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.
I would think this might depend on which plan (or which part of which plan) is adopted.
From the third page of the article:
[blockquote] In 2006, Massachusetts passed its medical overhaul — minus a public option — similar to what’s being proposed on a national scale now. It hasn’t worked as expected. Costs are higher, with insurance premiums rising 22% faster than in the U.S. as a whole.
“Health spending in Massachusetts is higher than the United States on average and is growing at a faster rate,” according to a recent report from the Urban Institute.
Other states with government-run or mandated health insurance systems, including Maine, Tennessee and Hawaii, have been forced to cut back services and coverage. [/blockquote]
This [url=http://www.massmed.org/AM/TemplateRedirect.cfm?Template=/CM/ContentDisplay.cfm&ContentID=31513 ]report[/url], just released from the Massachusetts Medical Society has some interesting data. Only 60% of family docs and just 44% of internists are accepting new patients. (I believe the wait time for a primary care provider in Montreal was about three years!) 42% of physicians in Massachusetts report being dissatisfied or very dissatisfied – with those numbers for family physicians and internists being 59% and 56%, respectively.
You can lead a horse to water…
I find it difficult to believe that many doctors have much use for the present system. It is a mess. The negatives fall heavily on the doctors themselves. It is interesting to contrast the IBD article in this post with the NPR piece in the adjoining one. I have no idea which reality is the more empirically valid. I suspect it has a lot to do with how the questions are asked and what facets of the current and proposed systems one focuses on.
I can’t imagine that 45% of doctors can afford to quit. What’s the follow-up story going to be: “40% of Doctors Threaten to Quit, But Keep Working Anyway”?
Interesting juxtaposition of articles, Kendall. Purely coincidental, I’m sure! Darn, can’t get the smileys to work!
I’m not convinced that this is any more “objective” than polls that say that doctors support health care reform. The poll was sponsored by [b]Investor’s Business Daily[/b] which may have an interest in promoting the health insurance industry.
NoVA is right about what “plan” are we talking about. There are a number of bills before both houses of Congress–last count I had was a half dozen, the new bill may make seven. We don’t know yet which bill will come to the floor of either house, what form either house may adopt, what would come out of what will certainly be a conference committee or what might end up on the President’s desk for his signature.
Again, the NPR story is about a poll of AMA members only. AMA represents only 18% of physicians and I know many physicians who refuse to belong to the AMA for their (liberal) policies. I also know many older physicians who would have retired or actually did retire and then came back when the economy dropped out. These older physicians practiced in a time when society gave them respect, they didn’t have to fight for it, when CYA wasn’t the first order of business, when paperwork was a lot less, etc. This includes pretty much all of the internists in town. I would take the opinion poll about 40% of physicians wanting to quit in the near future very seriously. The situation with internists is critical. Something like only 2% of medical school grads are going into general internal medicine. Internists or “adult doctors” are the ones who take care of the sickest patients – e.g., a diabetic with hypercholesterolemia, early renal disease, history of two MI’s, and diabetic neuropathy. These patients can’t be managed in a 5 minute time slot.
I think the poll is correct. There are many older doctors which make up a significant percentage of those still in practice who have slowed down, now have all the debts paid, children off the payroll, who are content to coast at low pay, who will be forced to just quit when the overhead skyrockets through mandates like expensive computer program, insurance cost for workers, more hassel and documentation burdens, fee cuts, who will just be forced to hang it up. This will be especially true for primary care docs. Not to worry though, because I have had politicians tell me that they really think all this load can be handeled by nurses and pharmacist, and other “health aids.” So this is what the Michael Jackson crowd has voted for. Enjoy.
It seems likely that my GP would still practice, as would most generalists. They would be able to accept a government salary, if that is where we went, or controls, if that is where we went with this. But the specialists – – the high-priced guys, the guys who are brought in to do the surgery that no one else within a thousand miles can do – – those guys are not going to work for a controlled salary, in whatever form the government would control it. And they can pretty much afford to quit any time they want to.
Look at it this way, if 45% of doctors quit, then Obamacare would be able to ration without actually rationing. Then he can say that it was not his fault, it’s those greedy doc’s fault for not working for less than accountants or PA’s get paid.
Think of the savings when people have to wait to get in to see the doctor! Most illnesses will pass spontaneously anyhow, and the ones that kill the patient in the days to weeks it will take to get to the doctor would probably have died soon anyway, so again they die cheaply and quickly instead of slowly or expensively.
Mission accomplished! Yes we can!
jkc1945,
No one has offered your GP a salary. Instead he will be offered decreased pay, continued assaults from lawyers intent on raiding the system, and the inability to order any of the expensive tests that he used to order to protect himself from the lawyers.
So, he will quit, most probably.
Honestly, in a few years when the access problem really hits hard after enough doctors quit, the goverment will perhaps see the light and try to go back and rehire the retired doctors by offereing them a salary. I’ll bet most will remain retired, the ones who take the salary will work like government employees. It will be great for the docs and bad for the patients.
Personally, I’m looking forward to a goverment salary with sovereign immunity from lawyers. Maybe I can see about half of my current patient volume for less money. However, that system is years off. In the meantime, Obama plans to stop defensive medicine, thus leaving us defenseless against his lawyer buddies.
Costa Rica looks better every year.
#4 [i] What’s the follow-up story going to be: “40% of Doctors Threaten to Quit, But Keep Working Anyway� [/i]
I couldn’t agree with your next headline more. Grandstanding if ever I saw it.
Right — because why on earth would physicians possibly be unhappy with their work, in the great collectivist industry that they will serve?
No no no — we will have 45% of the American people considering becoming doctors instead! ; > )
The physician shortage would be even more acute were it not for the many foreign medical graduates who practice here. America assumes that this is because “they are paid so well”. Actually the facts are more complex than that. An Indian internist practicing in India is paid much less than a US physician, but (since everybody else in India is paid less than she/he) has a much more enviable lifestyle. He/she will work about 60 hours, and come home to a large house, with a staff of 3-6 servants including nanny, driver, cook and housemaids. Her kids will be picked up at close of school day, will be fed, washed and tutored as needed by a private tutor who supervises homework. The physician will eat the excellent meal her cook has prepared, while chatting with her kids who have finished their homework, studied for all their tests, had some healthy exercise, and a healthy dinner, and are washed, dressed in pjs and ready for family time before bed.
A US internist will (depending on location) average about 80 – 120,000 (maybe up to 160,000). He/she will work a minimum of 80-100 hours/week. Her kids will go to aftercare, and then be picked up by a paid sitter to be taken to the sitters home to do their homework (or not) until Mom gets there. Mom will then pick up the kid, they will both eat at McDonalds, realize that most of the homework has not been done, and will spend the next couple of hours playing catch up on the homework front. Everybody will fall exhausted into bed. This pattern will continue on the weekends.
So why do Indian physicians come to the US?
It is simple. The dollar is extremely strong. If you save your money not in a stupid 401k but send it home to be saved in rupees, you will be able to retire in India at the age of 60, after having established your entire family.
We have had a bull market in overseas physicians wishing to come here, get rich, and (eventually they keep telling themselves) go home. They compromise over 25% of our physicians.
But now, right when the screw tightens on US physicians (and the 25% of physicians who are older than 60 will leave medicine) the dollar is about to plunge to the value federal money printing deserves. When that happens, folks whose main reason to work in the US is the strong dollar will remember that their lives are infinitely better at home.
http://forums.studentdoctor.net/showthread.php?t=547281
Actually I think that most physicians over 60 (some 25% of the total) will retire, a large number of the new grads will get jobs in the military, and a large number of the 40 year olds who have paid off their debts will immigrate to other countries in a reverse brain drain.
India now accepts US grads (they didn’t use to). So does New Zealand and Australia. All countries are basically English speaking. So is Saudi Arabia.
The main reason that US physicians will stay is if they have dollar denominated debt (mortgages/student loans) that they can’t discharge or flee from.