The Glade 4.0 :: View topic - Survey on physician's plans if health care reform occurs

Spoiler:

Survey Reveals Potential Impact of Health Reform on Physician Supply

What if nearly HALF of all physicians in America suddenly stopped practicing medicine? Such a drastic decrease in the physician workforce could become a reality, depending upon how the healthcare reform legislation is implemented, and which version of health reform passes into law.

In a physician survey conducted December 2009 by The Medicus Firm, a national physician search firm, 24.7% of physicians stated that they would "retire early" if a public option is implemented, and an additional 21.0% of respondents stated that they would quit practicing medicine, even though they are nowhere near retirement. This brings the amount of physicians who would leave medicine to a total of 45.7%.

Interestingly, the numbers were not as dramatic, but still troubling, if the public option is not part of the equation. If health reform passes without the public option, 7.4% of physicians stated that they would quit practicing medicine, unless they were nearing retirement, in which case 21.8% said they would retire early, bringing the total loss of physician workforce to nearly one-third of physicians leaving medicine.

"What many people may not realize is that health reform could impact physician supply in such a way that the quality of healthcare could suffer," states Jim Stone, Managing Partner at The Medicus Firm's Dallas office. "Based on the physicians' responses to the survey, health reform could significantly intensify the effects of the physician shortage. Depending upon which version of the health reform bill passes, the reality is that there may not be enough doctors to provide quality medical care to all of these newly insured people."

Over 50% of physicians who responded predict that a health reform would cause the quality of medical care to deteriorate in America. When asked how health reform could affect the quality of medical care, 40.7% stated it would "decline or worsen somewhat," while another 14.4% stated that the quality of medical care would "decline or worsen dramatically". If a public option is implemented as part of health reform, 64.1% of physicians predict that the quality of medical care in general will decline.

"Many physicians feel that they cannot continue to practice if patient loads increase while pay decreases. 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," states Kevin Perpetua, Managing Partner for The Medicus Firm's Atlanta division. "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. Health reform, and increasing government control of medicine may be the final straw that causes the physician workforce to break down."

Only 23.8% of physicians unequivocally support a public option for health coverage, according to the survey responses. 67.9% agree that reform is needed in some fashion, but not with the public option, and not as one sweeping bill.

Author:	Squirrel Girl [ Wed Mar 17, 2010 1:33 pm ]
Post subject:	Survey on physician's plans if health care reform occurs
The Survey: http://www.themedicusfirm.com/pages/medicus-media-survey-reveals-impact-health-reform Spoiler: Survey Reveals Potential Impact of Health Reform on Physician Supply What if nearly HALF of all physicians in America suddenly stopped practicing medicine? Such a drastic decrease in the physician workforce could become a reality, depending upon how the healthcare reform legislation is implemented, and which version of health reform passes into law. In a physician survey conducted December 2009 by The Medicus Firm, a national physician search firm, 24.7% of physicians stated that they would "retire early" if a public option is implemented, and an additional 21.0% of respondents stated that they would quit practicing medicine, even though they are nowhere near retirement. This brings the amount of physicians who would leave medicine to a total of 45.7%. Interestingly, the numbers were not as dramatic, but still troubling, if the public option is not part of the equation. If health reform passes without the public option, 7.4% of physicians stated that they would quit practicing medicine, unless they were nearing retirement, in which case 21.8% said they would retire early, bringing the total loss of physician workforce to nearly one-third of physicians leaving medicine. "What many people may not realize is that health reform could impact physician supply in such a way that the quality of healthcare could suffer," states Jim Stone, Managing Partner at The Medicus Firm's Dallas office. "Based on the physicians' responses to the survey, health reform could significantly intensify the effects of the physician shortage. Depending upon which version of the health reform bill passes, the reality is that there may not be enough doctors to provide quality medical care to all of these newly insured people." Over 50% of physicians who responded predict that a health reform would cause the quality of medical care to deteriorate in America. When asked how health reform could affect the quality of medical care, 40.7% stated it would "decline or worsen somewhat," while another 14.4% stated that the quality of medical care would "decline or worsen dramatically". If a public option is implemented as part of health reform, 64.1% of physicians predict that the quality of medical care in general will decline. "Many physicians feel that they cannot continue to practice if patient loads increase while pay decreases. 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," states Kevin Perpetua, Managing Partner for The Medicus Firm's Atlanta division. "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. Health reform, and increasing government control of medicine may be the final straw that causes the physician workforce to break down." Only 23.8% of physicians unequivocally support a public option for health coverage, according to the survey responses. 67.9% agree that reform is needed in some fashion, but not with the public option, and not as one sweeping bill. Bill O'Riley's synopsis: http://video.foxnews.com/v/4109502/talking-points-316 Since I posted what I have to do given the 21+% reduction in payment (and I know they have delayed it, but they also won't pay ANYTHING for a month 'while reimbursement levels are in flux'!), I thought I would give a bit more information about this mess.

Author:	Vindicarre [ Wed Mar 17, 2010 1:36 pm ]
Post subject:
The ramifications are pretty scary.

Author:	RangerDave [ Wed Mar 17, 2010 1:39 pm ]
Post subject:	Re: Survey on physician's plans if health care reform occurs
I'll believe it when I see it. I can imagine fewer people deciding to go into medicine in the future, but for someone who already has their medical degree and experience as a doctor, the sunk costs are so large that I find it extremely hard to believe that any sizable percentage of current doctors will quit practicing medicine.

Author:	Rorinthas [ Wed Mar 17, 2010 1:46 pm ]
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If the decrease is so bad that they can't make ends meet, then vested intrest isn't worth much. Though some of that number probably is saber rattling. At the end of the day we don't have an over abundance of medical professionals, especially in some regions

Author:	Rynar [ Wed Mar 17, 2010 3:25 pm ]
Post subject:	Re: Survey on physician's plans if health care reform occurs
RangerDave wrote: I'll believe it when I see it. I can imagine fewer people deciding to go into medicine in the future, but for someone who already has their medical degree and experience as a doctor, the sunk costs are so large that I find it extremely hard to believe that any sizable percentage of current doctors will quit practicing medicine. People go into busines to make money, RD. When it becomes impossible to make money, you close your doors. Doctors are bright people, RD. They have tons of options when it comes to employment.

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Author:	RangerDave [ Wed Mar 17, 2010 3:50 pm ]
Post subject:	Re: Survey on physician's plans if health care reform occurs
Rynar wrote: People go into busines to make money, RD. When it becomes impossible to make money, you close your doors. Doctors are bright people, RD. They have tons of options when it comes to employment. True, but in most cases, they'll have very few options that are going to pay anything close to what they'll be able to make as doctors even if their compensation does take a hit from reform. It's like all the wailing and moaning my fellow Big Law associates engaged in last year when firms froze salaries, slashed bonuses and reduced recruitment incentives because of the recession. Everyone pitched a fit about how it was no longer worth all the years of schooling, insane work hours, soul-crushing partners, etc., how firms were going to find it hard to attract top candidates away from investment banking and other professions, and of course how deeply unfair it all was! And then reality set in. People realized that a $60,000 pay cut may sting, but it's still damn hard to find any other jobs that pay $160-300k per year. Everyone who didn't get canned, stayed put; most who did get canned continued to apply for other Big Law jobs; and law school applications went up yet again. I strongly suspect it's the same deal in the medical profession. Sure, it'd suck for a doctor who goes from making $250k to making only $175k, but when he actually looks at his options and sees that being an analyst at some biotech firm will pay half that much, if he's lucky, and that it's unclear whether he can even get that job with no lab, investment, or management experience, he's probably going to suck it up and keep his little white coat. Which isn't to say I don't sympathize or that I agree with government price-setting. It's just that I'm very skeptical of the idea that doctors are going to quit en masse if health care reform passes.

Author:	Müs [ Wed Mar 17, 2010 4:05 pm ]
Post subject:	Re: Survey on physician's plans if health care reform occurs
RangerDave wrote: Rynar wrote: People go into busines to make money, RD. When it becomes impossible to make money, you close your doors. Doctors are bright people, RD. They have tons of options when it comes to employment. True, but in most cases, they'll have very few options that are going to pay anything close to what they'll be able to make as doctors even if their compensation does take a hit from reform. However, their overhead will drop considerably once they no longer have to pay to work.

Author:	Timmit [ Wed Mar 17, 2010 4:08 pm ]
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I don't think most doctors make as much as you think they do, RD... According to some some cursory web searching, the average income for a doctor in the US is roughly $140,736. http://www.worldsalaries.org/generalphysician.shtml

Author:	Xequecal [ Wed Mar 17, 2010 4:23 pm ]
Post subject:	Re: Survey on physician's plans if health care reform occurs
I fail to understand how the current health care "reform" on the table will be detrimental to doctors. A mandate to purchase health insurance can only be good for them. It's millions of people that are now required to pay them money. Every person that decides not to see a doctor now for trivial things will demand a first and second opinion, plus expensive tests. Hey, you forced me to buy the insurance, I'll milk it for all I can. Medical professionals can only win. The impending Medicare cuts have the potential to devastate doctors, but do you really think those are going to stick? Really? What do you think will happen when the by-far largest voting demographic suddenly can't find anyone to take their Medicare because they all either refuse to take it or are out of business? Those cuts will be reversed right quick, hell they'll probably get extra money added on top of it to placate them. It'll be a great time to take a year's vacation then come back to massively higher demand.

Author:	Aizle [ Wed Mar 17, 2010 4:24 pm ]
Post subject:	Re:
Timmit wrote: I don't think most doctors make as much as you think they do, RD... According to some some cursory web searching, the average income for a doctor in the US is roughly $140,736. http://www.worldsalaries.org/generalphysician.shtml Those numbers appear to be for general practicioners, which I believe are not paid as much as most of the specialty doctors.

Author:	Squirrel Girl [ Wed Mar 17, 2010 4:30 pm ]
Post subject:	Re: Survey on physician's plans if health care reform occurs
This is what most people don't get. They think Doctors are rich. Well most are not. The ones who think and diagnose get paid the worst. The ones who do a lot of procedures get a lot more. For example: The BEST listed salary for a physician in my specialty looking at one major site was $50,000 per year. And I would have to pay taxes, SS, medicare and malpractice insurance from that. This is why doctors are talking about quitting. They can't afford to work. This is mostly the family practice/ Internal Medicine/ pediatrics docs, with the neurologists, physiatrists, and rheumatologists going down with them. The Doctors who take day to day care of chronic medical problems.

Author:	Rynar [ Wed Mar 17, 2010 4:34 pm ]
Post subject:	Re: Re:
Aizle wrote: Timmit wrote: I don't think most doctors make as much as you think they do, RD... According to some some cursory web searching, the average income for a doctor in the US is roughly $140,736. http://www.worldsalaries.org/generalphysician.shtml Those numbers appear to be for general practitioners, which I believe are not paid as much as most of the specialty doctors. And what good are the specialized doctors, when there is no one left to refer them patients, because the GPs and diagnosers can't afford to stay in business?

Author:	RangerDave [ Wed Mar 17, 2010 4:50 pm ]
Post subject:	Re: Survey on physician's plans if health care reform occurs
Squirrel Girl wrote: For example: The BEST listed salary for a physician in my specialty looking at one major site was $50,000 per year. And I would have to pay taxes, SS, medicare and malpractice insurance from that. It's certainly true that primary care physicians are at the low end of the pay scale, but I've never met a doctor who makes anything close to that little except for one friend who worked in a semi-charitable capacity at a clinic catering to the poor and uninsured. According to the BLS, the mean income for Family and General Practitioners is $160k and for Pediatricians it's $150k. Not questioning your source, SquirrelGirl - the bottom 10% of the catch-all category (Physicians & Surgeons, All Other) is $50k - but that number is clearly far below the norm for the vast majority of doctors, including the vast majority of primary care physicians.

Author:	Rorinthas [ Wed Mar 17, 2010 4:51 pm ]
Post subject:	Re: Survey on physician's plans if health care reform occurs
Xequecal wrote: I fail to understand how the current health care "reform" on the table will be detrimental to doctors. A mandate to purchase health insurance can only be good for them. It's millions of people that are now required to pay them money. Every person that decides not to see a doctor now for trivial things will demand a first and second opinion, plus expensive tests. Hey, you forced me to buy the insurance, I'll milk it for all I can. Medical professionals can only win. The impending Medicare cuts have the potential to devastate doctors, but do you really think those are going to stick? Really? What do you think will happen when the by-far largest voting demographic suddenly can't find anyone to take their Medicare because they all either refuse to take it or are out of business? Those cuts will be reversed right quick, hell they'll probably get extra money added on top of it to placate them. It'll be a great time to take a year's vacation then come back to massively higher demand. They have to get the money not from the patients, but from the evil private insurers or the govenerment in the event of a public plan. The government is already cutting the amount of money they are paying said doctors from the existing public plans, apparently so much that they take these patients at a loss after their overhead. Also they have to treat the patients now, and get the money from the insurance companies/government later. If the company/government doesn't feel like paying then the doctor usually has to write it off. So the result is that doctors will have more patients to see because people will be coming to the doctor whether they need it or not. The doctor has to see them and separate the needed from the unneedy, all this taking time. Then the doctor has to deal with the insurance company (or government plan people) to get repaid. So it's more work with the greater likihood of the insurance providers finding more reasons not to pay because they have more claims to deal with.

Author:	Khross [ Wed Mar 17, 2010 7:14 pm ]
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No True Scotsman fallacy, RangerDave. That said, SquirrelGirl's in field expertise trumps your anecdotal evidence from a deflationary market.

Author:	RangerDave [ Wed Mar 17, 2010 8:48 pm ]
Post subject:	Re: Survey on physician's plans if health care reform occurs
Khross wrote: No True Scotsman fallacy, RangerDave. That said, SquirrelGirl's in field expertise trumps your anecdotal evidence from a deflationary market. *Edit: Actually, nm. Misunderstood what you were saying at first, Khross. I do disagree, though, regarding the "in field expertise" characterization. As I say in my reply to Lydiaa, below, being a doctor makes one an expert in medicine, not the medical industry.

Author:	Ladas [ Thu Mar 18, 2010 9:43 am ]
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Its a lost cause Taskiss.

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Author:	Taskiss [ Wed Mar 17, 2010 8:21 pm ]
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I've yet to see where the majority of folks don't incur debt commensurate with their income. A 20% cut in pay will put a ton of folks in hurt and probably not an insignificant amount in arrears.

Author:	Micheal [ Wed Mar 17, 2010 8:27 pm ]
Post subject:
At this point in time an announced 20% cut in my pay would most likely cause me to retire. It would take me 5-7 years to get back to the retirement income point I'm at now, not to mention the cut in pay making it less attractive to continue working. Then I could finally get around to finishing those half a dozen books I've started writing.

Author:	Lydiaa [ Wed Mar 17, 2010 10:51 pm ]
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Psst, RD, SG is part of the system, technically her claim to experience as a doctor is not quite anecdotal... check out this thread viewtopic.php?f=7&t=2024

Author:	RangerDave [ Wed Mar 17, 2010 11:16 pm ]
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Thanks for the pointer, Lydiaa. I knew she was a doc, but still, that doesn't make her personal experience any less anecdotal. Being a doctor makes her an expert on medicine, not on labor trends in the medical industry. That said, I don't actually have a problem with the use of anecdotes to make a point in a casual discussion like this. I think it can be illuminating as long as it's recognized for what it is. And incidentally, Squirrel Girl, sorry for all the references to you in the third-person. It feels rude, so I want to be clear that there's no criticism of you or dismissal of your professional situation intended.

Author:	Ladas [ Thu Mar 18, 2010 7:57 am ]
Post subject:	Re: Survey on physician's plans if health care reform occurs
Xequecal wrote: The impending Medicare cuts have the potential to devastate doctors, but do you really think those are going to stick? Really? What do you think will happen when the by-far largest voting demographic suddenly can't find anyone to take their Medicare because they all either refuse to take it or are out of business? Those cuts will be reversed right quick, hell they'll probably get extra money added on top of it to placate them. It'll be a great time to take a year's vacation then come back to massively higher demand. Could be they get reversed. Could also be just as likely that those in power will vilify doctors are part of the problem with rising health care costs, rising taxes to pay for health care and highlighting select salary ranges of some doctors are characteristic of the profession. This will get used as the starting point to pass health care reform, with such laws that if a doctor accepts insurance as a form of payment, they have to accept all insurance, including medicare/caid.

Author:	Uncle Fester [ Thu Mar 18, 2010 8:30 am ]
Post subject:	Re: Survey on physician's plans if health care reform occurs
http://seattletimes.nwsource.com/html/l ... ns18m.html 121 walgreens will stop taking Medicaid patients, they where operating at a loss.

Author:	Lex Luthor [ Thu Mar 18, 2010 8:44 am ]
Post subject:	Re: Survey on physician's plans if health care reform occurs
Rynar wrote: RangerDave wrote: I'll believe it when I see it. I can imagine fewer people deciding to go into medicine in the future, but for someone who already has their medical degree and experience as a doctor, the sunk costs are so large that I find it extremely hard to believe that any sizable percentage of current doctors will quit practicing medicine. People go into busines to make money, RD. When it becomes impossible to make money, you close your doors. Doctors are bright people, RD. They have tons of options when it comes to employment. Employment is based only on skill sets, not intelligence.

Author:	Taskiss [ Thu Mar 18, 2010 9:40 am ]
Post subject:	Re: Survey on physician's plans if health care reform occurs
Lex Luthor wrote: Rynar wrote: RangerDave wrote: I'll believe it when I see it. I can imagine fewer people deciding to go into medicine in the future, but for someone who already has their medical degree and experience as a doctor, the sunk costs are so large that I find it extremely hard to believe that any sizable percentage of current doctors will quit practicing medicine. People go into busines to make money, RD. When it becomes impossible to make money, you close your doors. Doctors are bright people, RD. They have tons of options when it comes to employment. Employment is based only on skill sets, not intelligence. Options are based on folks having intelligence - to be capable of reason is a measure of intelligence. Smart folks are better than not so smart folks at figuring their way out of problems, and getting a 20% cut in pay is a problem.