a sign of progress, the survey suggests that most physicians view health reform as a further erosion of the unfavorable medical practice environment with which they must contend.
It is The Physician Foundation’s position that a robust and engaged medical profession — one capable of attracting talented newcomers and retaining experienced professionals — is essential to the viability of America’s healthcare system. The survey suggests that health reform, at least in its initial stages, has further disengaged doctors from their […]
2010 Survey: Physicians and Health Reform
Survey Questions and Responses
1) What is your medical specialty?
The primary care specialties—family practice, internal medicine, and pediatrics—are among the largest in medicine, and physicians in these specialties accounted for the largest per specialty response. However, while approximately 60% of all surveys were sent to primary care physicians, primary care physicians accounted for only 47% of total responses, indicating that specialist physicians responded to the survey at a somewhat higher rate than did primary care doctors.
2) What is your age?
Physicians in active patient care are almost evenly divided between those who are 51 and older and those who are 50 and younger.** This divide is reflected in survey responses. About half of respondents (48%) are 51 or older while the remaining 52% are 50 or younger.
3) How many years have you been in medical practice (post residence/fellowship?)
The majority of respondents (86%) are experienced physicians who have been in medical practice six years or more and have had a chance to learn both the clinical and financial/administrative sides of medicine and how these may be affected by changes in policy.
4) What state do you practice in?
AMA Physician Master File
All others less than one percent
The top ten states listed above — California, Texas, Florida, New York, Pennsylvania, Ohio, Georgia, North Carolina, Missouri, Illinois — accounted for 46% of responses. Fifty-two percent of active physicians in the U.S. practice in these states. Response volumes by state generally are […]
6) What was your initial reaction to passage of the 2010 Patient Protection and Affordable Care Act?
Very positive 12%
Somewhat positive 15%
Somewhat negative 15%
Very negative 52%
Few physicians surveyed were on the fence regarding health reform when it passed in March, 2010. The initial reaction of over two-thirds of physicians was either somewhat or very negative, compared to 27% who were somewhat to very positive about the new law. Only 6% described their initial reaction as neutral.
7) How do you now feel about health reform?
I am more positive than I was initially 10%
My feelings have not changed 51%
I am more negative than I was initially 39%
Survey respondents had three to four months after passage of health reform to study the provisions of the law and consider its implications. For a few (10%) the passage of time has led them to view health reform more favorably than they did initially.
The majority (52%) did not revise their original opinion, however, while almost four in ten now feel more negatively about the law than they did initially.
Changing their opinion
Of those physicians who said they initially were either “very positive” or “somewhat positive” about passage of health reform, 24% said they are now more negative.
Of those physicians who said they initially were either “somewhat negative” or “very negative” about passage of health reform, only 3% said they now are more positive.
The survey indicates that the three to four month “cooling period” after passage of health reform did little to change the minds of those physicians who initially were unfavorably disposed toward the law. By contrast, one quarter of those physicians who initially were favorably disposed toward the law have since revised their opinion.
8) Do you believe the viewpoint of physicians was adequately represented to policy makers and the public during the run-up to passage of health reform?
Physicians approached unanimity in believing that their viewpoint was not conveyed to policy makers during the preamble to health reform. The American Medical Association, still the largest group in organized medicine, endorsed healthcare reform, though many physicians at the grass roots level were not in favor of the law, as this survey suggests. This disconnect between the AMA and many rank and file physicians, and the status and direction of organized medicine in the post-reform era, are addressed separately in this White Paper.
9) How do you think reform will affect patient volume at your practice?
Patient volume will increase 54%
Patient volume will remain the same 35%
Patient volume will decrease 11%
The majority of physicians (54%) anticipate that health reform will increase patient volume at their practices as more patients obtain health insurance over the next several years. Over one-third, however, do not think volume in their practices will change. These physicians may have largely Medicare practices, may practice in areas that have a high concentration of privately insured patients, or be otherwise positioned so as not to be affected by an influx of patients insured through Medicaid or new insurance exchanges. About one in ten physicians indicated they believe volumes in their practices will decrease, perhaps because they anticipate some of their patients may lose or change the coverage they currently have.
10) Do you now have the time and resources to see additional patients in your practice while still maintaining quality of care?
Though the majority of physicians anticipate rising patient volumes in their […]
21) Consider your practice plans over the next three years as reform is phasing in. Do you plan to (check all that apply):
Continue practicing as I am 26%
Cut back on hours 19%
Switch to a cash or concierge practice 16%
Relocate to another practice/community 14%
Work locum tenens 14%
Cut back on patients seen 12%
Seek a non-clinical job within healthcare 12%
Seek a job/business unrelated to healthcare 12%
Seek employment with a hospital 11%
Work part-time (20 hours per week or less) 8%
Close my practice to new patients 6%
The majority of physicians surveyed (74%) said they will make one or more significant changes in their practices in the next one to three years, a time when many provisions of health reform will be phased in. Only 26% plan to continue practicing as they are. Most of the changes physicians indicate they will make will have the effect of reducing or eliminating patient access to their practices.
Forty percent of physicians said they will take one of three steps that would remove them from patient care roles altogether: they will retire, seek a non-clinical job in healthcare, or seek a job or business unrelated to healthcare.
Others plan to cut back on the number of patients they see, work part-time, close their practices to new patients or take other steps that would reduce their role as full time equivalents (FTEs) or limit patient access to their practices.
Close to half of physicians (49%) said they would adopt a style of practice different from the traditional, full-time independent private practice model: they will work part-time, work temporary (i.e., locum tenens) assignments, practice on a concierge basis, or seek employment with a hospital. This response underscores the increasingly heterogeneous nature of medical practice, in which niche practice styles are replacing the formerly prevalent full-time, independent practice model.
The implications of these findings are examined in more detail in the section of this White Paper entitled “Health Reform and the Physician Work Force.”
Projected retirements by Age
35 or Younger 0%
65 or Older 24%
The survey suggests that it is not just physicians in their sixties who plan to retire in the next several years.
Twenty-one percent of physicians in their mid to late fifties, and 12% of physicians in their early to mid-fifties, indicated they plan to retire in the next one to three years. Even some physicians in their thirties and forties said they plan to retire in the next one to three years. Physician retirements at or even considerably below these rates would create severe disruptions in the physician workforce.
22) How do you believe reform will affect the independent, private practice model?
Will enhance the viability of the private practice model 10%
Will have little to no effect on the private practice model 10%
Will erode the viability of the private practice model 80%
Four out of five physicians surveyed believe that one of the consequences of health reform will be the erosion of traditional, independent private practice. Both the health reform law and market forces discussed elsewhere in this paper are driving a movement toward consolidation of physician practices and integration of practices with hospitals and other entities, eroding the viability of smaller, physician-owned practices.
23) Which best describes your view of the independent, private practice model?
It is a dinosaur soon to go extinct 28%
It is on shaky ground 58%
It is relatively robust and viable 14%
Over one-quarter of physicians […]
In addition to answering multiple choice questions, physicians completing the survey were asked to provide a written answer to the following question:
If you could make a statement to policy makers and the public about health reform and the state of medical practice today from the physician ’s perspective, what would you say?
“The AMA has totally failed primary care private practitioners – and I am a former Delegate! We have zero representation by AMA or ACP, which are way overloaded with academics who are clueless about private practice. Primary care doctors pay tens of thousands of dollars a year to send their expense records to people who get paid to analyze “quality” (as they call it). This is a huge and worsening whole in the side of a boat; not just the annoyance, the actual dollar costs are killing us financially.”
“Physicians have not done enough pushing back against the misguided policies proposed in D.C. We are too busy taking care of patients! MD’s should start running for state and local offices to get a bigger voice in government.”
“Health reform will decrease access to care for patients as it will drive doctors to retire early or leave medicine altogether at a young age.”
“We need more primary care residency slots to serve the newly insured. Also, all of the children should be insured. What kind of country doesn’t to that?”
“There must be more awareness of the price of services in the patients mind and there must also be more responsibility place on the patient to pay more directly for services. This way the competition will drive prices down.”
“Other professionals can unionize and push for more rights whereas physicians have to sit by and allow ourselves to accept what is handed down from our government. Claiming physicians support based on AMA support is unsustainable as the AMA is not supported by at least 75% of physicians.”
“Politicians should consider the ramifications of their actions on the medical community. If they fail to consider how physicians can deliver the best care, there will be no viable future for any plan. Physicians should be prime contributors to the debate, not just children who will be handed decisions to afterwards.”
“It would be nice to have a “regular Joe” type of MD in policy making. They forgot us – those who struggle in the trenches daily and have to pay exorbitant amounts to become “electronic”.
“I see an absolute crisis on the horizon. Obamacare is the Titanic”.
“Health reform is necessary. We must cover all patients regardless of the ability to pay. The system we have now is immoral. Reform should’ve gone further, gotten rid of insurance companies and given us a single payer option.”
“Healthcare is a benefit of modern society, but not a right. Certain health issues such as immunizations may fall into the public’s best interest and therefore may be electively provided by the state. Otherwise, the key to individual healthcare is portability beyond employment, individual responsibility and incentive-based rewarding of those taking responsibility for their own care.”
“I am two years out into cardiology practice and my group is being forced to sell its autonomy and the practice to survive. We are desperate about the future and what it holds for medicine in the U.S. – including the impact on patient care and access.”
“From my perspective reform was absolutely necessary. The way healthcare has been progressing was not sustainable. I think the general public needs to have a better understanding of the reasons these things are happening and to bear some responsibility in this whole […]
Doctor’s can become salaried as Rusty says and moonlight as consultants in their specialties, if they have one. That’s the way the do it here where there is a large “medical center” (private non-profit, kinda non-profit, if you don’t count the Medicaid/Medicare overbilling episode a couple of years ago.) They ain’t cheap as I learned when inspecting my bill for a ride to ER a couple of years ago. Cardiologist who said I needed to consult a rheumatologist (auto-immune disorder, not heart attack) charged $500 for a walk by. Looks to me like that would pretty much make up for the inconvenience of dealing with insurance companies.
MG is undoubtedly reporting the results of the survey accurately. But, doctors can’t afford to quit work anymore than anyone else can. 22% of Medicare enrollees have Advantage plans. The remaining 78% have traditional fee-for-service coverage. The principle effect of HCR now is to increase premiums for Advantage enrollees. No problem for them if they want to pay the additional premium, otherwise go with Parts A, B, and D. Saves big bucks for the system. I’m wondering what exactly would be the effect of this mass exodus of doctors? Will they emigrate? And, how are they gonna tell one private insurance policy from another? On the face of it, it seems like a solvable business problem. Just doesn’t seem to merit the response it has apparently produced. NancyO
Re Miley Cyrus–Bongs are tacky and evidence of a separate crime. Roaches you can eat. So, what’s wrong with Zig Zag? NancyO
thanks for the actual report MG.
I believe the trend with dissatisfaction of the practice of medicine started well before discussion of the bill, and even some to do with practices with the system as it stood in 2008 and earlier. This includes the money to be earned and the private practice model, and dissatisfaction with the insurance model as well.
The change to electronic records caused a lot of grumbling in MA…but that was forced by the group of five major hospital groups and insurance, not Obamacare.
We are watching profound impacts of the Great Recession as well on medicine, as nurse/patient ratios in many local hospitals come close to doubling in the last two years. Mass General hired about five new grad nurses out of their whole feeder program this summer, Deaconess I think three…
Per diem RN positions garner hundreds of applications, and hospitals in general in the area have laid off many nurses due to lower patient census and significantly elective medical prodedures.
I have not seen an effort by the medical profession (AMA) in MA to address ownership issues of diagnostic labs and frequency of referrals from the physician side of practice for instance, nor an effort to analyze the impact of the private practice model vs. being a hired hand (which is the current winner) which is creating lots of dislocations and attitude adjustments.
Insurance in MA sees many changes in how to do things, but their connection to Obamacare is certainly unclear, and look to be more a matter of gaining leverage in this environment than some overriding concern of actual policies.
MG: Is that all you’ve got? 🙂
The above confirms my
suspicions that you have degrees: BS, MS and PHD. The last is Piled Higher And Deeper.
“• In response to reform, 74% of physicians said they would take steps to change their current practice style in the next one to three years. Only 26% said they would continue as they are.
• 40% of physicians said they would drop out of patient care in the next one to three years, either by retiring, seeking a non-clinical job within healthcare, or by seeking a non-healthcare related job.
• The majority of physicians (60%) said health reform will compel them to close or significantly restrict their practices to certain categories of patients. Of these, 93% said they will close or significantly restrict their practices to Medicaid patients, while 87% said they would close or significantly restrict their practices to Medicare patients.”
Changing the medical practice style was a hot trend before Obama. Tom says it is accelerating…would it have accelerated because of trends in the profession anyway??
Patient healthcare is tedious and time consuming. Medical consultation to private companies and others pays better, much better.
Closing or restricting healthcare to Tricare, medicaid and medicare patients is a much older trend than the report would imply…this has been discussed well before ‘Obamacare’. My bet it has to do more with the Great Recession’s restrictions on medical income than the new legislation.
A trend for mental health professions is also away from private practice as private health insurance changes were driving the model. There is a growing trend for private practioners to not accept insurance if they want to maintain income levels. Those that can do this do so because they can charge double the going insurance rates and spend considerably less time or $ on the administrative pieces.
A back of the envelop cost to practice could be used thusly: 40 sessions/year time span for a once a week contract, due to vacations, sickness, client job demands taking precedence (ie. travel, mandatory demands on time, etc). 40 X 72.50 X 25 (30) clients equals 72,500-90,00 less expenses (30% overhead of rent, admin. phone, answering service) is not a viable model.
Obamacare is not a driver of these trends. Blue cross and Tufts are, and the association of hospitals.
What advantage do the physician groups see in becoming employees of the hospital rather than stand-alone private groups?
Why do you think it is appropriate to post verbatim information that any of us could have read for ourselves?
New medical schools have been opened. Existing medical schools have increase class size (mine went from 150 to 175 three years ago, and is planning to go to 200 in another year. In addition, US residency programs continue to accept large numbers of foreign-trained MDs who whill certainly stay here to practice.
Who cares what the geezers in this poll say? The fact is that there will be plenty of doctors in practice going forward. Only a mindless libertarian could believe that America’s physicians are gonna go Galt.
Did doctors disappear in Canada, Britain, France, Germany, Japan, Swedan, Denmark, Switzerland or any of the other industrialized nations on the planet that have embraced some form of government-regulated universal heath care?
increase = increased
whill = will
Maybe a reader could answer that for physicians.
Ditto for the link….and maybe page numbers as appropriate.
I noticed the heavy concentration of docs in ages saying planning to retire:
65 or Older 24%
Maybe they were paid too well??
I waited three hours to see if the thread was going to have any major activity. None happened.
I posted the survey because there are participants at Angry Bear who wouldn’t have bothered to dig down to page 47 in the pdf to find the study, and others who have problems downloading large pdf documents.
This is an very important white paper. A minor portion of its contents deserved to be posted somewhere at Angry Bear.
For those who didn’t any interest in reading the survey on this thread, I stated in the opening comment, “Complete results of the survey are included in the paper beginning on page 47.”
In the future, blog readers can always refer back to this thread without going through the difficulty of finding the survey in the 116 page white paper.
Reread my opening comment. I explained where in the 116 page white paper the survey began.
It’s unlikely in my opinion that you and many others would have bothered to locate the study after reading the main post.
I already had the study on file. Posting the survey was for the benefit of the Angry Bear readers who wouldn’t have bothered to dig down to page 47 of the pdf document and those who have stated on various occasions that they have problems downloading large pdf documents.
I haven’t seen you do much at Angry Bear to try to help this blog provide more professional presentations or engage in better comment thread dialogues.
For now… I would post other unrelated info and links on an open thread if we had a current one. We didn’t have one Wednesday or Friday. Oh, well.
You can go back and read their 2008 study. I don’t recall that it was ever addressed previously at AB.
I think it would be foolhardly to blow off what the 2010 survey results state. Only 11% of the survey respondents intend to seek employment with a hospital, as an example. That’s straightforward, as are the written comments from the physicians. These professionals are not happy campers about the healthcare bill.
It strikes me that intended retirement among the following age groups is a serious issue as well:
We can’t afford to lose many physicians in any of the age groups with what will be an expanded healthcare coverage system. Some of the physicians written statements are probably a bit alarming for the uninformed. Similarly, a rollback of physicians’ hours of availability and patient workloads will create more problems for the general population.
It would appear that we’re on a collision course. Doesn’t look good to me.
All true, but the majority will not retire, quit or work part-time.
Shift much of the administrative hassle and all of the financial risk to the parent entity.
I actually hoped to cause a discussion about 1) about hysterical pseudo-journalism and 2) physicans. Perhaps I did not write this in such a way as to make it clear.
I;ve heard that for a long time, but when they look at the year end 401(k) statement the urge to retire will likley be tempered.
(Most groups I;ve worked with dropped defined benefit plans a long time ago.)
I was actually hoping to have some discussion about hysterical pseudo-journalism, but clearly I did not make that really clear.
For what it is worth, I heard all of the above from physicians in 1993 while Clinton Care was being debated.
Physicians will retire when their 401(K) plans allow them to.
A future post will talk about younger physicians and the part-time issue.
Thanks to MG and his citation of a physician survey (BTW a simple link would have done just as well) we now know what the physicians who responded to the survey would like in the best of all possible worlds. Very interesting. I suppose that a survey of any profession would inform us that professionals in all walks of economic life would like their professions to generate more income with fewer hours of work. Maybe what is needed is more medical schools with lower cost of tuition. Is there a decrease in the number of med school applicants? That would be informative. What is the average p;physician income? How many hours of work are required to produce that income? I’m sure there are significant geographic differences, but I can tell you for a fact that the luxury car market is still servicing the medical community. They make up a robust portion of the customer group. General practitioners and internists may be at the bottom of the earnings totem pole, but the rest are still enjoying high earnings and the good life. Too bad we can’t get a better hold on CEO earnings. It would do the rest of the working class a world of good.
LOL…note to self…need to change meds.
I posted the survey because there are participants at Angry Bear who wouldn’t have bothered to dig down to page 47 in the pdf to find the study, and others who have problems downloading large pdf documents.
I’m trying hard to understand the problem here. America has reached the point where they cannot continue to afford increasing the wealth of doctors, insurance CEOs, major stockholders, etc. and we are worried that doctors who seemingly care little about their profession except for the money are going to drop out? I say good riddance. The AMA has held us hostage to profits and low numbers of doctors for decades. Time for a change to consumerism. As Reagan might say American Medical Association – Tear down those walls! (Choose your medical/physician organization and substitute.)
Maybe Medicare and Medicaid will need to open the door to overseas treatment. Isn’t that the result of most profit problems in the country? Outsource the talent?
Health care and not profits is the problem in this country. We now respect blackmail from surveys and polls? I am wondering what I should do; shake in my boots???
The health care system in this country is so broken that it really doesn’t matter what doctors think or want or threaten to do. If a gun is at the head of a person’s child, that person will empty their pocketbooks to save the child. That is our health care system today; it is just a transfer of wealth system. Not much of the “care” part in that.
What the survey says and what MG cuts and pastes is irrelevant to the long term solution. Rather the information informs us that we will need to change the way we educate health care professionals in this country, the model for the way they practice, and the emphasis of the education/profession.
My employer sends me happiness surveys several times a year. I always say I need more, might leave without more, etc. simply because I think it is dumb to ask me in the first place.
I welcome the attempt to travel overseas and enjoy universal healthcare elsewhere in the world.
Unfortunately, even if that was implimented, it will solve bascially non of the issues.
1)Chronic disease- unless you decide to reside in other countries, conditions such as hypertention, diabetes, auto-immune disesases etc, needed to be treated by your primary care physician.
2)Minor acute diease- if you have seasonal allergies, cold, your welcome to fly out of the country- most country in the world measures your body temperature and will most like deny you at port of entry- deported back to the US.
3)Medical Emergency- Stroke needs to be evaluated and treated within a golden 2 hour period, trauma- one hour, heart attack again one hour to 4 hours. Your welcome to fly to Canada, Britain, Japan, Cuba for treatment.
4)Most of the world is cash for medical care. If your not their citizen, just go ahead and try to get any advanced care. Most of the civilized nation’s universal healthcare system will ship you back to the US after they stabilize you medical condition-even if you have good US based insurance that will pay for it. Just imagine trying to use Medicare overseas…
5)Elective surgical procedures- this are you might be able to ship overseas and “save” money. But what kind of quality control do they have? What language do they speak? How do the overseas doctors deal with complications/malpractice?
I think the best solution is a system when citizens are proud of their medical system, treat the patients well. The medical providers themselves are respected and well treated by the citizen and the government.
It seems to me that the reason why most physicians aren’t happy because no one asked them about the healthcare reform. They are the one’s that deliver health care to the patient… Who’s idea is it to bypass them? The government? The medical insurance industry? The patients themselves? The hysterical media? Or simple ignorance?
I don’t think the physicans are blameless in our healthcare reform, certainly I think they could have been more vocal, but enough selfish profiteering doctors are out there to hurt their chances to have a real voice as patient/healthcare reform participants…
“Is there a decrease in the number of med school applicants?”
No. Of course, med school applications rise when the economy is bad, as it is now.
In addition, the growth of Physicians Assistant programs will create a growing cadre of healthcare workers capable of making hospitals and doctors’ offices more efficient.
The reality is that current growth in US medical schools and in medical school class sizes, togther with the coninued influx of foreign-trained physicians into US residency programs guarantees ample numbers of doctors going forward.
No one asked the AMA? Really? Or they feel the AMA does not represent them overall?
The influence of the AMA is greatly overstated. Much of the lobbying and strategy comes through the specific specialty groups, family practice (AAFP) orthopedics (AAOS), Cardiology (ACA) etc.
surveys are a nice barometer and usually mean little to me personally. so i asked my GP, whom i’ve known for 25+ years, and he said he’s being forced to become an employee and wants to hang on for a couple more years and retire (we’re both 55). he’s also not taking medicare patients anymore.
my daughter, sadly an unabashed liberal and medical student to become a Physicians Asst (PA), surprisingly said she wants her doctor to drive a mercedes (so do i). additionally, my GP’s daughter just graduated as a PA and is doing well. the doctors my daughter works with are pushing her to become an MD. i asked my GP and he encourages her to stay a PA. that’s where primary care is going and the hassle and expense of completing medical school isn’t worth being an MD anymore. we’ll all be government employees soon…
I think just about 50 percent or less physicians are members of AMA. They charge a pretty hefty fee for a physician to be a member. Most of the new graduates from medical school will have a hard time paying for it when they finish from residency and go out to practice in the community.
Most medical graduates in the US are saddled with debt, typically in the 200k range, in their early thirties. Faced with debt, and mountains of regulations, paper work, liabilities, a lot of them will be pressured to go for a high paying specialty, a large group practice, or work for the government. Today’s graduate will face more financial, legal decisions then a medical one.
Most of the older family practice that provides personal care is going away and being replaced by a number based system. Medicine basically have less and less people willing to sacrifice themselves to work long hours, because there is less medicine to practice and more and more legal, financial reasons to consider. Going away soon are the practices that takes Medicaid, even Medicare, because in a typical family practice, up to one third of the patient don’t pay anyway. Faced with a cut back, less actual time for practice of medicine, most people will chose lifestyle over work.
Over half of the physicians work more than 60 hours, those physicians are willing to sacrifice their personal time for patient care. Now there is less incentive for them to do so, more government regulation, less Medicare compensation, less insurance payment, public pressure, and SEIU trying to unionize the new doctors telling them to say no to long work hours, what will baby boomers do when they do retire?
Is there anything in the healthcare bill that addresses these issues?