Patients frequently ask me how Obamacare will affect the practice of medicine. It is really anybody’s guess, and there are many opinions on the subject. It is one of the most hotly debated topics at professional meetings and in the doctor’s lounge.
No one argues against the good intention of the law…to make health care more accessible to every citizen of the United States. There are many shared concerns, however, with the plan. One chief worry is a possible outcome exactly opposite to what the law tries to fix…that of improving timely access to competent primary care physicians. We currently have a glimpse of what I see as a looming national crisis. Medicare aged patients today have a very difficult time finding a primary care physician who will bill Medicare for services rendered. When they do find a physician, the wait to get in is generally quite long, and when the visit occurs, the appointment is usually rushed and inappropriately short.
Many of my middle aged physician colleagues are talking about taking an early retirement if the Supreme Court upholds the legality of Obamacare. Medical students traditionally tend to steer away from primary care due to its longer hours, required breadth of knowledge and (relatively) lower pay compared to surgical and medical subspecialties. Pair these factors with up to 50 million new patients seeking prompt medical care, and we have a crisis in primary medical care access. One solution would be to train significantly more mid level providers (physician assistants and nurse practitioners). While this is acceptable for a majority of health care visits, the shorter training period for these providers makes this a suboptimal choice when confronted with analyzing and diagnosing complex medical problems.
We’ll have to wait and see how Obamacare plays out if the law is upheld in court. If so, be prepared for the possibility of longer wait times, shorter visits and more basic primary care…..Richard R Samuel, MD Family Practice and Urgent Care Hayden, ID USA