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Obama-care Means 1/3 Fewer Doctors?

From the New England Journal Of Medicine:

Physician Survey: Health Reform May Lead to Significant Reduction in Physician Workforce

Mar. – Apr. 2010

What if nearly half of all physicians in America stopped practicing medicine? 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.

The Medicus Firm, a national physician search firm based in Dallas and Atlanta, conducted a survey of over 1,000 physicians to determine their expectations as to the impact of health reform on their practices, income, job satisfaction, and future career plans. In discussing career plans as part of the recruitment process, physicians have increasingly expressed apprehension and uncertainty regarding health reform’s impact on their practices, and The Medicus Firm wished to investigate this trend further…

A total of 1,195 physicians from various specialties and career levels in locations nationally completed the survey.

The results from the survey, entitled “Physician Survey: Health Reform’s Impact on Physician Supply and Quality of Medical Care,” were intriguing, particularly in light of the most recently published career projections from the Bureau of Labor Statistics (BLS). The BLS predicts a more than a 22 percent increase in physician jobs during the ten-year period ending in 2018. This places physician careers in the top 20 fastest-growing occupations from 2008 to 2018. Meanwhile, nearly one-third of physicians responding to the survey indicated that they will want to leave medical practice after health reform is implemented.

“What many people may not realize is that health reform could impact physician supply in such a way that the quality of health care could suffer,” said Steve Marsh, managing partner at The Medicus Firm in Dallas. “The reality is that there may not be enough doctors to provide quality medical care to the millions of newly insured patients.”

It’s probably not likely that nearly half of the nation’s physicians will suddenly quit practicing at once. However, even if a much smaller percentage such as ten, 15, or 20 percent are pushed out of practice over several years at a time when the field needs to expand by over 20 percent, this would be severely detrimental to the quality of the health care system. Based on the survey results, health reform could, over time, prove to be counterproductive, in that it could decrease patients’ access to medical care while the objective is to improve access.

Furthermore, even if physicians are unable to act upon a desire to quit medicine, there could be an impact in quality of care due to a lack of morale in physicians who do continue to treat patients despite feeling significantly stressed

Do physicians feel that health reform is necessary? The survey indicates that doctors do want change. Only a very small portion of respondents — about four percent — feel that no reform is needed. However, only 28.7 percent of physicians responded in favor of a public option as part of health reform. Additionally, an overwhelming 63 percent of physicians prefer a more gradual, targeted approach to health reform, as opposed to one sweeping overhaul. Primary care, which is already experiencing significant shortages by many accounts, could stand to be the most affected, based on the survey. About 25 percent of respondents were primary care physicians (defined as internal medicine and family medicine in this case), and of those, 46 percent indicated that they would leave medicine — or try to leave medicine — as a result of health reform.

Why would physicians want to leave medicine in the wake of health reform? The survey results, as seen in Market Watch, indicate that many physicians worry that reform could result in a significant decline in the overall quality of medical care nationwide.

Additionally, many physicians feel that health reform will cause income to decrease, while workload will increase. Forty-one percent of respondents feel that income and practice revenue will “decline or worsen dramatically” as a result of health reform with a public option, and 31 percent feel that a public option will cause income and practice revenue to “decline or worsen somewhat” as a result. This makes for a total of 72 percent of respondents who feel there would be a negative impact on income. When asked the same question regarding health reform implemented without a public option, a total of 50 percent of respondents feel that income and practice revenue will be negatively impacted, including 14 percent of total respondents who feel that income and practice revenue will “decline or worsen dramatically.” Additionally, 36 percent feel it would “decline or worsen somewhat.”

This article was originally written in January 2010 and the study preceded that date. So the survey included the possibility of a ‘public option,’ which may have skewed the responses somewhat.

Even so, given the inevitability of an eventual ‘public option,’ it is quite disturbing.

This article was posted by Steve on Wednesday, March 10th, 2010. Comments are currently closed.

8 Responses to “Obama-care Means 1/3 Fewer Doctors?”

  1. BillK says:

    No big deal – the Government will just require students to “serve” their Government as doctors in exchange for receiving medical school loans.

    It won’t be long before your Government health plan has you visit your Government doctor (and of course your Government food credits will be adusted so you can maintain your healthy diet, and…)

  2. proreason says:

    Socialism levels the entire playing field to the lowest common denominator. That’s what it’s all about. That way, the proles can’t rebel.

    Only a fool would think otherwise about the medical profession. From a statist perspective, doctors are second only to capitalists on the list of people that must be controlled. Doctors are highly educated, affluent, mobile and trained in objective thinking. Viewed from the statist perspective, they are EXTREMELY DANGEROUS.

    Doctors must be replaced with more compliant servants of the state.

    • Rusty Shackleford says:

      You said it. Where would the incentive be to recoup the cost of medical school/residency, etc? Then, the type of “doctors” we’ll see appear after the state controls it all and pays for it all, are those who otherwise couldn’t even get arrested. We’ll have the pathetic, ridiculous, mind-numb robots that consider it high fashion to be a “doctor”.

      Most everyone I know knows this is a bad deal. That when explored even casually, the pitfalls become obvious. Needless to say there are countless examples all over the world of what socialism does to the medical profession.

      The idealist/utopian dreamer has watched too much TV/movies and thinks that the quality/quantity of medical care will remain high, while everyone who needs it gets “cared for”. This is the basis for my looking at them and letting them know ho wrong they are.

      Currently active doctors will sell off/retire/quit and there will be an immediate shortage, followed by a glut of incompetents. In short, we’re all screwed.

  3. GetBackJack says:

    Hat Tip: Dr, Jack Wheeler, To The Point News

    One: Open Enrollments in Medical Schools.

    The American Medical Association (AMA) colludes with State Medical Boards throughout the 50 states to severely limit the number of medical and nursing schools, class size, number of teachers, and number of admitted students.

    Each year, tens of thousands of qualified students are unable to get into medical or nursing school because of these artificial restrictions. There are an estimated 10 to 20 qualified applicants for every vacancy available in U.S. medical schools. Despite a chronic shortage of nurses, most nursing schools have a two to three year waiting period for admittance.

    An instructive question to ask in this regard is: Why is there no shortage of chiropractors? The answer is that chiropractors do not have a medieval guild which has the political power to restrict entry into their profession. Chiropractor colleges accept virtually all qualified applicants. Those who can’t complete the curriculum or pass the licensing exams are weeded out. The number of chiropractors is controlled by the market – not by a medieval guild like the AMA.

    Health freedom legislation would terminate the AMA’s monopoly over the medical profession, allow open enrollment at current medical schools, and the construction of as many new medical schools as the market will bear.

    Licensing and testing must, of course, remain strict and reliable. But as the number of physicians and nurses rises, competition between them for patients will concomitantly increase, and thus their fees and salaries will go down with the law of supply and demand.

    This also applies to the cost of a medical education in the first place: it will decrease as the number of students and new schools increases.

    Further, health freedom legislation would end the AMA’s guildification of medical practices.

    Most things done by doctors can be done by physicians’ assistants, most things done by them can in turn be done by registered nurses, and them in turn by nurse practitioners. You don’t need a Ferrari racing mechanic to fix a Toyota. You need free market medicine with several layers of medical practitioners.

    • proreason says:

      Interesting post.

      Here’s what I think…..the AMA/medical profession has created a mystique about itself that is largely unfounded. Most people capable of graduating from high school could be adequate general practitioners.

      The real medical value comes from research MD’s, medical device inventors, and the people who develop pharmaceuticals. I believe that vaccines, medicines, and medical devices are responsible for 95% (or more) of the improvement in life expectancy (after cleanliness and water/food purity is controlled).

      You go to a doc because you have high blood pressure. He runs you thorugh a thousand dollars of tests, tell you that you have high blood pressure, and writes a prescription for tablets that reduce your blood pressure. Duuuuh.

      I’ve also read, and believe, that 4 factors are responsible for 90% or so of all medical costs….heart, weight, smoking, and hereditary cancers. And I’m doubtful that your internist has any significant impact on any of those that you couldn’t learn about on the internet.

      Not saying that there isn’t an important role for diagnostic doctors for people with special conditions. Just agreeing that a (very) high percentage of advise/prescriptions from doctors could be dispensed just as effectively by nurses, PA’s or Pharmacists who are just smart enough to spot something out of the ordinary.

      A LOT of what we pay big bucks for is essentially created by a century’s old campaign to create a mystique about the medical profession. The campaign is so successful that you have millions of 30 year-olds living in fear and spending 12 to 20 thousand dollars a years to protect against conditions that have tiny odds of occuring before a person is 50 years old. But hey, I do it myself. Mrs. proreason would never forgive me if I refused to be a medical cash dispenser.

    • GetBackJack says:

      It’s the same marketing scam as Unions and diamonds. Lots and lots of diamonds out there, so the trick to making them expensive is to get the excess off the market. Reminds me of petroleum resources here vs. what the world imports to us; cost f a car vs. the continuing decline of the cost of a computer, etc etc. Unions shouldn’t exist in a Free Market. Unions are the ultimate antithesis of Free Market. The AMA is … in fact … a guild of nanny-staters protecting their turf.

      A old old tactic, but it obviously puts serious money in the pockets of people who write laws PREVENTING the operation of a true Free Market. Free markets like Mexico, believe it or not … I trundle across the border and a see pharmacist I know, Harvard Medical School Grad, did his residency at John Hopkins then moved to Mexico so he could make real medicines as cost-effectively available as possible. For the cost of a drive across the border and a nice lunch with him, we get extremely valuable and effective treatment, and supplies to take home that I know for a fact would cost us in excess of $50,000 here. Reminds me of the nuns who were arrested for drug smuggling from Canada into America and their defense was that the drugs they were brining in were all perfectly legal in America … it was the PRICE they were smuggling.

      Limit the supply, drive up demand, profit from artificial market conditions enforced by legislation.

      What conservative wouldn’t hate that with their every breath?

      Let me put this in another perspective … there’s a machine built in Germany, researched for five decades in Switzerland and illegal in the United States. For years it was known simply as the Vega.

      The Vega was identical to the computer diagnostic plug-in for your late model car. Attaching a series of galvanic skin-dynamic leads, a couple of monitors and acupuncture points and the Vega would read out how your physical systems are doing. What goes into producing the Read Out is a vastly lot more complex than space here allows (and the balance of five decades of research), but in essence, the Physician is handed a Read Out detailing which systems are performing under par, which are overly excited, what the blood is doing, lymph fluids, etc etc etc. It is a 100% comprehensive diagnostic tool. Reads the whole body.

      But that’s just the beginning …. there’s a second machine that will then take the supplied information and (via acupuncture meridians) balance the energy grid of the body’s systems. Now, that doesn’t make any sense to the pill and scalpel crowd, but the chemistry behind pharmaceutical medicines is really energy … the energetic patterns of the chemicals involved are what change things in the body, not the chemicals themselves … chemicals are complex assemblies of energies held together temporarily by forces of attraction … that’s elementary physics. Everything is energy. Delivering the needed change in the energy pattern is what pharmaceuticals do, but in a rudimentary way. The Vega bypasses the crude delivery form of chemicals and directly balances the out-of-whack energies that need to be balanced.

      Yes, it works. No, you won’t believe it until you understand the physics of energy and the makeup of solid matter as a form of energy.

      That’s just one example of throttling the Free Market to favor legacy systems and their demands for more cash. There’re so many more, space cannot match the examples. Royal Rife is another. UCLA Medical Center. He’s delivered 10 Stage 4 cancer patients to treat with his revolutionary medical device that treats the energy patterns of the cells affected. Only American clinical test where exacting records in a medical complex record ten out of ten cured … and in a matter of days. Rife was arrested, his machine destroyed, all his records seized and died a broken man. That’s … how it works.

      The medical profession is as much to blame for the inconceivably out of touch costs of medical care as are the Legislatures that crafted laws to protect income streams, throttle free markets, deter development and distribution of other, better methodologies and lastly … good old fashioned arm twisting. All while assuring you and me it’s for our own good.

  4. U NO HOO says:

    “the law of supply and demand” always applies.

    Increase demand by mandating insurance means costs have to go up.

  5. marty says:

    Fewer doctors is easy to remedy. Free med school to illegal aliens!


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