ObamaCare's Most Frightening Consequence: Not Enough Doctors

ObamaCare's Most Frightening Consequence: Not Enough Doctors
by John Rossomando
08/02/2011

ObamaCare’s defenders promised the law would increase patient access to care, but a closer look shows that increased regulations combined with higher demand for health services could cause many physicians to give up practicing medicine.

“You are seeing a change that I haven’t seen in my over 30 years in the practice of medicine,” said Tennessee GOP Rep. Phil Roe, who worked as an OB/GYN before getting into politics. “I think what you are going to see is people going in to see a nurse practitioner, not a medical doctor, as has been the case for decades.”

According to Roe, Medicare will pay doctors less than Medicaid by 2020 should ObamaCare remain in place, which means that doctor who runs a solo practice with three employees and who grosses $300,000 could see a 30% cut in his reimbursements.

Doctor who use approximately half of their gross receipts on paying overhead costs would still have to do so even when their reimbursements are cut.

“His cut will be $50,000, meaning instead of making $150,000, he will only be making 50 or less,” Roe said. “It only takes a year or less of that to see why they are terrified of this.

“They have bills to pay. They have mortgages. They have school loans.”

Georgia GOP Rep. Tom Price, a fellow physician in the House Republican caucus, warns regulations will also cause doctors to change their minds about staying in medicine because they will make doctor-patient interactions more difficult.

“There will be limitations on medications that will be available, and shortages of medications through the FDA,” Price said. “Surgeries will have to postponed because of a lack of medications needed to put patients to sleep, damaging the quality of the care that is received.”

Price complains the regulations even come between patients and doctors when it comes to things as routine as how a doctor has to fill out paperwork to order oxygen tanks for patients who need them.

A November 2010 Physicians Foundation Survey underscored this when it found that 56% of doctors it surveyed anticipate the health care law will diminish the quality of care they can give their patients. A further 40% of physicians said they planned to retire, seek a nonclinical job in the health care field or leave the medical profession altogether.

A Galen Institute Study also found that ObamaCare’s regulations likely would force countless aspiring doctors to forgo entering the profession at a time when demand for care is on the rise.

“PPACA [ObamaCare] will strip away physician autonomy, drown doctors in bureaucracy and drain job satisfaction,” Dr. Jason Fodeman wrote in an April 2011 study for the Galen Institute. “As the profession deteriorates, older doctors will retire while younger doctors will look to switch careers.

“Many students considering a career in medicine will pursue other opportunities.”

According to Roe, only 4% of the nation’s students are getting into primary care fields.

A survey by the Associations of American Medical Colleges found the nation’s doctor shortage likely will increase the project shortfall of 62,900 doctors in 2016 to 91,500 in 2020.

“When these older doctors who are used to working 70 or 80 hours quit, I don’t know what we are going to do for internists and primary care,” Roe said.

The Galen Institute Study reports that Massachusetts, which many believe to be a precursor to ObamaCare, has seen a big reduction in doctor willingness to take on new patients. In 2007, the state’s Division of Health Care Finance and Policy Reported that 70% of general practitioners were willing to accept new patients in 2007, but that has declined to 60%. And today only 44% of internal medicine practitioners in the Bay State have indicated a willingness to take on new patients—down from 66% in 2005, before the state’s health care law took effect.

“Waiting times have increased even more since RomneyCare was passed,” said Cato Institute health care expert Michael Cannon. “And since government has inflated demand even more, it hasn’t done anything more to meet that quantity demanded versus the supply. Therefore, you get that sort of shortage.”

The Massachusetts Medical Society’s 2009 Physician Workforce Study found that the time needed to recruit physicians into specialties such as internal medicine, family medicine, orthopedics and neurosurgery had significantly increased in the three years following the implementation of the state’s health care reform law.

“It remains to be seen how the federal government will deal with this imminent fiasco on the national level,” Fodeman wrote. “Obviously the administration can’t make doctors practice, nor can it make people attend medical school.

“The likely solution will be a combination of rationing and an increased reliance on mid-level providers such as nurse practitioners and physician assistants.”

And the law’s defenders can only counter that the law provides for an increase of the number of graduate medical training positions, increases scholarships available for teaching centers in rural areas and provides state grants to increase access to care in rural areas.