Professional Dystopia: The ObamaDoc
As certainly as the stewardess became a flight attendant, and as garbage collectors became sanitation engineers, we physicians are now health care providers. It has a catchy, culty sound.
Older health care providers like me will slowly be put out to pasture. I am a workaholic, as are most of my fellow old-time doctors. But physicians as a whole are working fewer hours this decade than last -- down to 51 hours a week, from 56. There's a reason for that: the new young physicians this decade are reluctant to put in the time and energy to build a small business that can and will be taken away from them by a bureaucrat. Yet the ObamaDoc will have a better life than I did. Nine to 5, Monday through Friday, with every government holiday off. Perhaps the new health care providers should be unionized -- no different than the teamsters or UAW. Fifteen minutes for every patient visit, absolutely no double booking, equal time for each and every patient. We don't discriminate against race, religion ... or disease process. That's un-progressive. The patient with a hemorrhoid has the same equal rights as that of a patient with chest pain or cancer.
I'll be one of those old physicians telling tales on the front porch of the aged health care providers' mandated nursing home about how I used to see 50 patients in a day, delivered a baby or two at night, and enjoyed it. The new ObamaDocs won't believe me.
President Obama swears the new electronic medical records (EMR) will save us billions, yet it can only possibly save money by taking away choices. What it will do is really great for the ObamaDocs, though: forget professional expertise -- just input the symptoms and the EMR will dictate the drug of choice. Of course, the drug of choice will be the least expensive drug available, never mind if it gives Mrs. Jones an upset stomach or Mr. Smith a headache.
The new EMR will also tell us when and what type of testing needs to be done. Let the system decide if you qualify for a CT scan or MRI. You don't want a physician to decide that! He or she may put emotion or gut feeling into that process.
The EMR savings were based on false assumptions from an original Rand Corporation review, which admitted that these savings were hypothetical and based on those many assumptions. They even used a model saying that we would save money by not needing a dictation service, because the physician is now the data entry clerk!
The new ObamaDocs will be on salary for some large corporate entity -- so no need to work extra hard. Did you know that as recently as 2003, some 70% of physicians were in private practice? That means a small business -- a mom-and-pop shop where you knew the doctor, the receptionist, and medical assistant. Like the old-time pharmacist or grocer. You used to choose your physician; now you'll just call the corporate headquarters and be assigned one. Never mind that you may not see him or her again for any emergency -- the number of physicians in a private setting is now about 50%, and Pelosi and the president don't want private practice doctors as part of their overall plan.
They didn't count on a lot of physicians retiring early. A recent New England Journal of Medicine article cited a survey showing that roughly 50% of physicians would retire if there were a government health care plan, and 25% would retire with the existing plan just made into law. The 21% Medicare cut will eventually have to be implemented. Fifteen million new patients will be added to Medicaid. Obama intends for ancillary health care providers, such as nurses, nurse practitioners, aides, and assistants, to be the actual primary care providers, and for a physician to be a backup for only serious problems. There was not one iota of effort made to curb runaway legal expenses, such as defensive medicine, documentation, and malpractice costs. The majority of Americans did not want this outrageously expensive bill to pass. The numbers given the CBO were disingenuous at best -- the real costs are somewhere around $2.8 trillion. The structure for funding this new law is a Ponzi scheme. Pelosi arranged for her and her compatriots to opt out of the new health care pool.
I don't know about you, but I've had enough.