Stanley Feld M.D.,FACP,MACE
More and more physicians are beginning to realize the effect President Obama’s healthcare reform law is going to have on their practices and on their physician patient relationships. They do not like it.
Recently, Daniel Palestrant, MD Founder & CEO of Sermo, Inc. wrote an excellent summary of what is causing physicians to be galvanized in their opposition to the healthcare reform law.
Sermo has 115,000 practicing physicians in its online community. Sermo is revolutionizing the way physicians communicate across the United States. It’s where practicing US physicians—spanning 68 specialties and all 50 states—communicate on difficult cases and exchange observations and views about drugs, devices and clinical cases, clinical issues and healthcare reform.
Sermo has been named to Fast Company Magazine’s list of the world’s most innovative companies. Sermo, through its surveys’ on healthcare reform, is rapidly replacing the AMA as the voice of the practicing physicians.
Dr. Palestrant put together a list of the most important issues that seem to be causing practicing physicians to speak out:
1. Turns Out Legislators Want Physicians To Be Employees After All
“Very quietly, the State of Massachusetts has started the process of linking a physician’s eligibility for medical license to their participation in the state’s public access program.”
This critical development is necessary for President Obama’s healthcare reform. It eliminates physicians’ freedom. President Obama’s healthcare law is similar to the Massachusetts healthcare reform. Massachusetts healthcare reform did not attack the root causes of healthcare inflation.
This step is necessary to force physicians to participate in government programs against their will.
“If any plan is tied to licensure just keep practicing without a license.
They can’t throw everyone in jail unless they make room by putting the druggies on the street.
The public would be on our side in a minute……IF we continue to practice. If we close our doors because we fear government reprisal, we lose the patients because they’ll never get the real message, and we lose to the government.
Hang together or we’ll surely hang separately, someone once said?”
“Strike, for the love of Gad and the sake of all physicians in the country! The Massahatchet Massacre should not be allowed to succeed.”
“I am not optimistic about my future here in Massachusetts. I am really considering my options for an exit out of this state. Main concern is where to go……is the grass greener and what practice model to involve myself with?”
“If you can stand the heat, pack your guns and try Texas. Land of the free and home of the brave!
There’s no future for Docs in Massa-useless!”
“For the country it is the perhaps the clearest evidence yet what could be the unintended consequences of this reform effort and an alarming move towards socialism.”
2. Physicians WERE Right About the cost of Tort Reform
The timing around the recent Congressional Budget Office "revelation" that tort reform would in fact lead to "at least" $50 Billion in cost savings over 10 years, rather than originally estimated $5 Billion.
The CBO is still way off. I suggest President Obama and the CBO read the Massachusetts Medical Society survey on defensive medicine and malpractice reform. My calculated cost is closer to $700 billion per year. A popular number quoted by some is $300 billion per year.
Defensive medicine is the cause of excessive testing. Only tort reform will solve the problem.
“ Sermo physicians had listed tort-malpractice reform as a number one priority back in May, when the Physician’s Appeal was launched.”
President Obama should listen to his medical care providers (Physicians).
3.Recognition that the AMA’s Support was "Purchased"
Physicians have finally realized that the AMA’s support of President Obama’s healthcare reform effort was less about physician advocacy and more about the AMA protecting its own financial interests. We all recognize the deals President Obama makes to “convince” organizations to support his efforts.
“ The fact that the AMA receives the bulk of their $300MM in revenue, not from its physician members, but from insurance companies and hospitals, through a "special" arrangement with the government to provide CPT billing codes seems to be further eroding the claim that physicians in fact support the current reform efforts, not to mention the AMA’s legitimacy.”
“I think things will continue to get worse until we take a stand. The problem is that currently so many physicians are in the dark and have no idea what is coming. I do not think they will be ready to take a stand until it is too late.”
“Life seems hard now. I am resentful and feel contempt for the political processes that are occurring now. I feel trapped. Sermo has been good. Feedback has great. But still our profession has no powerful organization that stand for us and that is what we need.”
2. Market Forces Will Be Felt By Patients
Physicians are starting to take the necessary steps to maintain their own financial viability and autonomy. Patient access to healthcare resources will decrease as a result of these steps.
Most physicians have tried to serve their patients well. The healthcare system is dysfunctional. Both patients and physicians have been abused. When a person is sick they want the best care. The dysfunction and new government regulation will destroy medical care rather than improve medical care in America.
“The majority of our brethren are clueless. They are being let like calves to slaughter.”
“I can’t wait until the 40 million uninsured start showing up in the ER (Emergency Room) after ins
urance reform, when they can’t get in to see their PCP(Primary Care Physician). It’s going to get ugly.”
Ultimately, this strain will re-unite patients and physicians and start to squeeze out the countless interlocutors who created much of the inefficiencies in our healthcare system. That being said, it will be a tough couple of years for patients, especially senior citizens and those with lower income, as their access to physicians is increasingly jeopardized.
Dr. Palestrant doesn’t think physicians are going to remain victims much longer. The comments on Sermo confirm his observation. Physicians are getting angry and depressed.
“Where organizations and associations have largely failed physicians, the doctor’s drive to stay in business so they can continue to treat their patients will force them to make some hard decision, and gradually allow market forces to accomplish what advocacy never could.”
Physicians want a reasonable income, a good patient physician relationship and freedom to practice without bureaucratic restraints. They also want continuing medical education to improve their practices. They do not want government surveillance.
Right now I am just devastated by the changes.
The end of consult codes is very devastating for endocrinologists. If I was done paying off my student loans, I would not feel as bad.
That’s my only debt! I have lived so frugally in order to save and invest and be debt free and because I want a great education for my child.
So all of the sacrifices that I have made mean nothing now. I delayed fertility for my profession. Thank God I have a beautiful 2 year old son, but he will be an only son because I recently lost a baby after 3 weeks in the NICU (he was born premature at 28 weeks b/c/o placenta abruption).
I keep thinking that if I had chosen another profession and had children before the age of 35 that may not have been the case.
For my sacrifice, I feel like the envy of the ignorant public fueling the greediness and power hunger of politicians. Politicians are out to destroy our profession, our prestige, our hard work.
As you can see, I am in a very negative state of mind. I’m glad to have read something that has a positive outlook.
The medical profession needs hope. President Barack Obama is not representing that hope.
The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone.