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Doctors’ Opinions And The Impending Physician Shortage

By Stanley Feld MD, FACP, MACE

Sixty three percent of physicians are unhappy with the implications of President Obama’s healthcare reform plan. The government has reduced reimbursements arbitrarily over the last decade.

Physicians have had an underlying mistrust of government healthcare policy. Congress and especially Pete Stark mistrust physicians. Pete Stark feels all physicians game the healthcare system.

I believe there is some abuse of the healthcare system by a small percentage of physicians. I also believe congress has a lack of understanding of medical practice expenses, the value of physicians’ intellectual property and skill sets. 

In September 2009 an Investor Business Daily Survey was criticized for its findings in a physician opinion survey.

“We were harshly criticized last September for an IBD/TIPP Poll that showed 45% of doctors would consider leaving medicine if a health care takeover passed.”

The liberal media refused to believe the survey. It is a pity the media is so polarized. The liberal media is blind to information that could affect liberal healthcare policy adversely.

“IBD/TIPP Doctors Poll Is Not Trustworthy,” ran the headline of one much-read piece on the FiveThirtyEight: Politics Done Right blog.

The Huffington Post attacked the very integrity of our poll: “Investor’s Business Daily Publishes Ludicrous Poll Claiming 45% Of Doctors Would Quit Over Reform.”

While the Democratic caucus in the Senate and the House were crafting the healthcare reform bill, no one asked practicing physicians how they felt about a government takeover of the healthcare system. The implementation of healthcare reform is dependent on physician support.

The government villainized the healthcare insurance industry. It is hard to tell who is the bigger villain the healthcare insurance industry or the government.

The government will hire the healthcare insurance industry to provide administrative services for the healthcare reform bill.

The healthcare insurance industry will continue to receive 65 cents of every healthcare dollar.

The Medicus Firm, a physician search firm, conducted a survey published in the Investor’s Business Journal, March 18, 2010. 

For text:

The Medicus Firm survey was emailed to a random sample of 2,250 physicians from their physician database. Of the 2,250 emailed, 1,195 responded. Of the 1,195 responses, 36.4% were primary care physicians (family practice, internal medicine, or pediatrics), and 63.6% were specialists.

This survey response was impressive.

  • 45% said they’d consider closing their practice or retiring early if the healthcare reform bill being considered was enacted.
  • 65% said they opposed the government’s attempts at taking over the health care system.
  • 33% supported President Obama’s healthcare reform bill.

“Given that the White House and Congress both promised then — as they do now — to provide health care coverage for 31 million new patients while at the same time cutting costs from the $2.4 trillion a year we spend on medical care.”

“The poll reveals that doctors won’t go along with it, says IBD:”

  • If the sampling is valid of the 800,000 physicians practicing in the United States in 2006, as many as 360,000 might leave the profession.
  • President Obama will be trying to cover 31 million more patients with up to 45 percent fewer doctors. 

“Impossible.  It can’t be done, says Investor Business Digest.”

· 29.2 percent of the 1,200 doctors said they would quit or retire early if a health reform bill was passed.

  • That number jumped to 45.7 percent — the same Investor Business Digest‘s original survey — if a public option were included. 

“Many physicians feel that they cannot continue to practice if patient loads increase while pay decreases,” wrote Kevin Perpetua, managing partner of the Medicus Firm, summing up his findings.

“So for the record, we still stand by our findings said IBD. Our poll wasn’t “ludicrous” or “untrustworthy.” It was dead-on. And it’s still relevant.”

It is interesting to look at some of the survey questions and answers. The questions were asked without or with a public option.

Only 24% of the physicians were in practice for more than 20 years.

Without a Public Option

Your Career Satisfaction:

  • 1.2%= improve Dramatically
  • 13% = Improve Somewhat
  • 40% = No Impact / Remain Same
  • 33% = Decline/Worsen Somewhat
  • 13.2% = Decline/Worsen Dramatically

With a Public Option

Your Career Satisfaction:

  • 5.5% = Improve Dramatically
  • 16.5% = Improve Somewhat
  • 14% = No Impact / Remain Same
  • 25% = Decline/Worsen Somewhat
  • 39% = Decline/Worsen Dramatically

Without a Public Option

Physician Supply in General:

  • 2% = Improve Dramatically
  • 9% = Improve Somewhat
  • 33% = No Impact/Remain the Same
  • 42% = Decline/Worsen Somewhat
  • 14% = Decline / Worsen Dramatically

With a Public Option

Physician Supply in General:

  • 3% = Improve Dramatically
  • 11% = Improve Somewhat
  • 14% = No Impact/Remain the Same
  • 27% = Decline/Worsen Somewhat
  • 45% = Decline / Worsen Dramatically

Without a Public Option

Quality of Medical Care in General:

  • 1% – Improve Dramatically
  • 11% = Improve Somewhat
  • 34% = No Impact/Remain Same
  • 40% = Decline/Worsen Somewhat
  • 14% = Decline/Worsen Dramatically

With a Public Option

Quality of Medical Care in General:

  • 9% – Improve Dramatically
  • 17% = Improve Somewhat
  • 6% = No Impact/Remain Same
  • 30% = Decline/Worsen Somewhat
  • 40% = Decline/Worsen Dramatically

Which of the following best describes your overall opinion / support for health reform?

  • I support the current proposed legislation – 28.5%
  • I support the current proposed legislation minus the public option* – 5.0%
  • I support reform but would prefer a different, more incremental approach – 63.0%
  • I prefer the status quo – the healthcare system is fine the way it is – 3.6%

*at the time of the survey, public option was still a possibility. It still is by default.

President Obama ought to pay attention to physician opinion. If he doesn’t, there are going to be severe shortages in physician manpower.

*This blog post was originally published at Repairing the Healthcare System*

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