One-Third of Doctors Could Leave Medicine if Health-Care Reform Passes, N. E. Journal of Medicine Says

[Danno 1,228]

Nearly One-Third of Doctors Could Leave Medicine if Health-Care Reform Bill Passes, New England Journal of Medicine Says

Tuesday, March 16, 2010

By Christopher Neefus

http://cnsnews.com/news/article/62812

Doctors meet with President Obama to discuss Meidcare and health-reform legislation. (AP photo)

(CNSNews.com) - Nearly one-third of all practicing physicians may leave the medical profession if President Obama signs current versions of health-care reform legislation into law, according to a survey published in the latest issue of the New England Journal of Medicine.

The survey, which was conducted by the Medicus Firm, a leading physician search and consulting firm based in Atlanta and Dallas, found that a majority of physicians said health-care reform would cause the quality of American medical care to “deteriorate” and it could be the “final straw” that sends a sizeable number of doctors out of medicine.

More than 29 percent (29.2) percent of the nearly 1,200 doctors who responded to the survey said they would quit the profession or retire early if health reform legislation becomes law. If a public option were included in the legislation, as several liberal Senators have indicated they would like, the number would jump to 45.7 percent.

The medical journal published the results in its March and April edition, saying: “While a sudden loss of half of the nations physicians seems unlikely, a very dramatic decrease in the physician workforce could become a reality as an unexpected side effect of health reform.”

Kevin Perpetua, managing partner for the Medicus Firm, reported that a reform bill could be “the final straw” in an already financially precarious industry.

“Many physicians feel that they cannot continue to practice if patient loads increase while pay decreases,” Perpetua said in the study. “The overwhelming prediction from physicians is that health reform, if implemented inappropriately, could create a detrimental combination of circumstances, and result in an environment in which it is not possible for most physicians to continue practicing medicine.”

“With an average debt of $140,000, and many graduates approaching a quarter of a million dollars in school loans, being a doctor is becoming less and less feasible,” Perpetua said. “Health-care reform and increasing government control of medicine may be the final straw that causes the physician workforce to break down.”

The survey shows that many doctors already find their situations difficult:

-- 36 percent said that they would not recommend medicine as a profession to others, regardless of whether health-care reform passes;

-- another 27 percent would still recommend medicine as a career, but not if the current reform proposal passes.

In total, 63 percent of doctors would not recommend the profession after health-care reform passes. Just 12 percent do not recommend becoming a physician now but think they would if current reform proposals pass.

Primary-care physicians, those who work in the critical fields of family and internal medicine, not only feel that they would want to quit but that they might be cast out of medicine. 46.3 percent of those physicians said that they would either want to leave medicine or that they would be “forced out” by the changes to the system.

Despite all the opposition to the bill as it stands, only a little more than 3 percent of respondents said the status quo was best, with the vast majority (62.7 percent) saying they believe changes are needed.

The same 62.7 percent said they wanted reforms made, but that they “should be implemented in a more targeted, gradual way, as opposed to the sweeping overhaul that is in (the) legislation.”

Andrea Santiago, a spokeswoman for the Medicus Firm, said those numbers were the most striking.

“Please allow me to emphasize that 96 percent of the physicians surveyed in our report are in favor of health reform, in some form or fashion,” she told CNSNews.com in an e-mail. “To me, the fact that so many physicians surveyed want health reform, but relatively few are in favor of the current legislation, was one of the most significant, telling results.”

Congressional Democratic leaders, meanwhile, have said that doctors favor the bill and are part of an “unprecedented coalition” of doctors rooting for its passage. The claim is based on the American Medical Association’s endorsement of the legislation in Congress.

According to the Bureau of Labor Statistics, in 2008 there were 661,400 physicians and surgeons within the United States. Of that number, 250,000 are members of the American Medical Association (AMA) -- and nearly 100,000 of those are medical students.

Santiago explained the AMA could not claim to represent all doctors, nor perhaps could any other group, and said the potentially massive shortage of physicians has stayed largely out of the debate because public figures have been trying to speak for doctors instead of speaking to them.

“I think the reason it hasn’t become a big issue in the political debate is maybe because no one else has really thought about the effects of health reform on the physician workforce. Or, maybe people didn’t want to think about it, but as recruiters we can’t help but think about it and take notice,” she said.

“If you are not talking to physicians every day about their career plans, it may not occur to someone that it would even be an issue. Plus, many public figures, media, and organizations are speaking for doctors in professional associations and groups, proclaiming ‘doctors want this.’ Without surveying each and every doctor, no one can claim that all doctors want this particular version of health reform, including us.”

Santiago said one problem with a comprehensive bill was all the uncertainty about its effects that comes along with it.

“When you’re on the phone with doctors each and every day, discussing their career plans, like we are as recruiters, you start to notice hot-buttons that are related to their career decisions, and health reform was increasingly and repeatedly coming up as an issue that was causing doctors apprehension when making career plans,” Santiago explained.

“Many seemed frustrated by it. Part of it, I think, is fear of the unknown -- the current health reform bill is so large and all-encompassing, no one really knows for sure what will happen when/if this bill passes, so how does a physician make major career decisions when so much is hanging in the balance?”

The key findings of the survey can be found here.

[The_Dude 1,142]

Your source is the conservative news service? Come on Danno, at least try to come with something a bit less sensationally biased.

[Danno 1,228]

At some point in time you have to face reality and quite blaming everything on the evil conservative news reporting.

Now will you believe it? Or is the NEJOM also a far right Medical cabal?

http://www.nejmjobs.org/rpt/physician-survey-health-reform-impact.aspx

Physician Survey: Health Reforms Potential Impact on Physician Supply and Quality of Medical Care

Mar. – Apr. 2010

Key Findings

Physician Support of Health Reform in General

• 62.7% of physicians feel that health reform is needed but should be implemented in a more targeted, gradual way, as opposed to the sweeping overhaul that is in legislation.

• 28.7% of physicians are in favor of a public option.

• 3.6% of physicians prefer the “status quo” and feel that the U.S. health care system is best “as is.

Health Reform and Primary Care Physicians

• 46.3% of primary care physicians (family medicine and internal medicine) feel that the passing of health reform will either force them out of medicine or make them want to leave medicine.

Health Reform, Public Option, and Practice Revenue/Physician Income

• 41% of physicians feel that income and practice revenue will “decline or worsen dramatically” with a public option.

• 30% feel income will “decline or worsen somewhat” with a public option.

• 9% feel income will “improve somewhat” with a public option, and 0.8% feel income will “improve dramatically” with a public option.

Health Reform, Public Option, and Physician Supply

• 72% of physicians feel that a public option would have a negative impact on physician supply, with 45% feeling it will “decline or worsen dramatically” and 27% predicting it will “decline or worsen somewhat.

• 24% of physicians think they will try to retire early if a public option is implemented.

• 21% of physicians would try to leave medicine if a public option is implemented, even if not near retirement age at the time.

Health Reform and Recommending Medicine to Others as a Career

• 36% of physicians would not recommend medicine as a career, regardless of health reform.

• 27% would recommend medicine as a career but not if health reform passes.

• 25% of physicians would recommend medicine as a career regardless of health reform.

• 12% would not recommend medicine as a career now but feel that they would recommend it as a career if health reform passes

Source:“Physician Survey: Health Reform’s Impact on Physician Supply and Quality of Medical Care,”

The Medicus Firm, www.TheMedicusFirm.com

[Ali G. 37]

That survey is full of it. If those not eligible to retire will apparently leave, where will they go work?

Where else can you charge $185 for 15 minutes work, as I was charged by the GP?

[Ban Hammer 13,656]

Where else can you charge $185 for 15 minutes work, as I was charged by the GP?

be a hooker

[natty bumppo 297]

be a hooker

what ... docs will enter the work force... join a union ... get their hands dirty (besides prostate exames) ... be consultants for health ...

i think not ... the money is too big for them so they stay a doc .... ** you docs ...

[Niels Bohr 72]

OMG! All the Doctors in Canada must be wanting to leave their jobs! Watch out! How is this related to the US? Well, the right wing groups are always opposed to change. Heck, they didn't even want to accept science in the classroom because it's so true.

[Obama 2012 1,714]

http://www.investors.com/newsandanalysis/article.aspx?id=506199

Two of every three practicing physicians oppose the medical overhaul plan under consideration in Washington, and hundreds of thousands would think about shutting down their practices or retiring early if it were adopted, a new IBD/TIPP Poll has found.

The poll contradicts the claims of not only the White House, but also doctors' own lobby — the powerful American Medical Association — both of which suggest the medical profession is behind the proposed overhaul.

It also calls into question whether an overhaul is even doable; 72% of the doctors polled disagree with the administration's claim that the government can cover 47 million more people with better-quality care at lower cost.

The IBD/TIPP Poll was conducted by mail the past two weeks, with 1,376 practicing physicians chosen randomly throughout the country taking part. Responses are still coming in, and doctors' positions on related topics — including the impact of an overhaul on senior care, medical school applications and drug development — will be covered later in this series.

Major findings included:

• Two-thirds, or 65%, of doctors say they oppose the proposed government expansion plan. This contradicts the administration's claims that doctors are part of an "unprecedented coalition" supporting a medical overhaul.

It also differs with findings of a poll released Monday by National Public Radio that suggests a "majority of physicians want public and private insurance options," and clashes with media reports such as Tuesday's front-page story in the Los Angeles Times with the headline "Doctors Go For Obama's Reform."

Nowhere in the Times story does it say doctors as a whole back the overhaul. It says only that the AMA — the "association representing the nation's physicians" and what "many still regard as the country's premier lobbying force" — is "lobbying and advertising to win public support for President Obama's sweeping plan."

The AMA, in fact, represents approximately 18% of physicians and has been hit with a number of defections by members opposed to the AMA's support of Democrats' proposed health care overhaul.

• Four of nine doctors, or 45%, said they "would consider leaving their practice or taking an early retirement" if Congress passes the plan the Democratic majority and White House have in mind.

More than 800,000 doctors were practicing in 2006, the government says. Projecting the poll's finding onto that population, 360,000 doctors would consider quitting.

[Ban Hammer 13,656]

More than 800,000 doctors were practicing in 2006, the government says. Projecting the poll's finding onto that population, 360,000 doctors would consider quitting.

change we can believe in......

[Obama 2012 1,714]

http://www.modernmedicine.com/modernmedicine/Practice+Management/At-the-Breaking-Point/ArticleStandard/Article/detail/656701?contextCategoryId=40137

(The following was excerpted from In Their Own Words: 12,000 Physicians Reveal Their Thoughts on Medical Practice in America by lead author Phil Miller, based on his first-hand, on-the-ground experience dealing with primary care doctors—their problems and frustrations, their strengths and weaknesses, and their central role as the foundation of the American health system.)

In reviewing the thousands of comments submitted by physicians, several general themes emerge. Many physicians wanted policy makers and the public to know that the pressures of medical practice are coming to a head. For hundreds of doctors who added comments to the survey, the practice of medicine has simply become untenable, for a variety of reasons expressed in the comments below. Statements underscoring the various themes are highlighted in bold.

* “I believe most primary care physicians are at the breaking point. There needs to be a grass roots effort to make everyone aware of this.”

* “Something has got to be done and urgently to assist physicians, especially primary care physicians, to incentivize medical students to go into primary care and help those of us who are burned out to find renewed joy in seeing patients. Malpractice, government regulations, EMRs, even our own medical associations all have their hands out wanting and expecting more time, money, and effort just to maintain what we have. The whole thing has just spun out of control. The days of seeing patients as people and establishing relationships are done. I plan to retire early even though I still love seeing patients. The hassles are just too burdensome.”

* “My advice to policy makers is to wake up and deal with the primary care crisis before it’s too late. When I graduated from medical school in 1983 I would not have believed it if someone told me you can’t make a decent living as a primary care physician! Thorough, conscientious internists are a dying breed!”

* “I have been in practice for 10 years now, the last 5 years as a private solo practice owner. I’m very disheartened and disappointed over the state of the practice of medicine! The combination of low reimbursement and managed care issues over the last three years has made the practice of medicine almost unbearable. If not for a son who I’m working to put through college and a house mortgage, I would quit medicine in a heartbeat! I’m beat, tired, and underappreciated. Sometimes I cry myself to sleep wondering why I got into all this. Am I paying myself this month? Do I have enough to pay this month’s debt and lease?”

* “I just want to be able to treat my patients to the best of my ability with all the compassion and excellence they deserve. I want to provide a stable employment environment to my employees without them being overworked on a constant basis. I want to see a profitable practice that grows, expands, and becomes successful over time, both financially and in terms of providing excellent care. We need policy makers who understand that they are creating a situation in which these goals will soon be impossible in the United States.”

* “I am not willing to reduce quality so I see fewer patients per day, and my backlog is increasing. I cannot hire new family practice doctors though we are always trying to hire. I cannot continue seeing fewer patients for less money and adding more paperwork requirements. I’ve had one nervous breakdown already and would rather not do that again!”

[Editor's Note: For more information about this book, read the preface and additional excerpts.)

[Niels Bohr 72]

Medical Doctors are medical doctors. They aren't experts in finances. Heck, many people think Medical Doctors invented EKG, MRI, X-Ray machines. The people who build them are generally physicist, or engineers.

Edited March 17, 2010 by Niels Bohr

[spookyturtle 9,466]

One-Third of Doctors Could Leave Medicine if Health-Care Reform Passes, N. E. Journal of Medicine Says

What are they going to do, become lawyers?

[natty bumppo 297]

change we can believe in......

does this mean we can get back to docs that have english as a 1st language? ...

[Leafgal 3]

One-Third of Doctors Could Leave Medicine if Health-Care Reform Passes, N. E. Journal of Medicine Says

What are they going to do, become lawyers?

True not sure where else they can rake in the money and keep patients in the waiting room for 30 minutes after their scheduled appointment time.

[Ali G. 37]

True not sure where else they can rake in the money and keep patients in the waiting room for 30 minutes after their scheduled appointment time.

I could have sworn some here told me that doctors take you in under 1 second flat.

I am not dissing the doctors though, as many do an outstanding job and save lives.

The biggest difference I noticed is that doctors clinics have lots and lots of staff on the premises. The other large expense for doctors is litigation insurance. The reason universal health care works in other countries is because you cannot sue a doctor for $5 million because a stitch broke.

Edited March 17, 2010 by Ali G.