Does your doctor want to quit because of Obamacare?

What does it mean for the future of Obamacare if 83 percent of physicians surveyed say it makes them think about quitting?

Even before the Supreme Court upheld the law, experts were forecasting a massive shortage of physicians in the United States within the next few years, fueled mostly by an aging workforce. How will affordable care look when no one is around to provide it?

Well, hang on a sec.

The Doctor Patient Medical Association Foundation released a survey this week that contained the 83 percent figure. It’s gotten some play nationally, but it’s hard to know exactly how representative the figure is. The group sent survey questions in faxes to 36,000 physicians in active clinical practice. Only 16,227 of them were actually delivered, and of that only 699 completed surveys were returned.

I’m guessing the doctors who were upset by the Affordable Care Act were most likely to fill out the form and return it. So, with a 4.3 percent response rate and 83 percent of those people saying they are thinking about quitting … well, it puts things in a little different perspective.

Which is not to say doctors are thrilled with the new law or the thought of having to provide care to many people when, as the chair and co-founder of the organization said in an op-ed piece this week, they “can’t afford to see patients at the lowball billing rates.”

The Affordable Care act guarantees everyone insurance, not care. Don’t expect 8 of every 10 doctors to toss their stethoscopes and head for the door, though.

But a different angle on Obamacare is more interesting. While most people focused on the Supreme Court’s ruling regarding the individual mandate (which requires everyone to get insurance or pay a “tax”), the court also ruled that states cannot be forced into providing health care exchanges, which the law says should be set up to provide a marketplace in which consumers can shop for insurance.

The ruling also said states cannot be coerced into paying for an expanded Medicaid program.

Texas Gov. Rick Perry this week sent a letter to Washington saying his state isn’t going to do either of those things. Several others states are expected to do the same.

Washington will create health care exchanges for those states that won’t do so, but an argument has arisen over whether the federal subsidies to help poor people buy through these exchanges (amounting to $6,000 per person) apply only to state-run exchanges.

The answer to all this probably lies in the Department of Health and Human Services’ reply to Gov. Perry.  “We will continue to work with states to ensure they have the flexibility and resources they need to implement the Affordable Care Act,” it said in part.

What the court did, then, was to give considerable leverage to states, especially big ones like Texas. President Obama has hinted that the law may need tweaks and changes. Expect states to have a big hand in that.

(For more content, click here to visit Jay Evensen’s web site.)

Categories: Washington

About the Author

Jay Evensen

Jay Evensen is the Senior Editorial Columnist for the Deseret News. He has 32 years of journalism experience covering politics and a variety of other assignments at news organizations ranging from United Press International in New York City to the Las Vegas Review-Journal and the Deseret News, where he has worked since 1986. During that time, he has won numerous local, regional and national awards. Most recently, he was given the Cameron Duncan Media Award, given annually in Washington, D.C., by the advocacy group RESULTS, to the journalist judged to have done the most to further the cause of the world's poorest people.

22 comments

  1. Moderate

    Doctor shortage? Sounds like a great opportunity for American kids. At least you know your job won’t be shipped to India. If American kids aren’t smart enough anymore, I’m sure there are plenty of kids that would emigrate from India for a job.

  2. LDS Liberal

    Makes me question their motives as to why they became Doctors in the 1st place.

    Do they REALLY want to save lives and help people,
    or
    Did they just pick this vocation so they can make a lot of $$$ money so they can be wealthy?

    Nothing against making alot of money –
    but valuing the lives of people as opposed to those who make a living trading stocks and bonds, banking or owning a manufacturing or business is immoral — IMHO.

    Look at Doctors working in 3rd World countries on kitchen tables as opposed to these snobs who’d quit over not being able to keep up with the Jones at the Country Club.

      • LDS Liberal

        Absolutely not.

        How much did Jesus make for healing the sick and afflicted?

        Again, I’m not advocting a Doctor render services for free by any means —
        One who can perform Modern Medical Mircale should be entitled toa very comfortable living.

        BUT – gouging the sick or threatening to quit because your no longer a Multi-Millionaire is Greed on the 1st order of magnitude.

        Like I mentioned —
        The BEST Doctors I know worked in 3rd world contries, in the poverty stricened areas of America, or were serving in the U.S. Military.

        Money can’t by Happiness – NOR the best Healthcare.

        Don’t beleive me?

        Professional Sports players and other Millions go to EUROPE for their Healtchcare.
        [Also proving Socialized medicine is actually the best money can buy].

    • Tut

      Anyone put into a situation to save lives through surgeries, prescribing medicine, being called into an Emergency Room at 2 o’clock in the morning deserve to be paid a little more than someone who answers phone calls and schedules appointments. Although motives are very important, we don’t live in a perfect world. The pay scale helps a lot of people decide to enter the field of medicine so they can live comfortably and also help people. If it were just to help people, doctors would not last long and we would run short quick. If you’ll notice there is a large shortage of doctors in third world countries… hmm I wonder why

    • MFR

      Everyone chooses a career in which they have a secured future. And I’m pretty sure that one becomes a doctor not only for the money sake, but also for their passion to serve community and heal people. Without the passion, one cannot last the countless hours of being on call. So the obviously deserve to have a comfortable living.

    • PhysicianInTraning

      Jesus didn’t pay a butt load of tuition and go through years of training to heal. Also, you, whom I assume have not been through the system of obtaining an MD and practice (trials after trials that tests your intelligence and resilience), should not have the right to judge physicians. Thirdly, not many people respect someone who coerce other people to play Jesus and not contribute in the same mean– it’s like someone forcing others to donate money (but not themselves), and a child who cries the unfairness of having low grades while not putting in the effort of studying…

    • Kasey

      Obviously you are clueless when it comes to the amount of money physicians make. Malpractice insurance alone is probably more than most of us make in a year! The assumption that most physicians are multi-millionaire’s is absurd! Coming from a wife whose husband is in the medical field, these changes are very concerning…… As it stands now, my husband can’t afford to see medicaid patients because the reimbursement for these patients are so low that he would lose money. For my husband to be able to keep his lights on he would have to triple his case load with Obamacare. This means shorter times with each patient and less quality care because they are being led in and out of the office like cattle! I don’t think most people are looking at the consequences of this huge change. It really scares the living daylights out of me!!!!!

    • dct

      @LDS Liberal … seriously ignorant statements.
      do you have any clue how much money it costs to get through med school + start a practice with a small business loan ?
      on top of that, how would you feel after 10 years of school, seeing your pay get cut on every surgery you perform ?

    • health care provider

      LDS Liberal:
      Do you even know what you are talking about. Have you seen the latest sallary of a general practitioner or a pediatrician? They make less than you really think. Do you know how much medical school costs these days? And do you know how much heart surgeons make today? You do not! If you did you would not be talking. Yes there are a small perecnetage now that make close to 1mil as heart surgeons. Though, they are well known and have done some tremendous things. The rest, make less than 300K. You might say that is alot! Well if you have ever been inside an operating room during open heart surgery or spent a week in the ICU, you would give them even more! They do not sleep they do not eat, they are standing looking inside a open chest for sometimes 10 hours with out going to the bathroom. Oh in a few years if you need to have open heart surgery, guess what, you will be on a waiting list and probably die waiting!!!

  3. Big Dave

    So let’s see here – doctors want to quit the profession because they will be compensated at a much lower rate (see their salary shrink) and they will be saddled with all sorts of legal troubles due to the Obamacare regulations. I have to think the quality of care is going to go south as well as doctors start to bail out. Sounds like this hope n change stuff is really working out well for the good ole USA.

  4. maddy

    I would just note: the “survey” was conducted by an organization established in 2011 whose founder and co-founders are fellows at a conservative organization, Pacific Research Institute.

    Secondarily, as Mr. Evensen noted, the sample size of the respondents was extremely small, to the point of being insignificant.

    ACA will provide Drs. with many more paying/insured pts. Actually, private insurance companies make Drs. billing job infinitely more complex and onerous. If pts. had to be responsible for dealing with insurance companies and getting reimbursement I have no doubt single-payer would be a popular idea.

  5. Retired MD

    Those who go to foreign countries for medical care go primarily for three reasons: 1. Some of the treatments they seek are not FDA approved in the US, 2. They usually go in the private practices of physicians, not the government health care system, and 3. The competition of those in private practice in Europe forces lower prices, something not allowed in the US.

  6. maddy

    Since Mr. Evensen didn’t track down the details on the survey I will share what I learned from politifact:

    The question asked: “How do current changes in the medical system affect your desire to practice medicine?” According to the group, 83 percent answered, “Makes me think about quitting,” 5 percent said, “I’m re-energized,” while 13 percent said they were unsure or had no opinion.

    In an interview, Kathryn Serkes, the founder and CEO of the Doctor Patient Medical Association, emphasized that the group was not asking specifically about the health care law. She noted that other findings in the survey painted a more nuanced picture than pure anti-Obamacare sentiment.

    Should newspapers be more discriminating and careful to present factual information?

  7. geodoc

    Its very simple really. No doctor is going to starve voluntarily. IOW, those who can afford to retire early will, as many already have. Those who have a different skill may change jobs if the frustration is high enough. The remaining majority will bow down to Obama and become slaves to government control to keep food on the table for them and their families. What else can they do, you ask? They can stand up against evil as a unified group, as the strongest medical lobby in the country, and force changes. Alinsky did it with only a few minorities and illegal immigrants who were nearly as educated. I am appalled at the spineless response of my comrades.

  8. JT

    Your comments make no sense. Not every doctor is rich. After paying 300,000 in school loans, medical malpractice insurance yearly, and a house payment, not to mention 4 kids, and most of the money goes to employees and overhead costs of a practice, little is left. You can make more money in business or in a different profession. Your just jealous because your not a doctor.

  9. Nick

    This is meant for LDS Liberal:

    Jesus made billions of tax free dollars (through the corrupt church system) for “healing” people.

    It is ridiculous to think that doctors who go through 10+ years of school and training, who leave school in mountains of debt from the exorbitant prices of tuition, should be expected to work longer hours to treat more people for less pay.

    • Kevin Smith

      Thank you! And not only that they shouldn’t have to listen to the government on how to run their business. Whatever healthcare in America is officially sinking. Its the titanic all over again. I know America has had a very inefficient healthcare system for a long time. But in terms of service. There is no higher quality service in the world period. If you have the money, America is where you come to get medical treatment. Say good by the that superior American quality. Now we get to be inefficient and extremely low quality. Hooray for us. And if you don’t believe me look to Canada’s healthcare system. Sorry, but if you have cancer and you live in Canada you might as well be living in Mexico. At least the weather is nice there.

  10. DrDan

    The public has a huge misconception about doctors. As a current medical student I’m well aware I probably won’t be “rich” like the docs of the 90′s. I’m going to be graduating with 200K+ in debt, which including interest payments will amount to closer to 400-500 K. With physician compensation probably decreasing, one would be foolish not to consider the ramifications of Obamacare. Not only are some docs second guessing themselves, Obamacare will also lead intelligent people into other professions. Medical school, residency and the like are very hard work, and if docs are not compensated well, people will avoid the profession. If you are actually in health care you can see why Obamacare won’t work– it sounds good on paper but healthcare reform from anyone outside the field will lead to disaster. It’s easy to say docs should see more patients, get payed less, work more and provide quality care- but I think we all know the reality of that.

    • Kevin Smith

      Yeah it is easy for people on the outside to point to people on the inside and say they know what they are doing wrong. It’s a totally different story for people on the outside, like the government, to actually be able to go in and improve upon the situation. Obama has NO idea what it is like to be a doctor. He may think he is in control of American lives. But there is no way it is the same as being in the O.R. with somebody whom you have met holding their life in the balance. Talk about major pressure on a day to day pressure. Thank GOD they do a better job than the president. I am SO happy our doctors are higher quality than our politicians.

  11. Mark the Economist

    You should be more concerned about “medical tourism” eating away at high margin practices, forcing more MDs to compete with your husband. Radiology is outsourced to India right now, orthopedic procedures are being done by US-trained surgeons at resort like hospitals for 1/3 the cost. Need your knee done? Take the whole family, start your rehab in a beachside facilitity, the insurance company will cut your deductible.

    How does that feel? Now you know what a lot of Americans have been going through, as you’re ignorant that Mitt was a pioneer in outsourcing.

    The lower the US average wage falls, the more pressure on physicians to lower their costs.

    It seems a little more personal now, huh?

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