Wednesday, March 24, 2010

Many physicians will leave clinical practice due to health care reform

Recently, I had the chance to poll physicians (and I'd like to thank all those physicians who helped me with this). It was an informal poll, but I wanted to know how many physicians were planning on leaving clinical practice now that the health care reform bill has been passed. It's no surprise, but an overwhelming majority of physicians were more determined to look for a transition into the non-clinical field of medicine. To some, this may mean a career in administrative medicine. To others, it could be medical writing or medical education. Some want to get into the pharmaceutical industry.

In the past, many physicians would have indicated a strong desire to work for insurance companies. That trend has changed and I think physicians recognize that career opportunities in the health insurance industry may be diminishing as the government rolls out a public option and creates some serious competition.

How will patients receive proper medical care if so many existing physicians choose to leave clinical practice? What's going to happen in areas where physician shortages are causing patients to drive several hours to receive care? More physicians may plan to retire early instead of hassling with the public option and with the electronic health record requirements outlined in the HITECH Act.  Our nation will experience some significant changes in the health care world, but will these be overwhelmingly positive or negative for the public?


  1. Good post Joe, I agree the landscape is clearly changing for real this time. Docs need to be careful though about going from frying pan to fire... although with all the changes likely to occur, there should be plenty of good opportunities.

    I am betting that we will eventually see many more physican extenders handling primary care and hospitalist duties, "quarterbacked" by physicians. I am not sure what will happen to the specialites though. Still thinking about it.

    Thomas Pane M.D.

  2. I really get that docs are unhappy, and for me the most pressing need for equity 'load balancing' (i,e, effective remedies) relates specifically to the over worked, under appreciated and marginally paid primary care specialties. Gross payment inequities exacerbated by too many hoops to jump through in order to be paid for services rendered are material problems without plausible justification. Yet, there may remain a need to vet those 'disgruntled' physicians whose interests are less than patient care friendly, and more oriented to the production side of the business. Lets face it, other that the medical innovators' in the mix, who in medicine is really interested in pay for performance or otherwise migrating from a charge based production system to bundled, capitated or other quality incented bases for payment. No, this adjustment is a paradigm shift that will inevitably be associated with industry fallout. So, let it must be about putting patient's first; not appeasing docs in chatrooms.

  3. I can play this game too!

    I took an informal poll of physicians that I know and they all told me that they are delighted that health care reform has passed. They believe it is the best thing to happen to the country since Medicare and Medicaid were created. They plan on staying on at their current jobs even longer than they originally had planned on.

    Wow, things sure are easier when you don't restrain yourself to verifiable facts.