How will Health Care Reform affect DOs?

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As we are well aware, most DOs are geared towards going into primary care, such as family med or internal med. How will the new bill passing affect us DOs compared to MDs who may have MORE students going into specialities such as ROADs. Does it benefit us? Will family med and IM be more worth it now? Thoughts please..

From what I've gathered, doctors are worried that it will be cheaper for businesses to not provide health insurance for their employees and instead dump those employees into the federal exchange market. As a result, the exchange market will have so many users and so much power that they will be able to determine reimbursement rates, which might decrease physician salaries by 20 to 30%,

Originally Posted by cliquesh

From what I've gathered, doctors are worried that it will be cheaper for businesses to not provide health insurance for their employees and instead dump those employees into the federal exchange market. As a result, the exchange market will have so many users and so much power that they will be able to determine reimbursement rates, which might decrease physician salaries by 20 to 30%,

I doubt reimbursements for everyone will decrease (how much more can FM go down?) without a doubt the "ROADS" specialties have a target on their proverbial back and reimbursements will definitely be going down. Most FPs I have spoken too see their compensation proabably going up with the new reform. The issue of reform is going to be specialty dependent, not MD vs DO.

Medicare determines reimbursment rates, I don't see that changing anytime soon.

Restrictions on scope to just OMM obviously....

[QUOTE=preDoGuy24;12759407]I doubt reimbursements for everyone will decrease (how much more can FM go down?) without a doubt the "ROADS" specialties have a target on their proverbial back and reimbursements will definitely be going down. Most FPs I have spoken too see their compensation proabably going up with the new reform. The issue of reform is going to be specialty dependent, not MD vs DO.

Medicare determines reimbursment rates, I don't see that changing anytime soon.[/]

It sounded like everyone's salary was going to take a hit.

From my research I've come to one big conclusion:

No one has any clue how it's going to work out.

I've heard arguments that pay will drop and I've read some that say if doctor's come together and truly try to use the system as intended (highly doubtful), their pay could increase. Time will only tell.

If anything I've noticed that doctor's are terrible at anything related to money and tend to base their opinions on what they've heard.

Originally Posted by museic

If anything I've noticed that doctor's are terrible at anything related to money and tend to base their opinions on what they've heard.

Not to mention that humans are generally horrible at prediction. Anyone who says the reform is bad for doctor's pay doesn't kknow what they are talking about.

And anyone who says it is good for doctor's pay doesn't know what they are talking about.

Anything at this point is pure speculation. It is easy to logically argue both a pay decrease and a pay increase. Look into the ACA and make a conclusion yourself. That is the only way you can get an answer you can stand behind.

Originally Posted by museic

From my research I've come to one big conclusion:

No one has any clue how it's going to work out.

I've heard arguments that pay will drop and I've read some that say if doctor's come together and truly try to use the system as intended (highly doubtful), their pay could increase. Time will only tell.

If anything I've noticed that doctor's are terrible at anything related to money and tend to base their opinions on what they've heard.

Would you by any chance have links to this argument?

Stole this post from bluedog,


http://www.medscape.com/viewarticle/767033?src=rss

Quote:
Under today's CMS proposal, Medicare pay would increase by 7% for family physicians, 5% for internists, and 4% for geriatricians. Most of this increased reimbursement would result from a separate payment that Medicare would make to physicians for coordinating a patient’s care for the first 30 days after discharge from a hospital, skilled nursing facility, or certain outpatient services. The fee, which will have its own procedure code, reflects the Obama administration's push to reduce hospital readmissions caused by sloppy follow-up care. At the same time, the administration has made it an overall priority to improve reimbursement for primary care services, according to CMS.

wow so according to this the pay would be going up ?

In many purely socialized systems, the primary care physicians have more financial incentives to push preventative care. Government literally offers rewards and bonuses for certain items. Because of this, primary care physicians often make substantially more than their specialized counterparts.

the disparity between certain specialists and pcp's has attracted a lot of media attention, and there is much public sympathy and concern for pcp's.
from the same above-referenced article:
The biggest losers in the proposed 2013 fee schedule would be radiation oncologists, who would take a hit of roughly 15%.
Anesthesiology -3%
Cardiology -3%
Interventional radiology -3%
Neurosurgery -1%
Pathology -2%
Radiology -4%
Urology -2%
Vascular Surgery -3%

most do go into primary care so it could be a good thing for us

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Originally Posted by bigkahunaburger

Stole this post from bluedog,


http://www.medscape.com/viewarticle/767033?src=rss

Quote:
Under today's CMS proposal, Medicare pay would increase by 7% for family physicians, 5% for internists, and 4% for geriatricians. Most of this increased reimbursement would result from a separate payment that Medicare would make to physicians for coordinating a patient’s care for the first 30 days after discharge from a hospital, skilled nursing facility, or certain outpatient services. The fee, which will have its own procedure code, reflects the Obama administration's push to reduce hospital readmissions caused by sloppy follow-up care. At the same time, the administration has made it an overall priority to improve reimbursement for primary care services, according to CMS.

Originally Posted by FrkyBgStok

In many purely socialized systems, the primary care physicians have more financial incentives to push preventative care. Government literally offers rewards and bonuses for certain items. Because of this, primary care physicians often make substantially more than their specialized counterparts.

Not to mention

1) Students take tests during high school that determine which vocational path they go into (including medicine and dentistry). They take on none of the costs associated with taking time off work to volunteer/shadow, submitting applications/interfolio, and going on interviews.

2) They go from high school straight into medical school, saving an extra two years of time and money from having to take "philosophy and english lit" in undergrad.

3) Their medical schools are highly subsidized by the government, so their educational debt is minimal compared to ours.

Originally Posted by museic

from my research i've come to one big conclusion:

No one has any clue how it's going to work out.

+1

Originally Posted by 0011000100

Would you by any chance have links to this argument?

Here is an article that was a good read, which includes the idea that doctors could get paid more.

http://www.ama-assn.org/amednews/201...2/gvsa0702.htm

Most people are stuck on the whole personal mandate business. In my honest opinion it's just conservative cannon fodder but that's another story. When you look beyond that and want to see what is really going to change for doctors, you have to look at the required ACOs by 2017 (I think thats the year). For a quick link here is wikipedia's explanation of an ACO:

http://en.wikipedia.org/wiki/Account...e_organization

More or less the health care act is a huge step towards integration of patient care because people on medicaid will have a cap on their care. This more or less forces doctors to take that extra step in their care because the patient will need to stay below a certain threshold. In return the better a physician does at this, (ie doctor A's rate of diabetic pt ER visits is 5%, while B's is 50%) the more they get paid. As you can see this has the potential to be great or terrible. It's an incentive for doctor's to be better and care more but at the same time if the system is not careful you will see lots of cash only/private insurance doctors or doctors that will give their pt's ultimatums to lose weight, quit smoking etc. or be dropped from their service.


Bottom line is that everyone will be covered, thus many many more patients to treat/get reimbursed for. Work hard, work effectively, make more $$$. The medicaid system was on a track for bankruptcy anyways so while our pay could go down from the new system it beats having the US gov't default on paying us!

Once again this is the best that I could make of the craziness but only time will tell. If you ask me we ought to start a new "Association of Medical Student's" with one agenda, loan forgiveness!

Here's my logic.

There is an estimated 20,000 shortage which is only going to get worse as the number of people 65 and older will triple by 2020. I'm not an economist but I do recall supply and demand. Everyone is going to need and doctor, and there is not going to be enough of us= making lots of money