Another Obamacare Side Effect: Doctors Abandon Private Practice for the Safety of the Hospital Staff
Next Saturday marks the third anniversary of the signing of Obamacare – – the Patient Protection and Affordable Care Act. It will be yet another reminder that government seizure of free-market medicine provides neither patient protection nor affordable care.
Only a year short of full implementation of Obamacare, we now know that almost nothing that the president promised from his signature piece of legislation is true.
Repeatedly the president said that his health care scheme would reduce the cost of annual premiums. He said the plan would not add to the deficit. He claimed that patients could keep their doctor and insurance plans. These claims were all false.
In addition, we now see thousands of pages of Obamacare regulations, a host of new taxes, and a reversal of protection against the use of federal funds for abortion.
The most alarming side effect of Obamacare is the impact on doctors themselves. Doctors nationwide are retiring early. They are refusing to accept new Medicare and Medicaid patients. Now we witness the demise of the private practice and the increasing trend that sees doctors signing on as salaried employees with big hospitals.
Only last year, a survey among doctors conducted by the Doctor Patient Medical Association Foundation found that 83% of respondents believed that changes in the medical system made them think about quitting medicine altogether. By a margin of 85%, survey respondents said the doctor-patient relationship was declining. An alarming 61% flatly said that it was getting more difficult to adhere to the Hippocratic ethic of medicine.
The survey also reported that respondents believed corporate medicine (including hospitals and insurance companies) is intentionally trying to destroy private practice.
Dr. Scott Gottlieb, a physician and resident fellow at the American Enterprise Institute, recently focused on the problem in an article in the Wall Street Journal under the headline: The Doctor Won’t See You Now. He’s Clocked Out.
Gottlieb explains that Obamacare is making the local doctor- owned medical practice a relic as more and more doctors become hourly wage earners in hospitals. Why has this happened? Gottlieb provides the answer in the first sentence of his article: “Big government likes big providers.”
He goes on to write that Washington doesn’t like doctors in private practice in small offices because it’s harder to regulate them. It is easier to regulate them if they work for big hospitals, he writes, so Obamacare “shifts money to favor the delivery of outpatient care through hospital-owned networks.”
Gottlieb writes that by next year about 50% of U.S. doctors will be working for a hospital or hospital-owned health system. He cites a recent survey by the Medical Group Management Association that showed a nearly 75% increase in the number of active doctors employed by hospitals or hospital system since 2000, “reflecting a trend that sharply accelerated around the time that Obamacare was enacted.”
When doctors become salaried hospital employees, Gottlieb explains, their productivity falls. This loss of productivity reflects a lack of physician accountability as well as a drop in the performance of medical procedures.
Gottlieb concludes that hospitals are not buying doctors’ practices because they want to reform healthcare delivery.
“They are making these purchases to gain local market share and development monopolies,” Gottlieb writes. “They are also exploiting an arbitrage opportunity presented by Medicare’s billing schemes, which pay more for many services when they are delivered at a hospital instead of an outpatient doctor’s office.”
Prepare for the day when your once personal physician is now punching the clock at a corporate- owned hospital. When you call the hospital to reach your doctor you will be put on hold, only to learn that the doctor is out. Try again on Monday.