Medical Practitioner’s View of Current Healthcare Changes

side effects obamacare Packing up the last few boxes of our Medical office, that’s been open for business for approx 35 yrs., provided me with time to reflect on our inside view vs the government’s value and goals towards healthcare priorities. We have personally worked very hard and invested time, as well as hundreds of thousands of dollars in diagnostic equipment, computers and staff to run these over the years, with the last big purchase being within the last decade. These investments were necessary in order to do our business and it wasn’t ever easy taking on the financial burdens, but we had to perform at the level of quality standardized by the industry.  We freely made the conscious decisions and took on the risk to do so, without government intervention.

We are within 96 hrs of closing the doors at our medical practice and are facing the realization of our investment dollars and the financial losses we incurred without passing this on to taxpayers. Medical practices are currently in the state of flux with all the changes preempted by the coming of Obamacare, therefore, the value of such entities is not like it use to be or should be. With the cost of post-graduate education at over a hundred thousand dollars, the burden of even considering a medical degree takes a lot of forethought and commitment., fully well knowing that your debt isn’t capped and will grow exponentially more, once you graduate and set up practice. In addition to the aforementioned burden, now consider throwing in the current healthcare changes with increased regulations/demands, decreased reimbursements, Electronic Health Records etc. and imagine what these young individuals coming out of college are facing. The amount of time it will take healthcare professionals to pay back their debt on decreased reimbursements, will be considerably longer. Medical schools across the country are not increasing their numbers of graduates at a rate that will compensate  the upcoming Obamacare influx of patients into the system, which makes one wonder how much of a burden this will create on the current system and professionals.

The medical industry is seeing many practitioners, directly affected by Obamacare, either downsizing, selling their practices and/or joining with hospitals or clinics. Solo Practitioners are slowly becoming extinct secondary to not being able to carry the ever-growing overheads with increasing costs of healthcare. Most of you have noticed that secondary to Insurance contracts, most practitioners salaries have decreased and are now at the levels of reimbursement comparable to the late 70’s, yet facility costs and other medical expenses have continued to rise.

With a socialized type medicine on its way in, I personally believe that people will be directed to large clinics and/or hospitals for their care. There will be more mid level personnel such as nurse practitioners, PA’s etc. carrying out-patient care, vs MD’s, as in the past. Once the 30 million people created by Obamacare are added into the current system, people will find it harder to find practitioners to follow their care as well as will note an increased wait to get in. I foresee that the elderly will have a harder time finding doctors as the reimbursement/expense numbers have to balance.  Consequently, a practice based entirely on caring for the elderly, will not be able to make it financially, therefore, medical practices will be limiting the number of elderly.

Even though we’ve been told insurance costs will not go up, don’t count on that. With the ever-increasing bottom line of medical supplies and costs, increases in insurance premiums are inevitable, as everything has to be paid for. Physician salaries have pretty much stabilized yet the costs at the bottom have continued to increase.  Finding staff with mental and physical capabilities to work with EHR, is more limited when compared to the past, where staff were only required to document in hard copy charts. In addition to requiring training to use EHR, staff now have to maintain electronic health records or practices are having to budget for IT system maintenance, with no additional monies to do so. Without a cap on overall bottom line costs, there is no clear-cut way to control medical care costs.

Electronic Healthcare Records have put a large burden on the medical system. Even though it has helped standardize documentation requirements, it is a long way from carrying its weight. There is a demand created by EHR that has taken staff time away from patient care, in order to get the information inputed in a timely manner. EHR has not cut down on medical errors and I personally feel that it is moreso related to human error, which is not entirely preventable. The downside to EHR is that the software programs across the board aren’t the same. The reporting of data is standardized but there are still many software companies out there with many different programs, therefore, the link of communication isn’t as smooth as it should be. It still takes time to print and either email or fax information out; not a great change from copying records in the past with consequent faxing or emailing. Data is now more standardized but the time element still creates a large issue in caring for patients, thus seeing redundant but necessary tests, when information is needed, yet not available. Again, no significant change from the past.

There is something called “meaningful use” that the government is currently measuring by way of practitioner input of codes related to diagnosis related modalities. I personally feel that what they are attempting is a good start but rather vague and inconclusive in describing the big picture of actual patient visits. The incentives set up for committing to being a part of meaningful use are notable but don’t come near paying for the related additional staff time/electronic record maintenance expenses. In my opinion, for what its worth, these extra steps are doing nothing other than giving the government numbers that they will base OUR future medical recommendations on and which will be as-cued, in that they don’t create a total picture of the individualization/uniqueness of patient care.  This to me is disconcerting, especially when considering that now the government, rather than the total Society of Medical Doctors, will make these decisions, not having earned a medical degree or possessing first hand knowledge of patient care. It’s interesting that the medical profession doesn’t spend their waking hours intertwined in either Congress and/or the Senate, in telling them how to do their jobs. Maybe in hindsight, they should have been and things might be different today.

As we lock the doors, we will continue to worry about the direction of healthcare. The only way to make changes will unfortunately be through lawsuits and/or the ever-growing voice of disapproval by the people. We wish all the best of health and leave ya’ll with the realization that anything man-made can be undone.




Speak Your Mind