YA7ES

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How is this healthcare bill going to effect the salaries of doctors?
Everything seems to contradict itself.
I've heard:

A. The "public option" will decrease physician salaries anywhere from 15-20%

or

B. The "public option" will increase the number of insured patients by 32 million and therefore the demand for doctors will be high enough to boost salaries.

or

C. You will be forced to see several more patients per day and still not make as much money as you could have had the health care bill not passed.


Is anyone else as confused as I am? It seems that no one really has a clue as to what is going to happen, and frankly that scares the sh!t out of me.
 
Dec 13, 2009
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Public option was not included.

You are not forced to see anyone as a physician.

You will never be poor as a physician if you can work.
:thumbup: I agree. I think I can speak for all health care students/workers that we caught a HUGE break when they didn't include a public option and didn't require physicians to accept certain plans. It could be alot worse.

Only thing in question in terms of salaries is that change from "quantitative payment to qualitative payment." That's a loose term, and I don't know how this is written into the bill. Its in there, but I don't know if it specifically states how. If its not specific :)xf:), we can expect the republicans(who will be in power by the time it kicks into effect) to twist this term into their/our benefit. If it there is a specific clause, the republicans can simply reconcile that clause. Not saying increased quality is bad, its just that 'quality' is a relative terms and isn't really measurable.

So the only 3 main negatives for physicians I see are:
-The taxes we have to pay
-No tort reform(Don't bet on it ever happening)
-No way to define 'quality based payment'.

Negatives for general public:
-Taxes (again)
-Required to buy health insurance(People in with hardships are exempt, but hardship is another relative term which doesn't apply to people on the borders between middle class and poverty. They still have to pay, but it puts stress on their budgets.)
 

sexyman

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you guys might want to give getting out while you can. easier to go Galt now then when you're not already 100k in debt.

Just something to think about.
 

sexyman

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lol im class of 2012 too, point of no return has surely passed for me as well. the comment was more for those of us that havent started...

check this out though, kind of interesting...(poll was taken in 2009, so it doesnt reflect this EXACT bill, but nevertheless).

The New England Journal of Medicine reports a recent poll showing:
46.3% of primary care physicians (family medicine and internal medicine) feel that the passing of health reform will either force them out of medicine or make them want to leave medicine.

24% of physicians think they will try to retire early if a public option is implemented.

21% of physicians would try to leave medicine if a public option is implemented, even if not near retirement age at the time.

http://www.nejmjobs.org/rpt/physician-survey-health-reform-impact.aspx


just couldnt resist...heres some more food for thought

http://www.patientpowernow.org/2010/03/15/health-care-reform-bill-immoral-impractical/


 

sexyman

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my post says NEJM reports...
 

OpalOnyx

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i was just thinking about this.... the person who said it could be a lot worse is correct.

but i hate that "quality" clause.
 

sexyman

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what is your point azadre?

here is the link to the exact firm that did the study

http://www.themedicusfirm.com/pages/medicus-media-survey-reveals-impact-health-reform

and an excerpt from their methodology that is posted on that same page.

"
About our recently cited Physician Survey regarding healthcare reform:

Due to the timing of our survey of physicians about health reform, numerous media outlets have taken a great deal of interest in the results. Due to the high volume of inquiries, The Medicus Firm is providing the following information to address the questions regarding how our survey was conducted.
  • Our survey was emailed to a random sample of 2,250 physicians from our physician database.
  • Of the 2,250 emailed, 1,195 responded.
  • Of the 1,195 responses, 36.4% were primary care physicians (family practice, internal medicine, or pediatrics), and 63.6% were specialists.
    Note: only IM and FP (25% of total physician sample) were included in the Primary Care statistics referenced in the article.
  • This survey was done using a "simple random sampling". The survey was not a targeted survey based on any demographic category or geographic region.
  • The survey was conducted in-house, via a professional web-based surveying application. Below is the set of questions sent to physicians.
  • The key findings and article can be found here."
Im sure the rest of our colleagues on this board are able to read just as well as you can...

apparently you are excited about bigger government, more controls, higher taxes, and less reimbursements- congrats? i dont know what to tell you...
 

sexyman

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i was just thinking about this.... the person who said it could be a lot worse is correct.
We should be thinking about how much better our system could be, not the other way around guys. Sure if the world literally caught on fire tomorrow it would be worse than this, but what does that really mean?
 

CAPiTAtwo

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We'll just have to see how things trickle down...the 20% cut in medicare payments is the big problem. Yeah, they 'expanded' medicaid, but still 20% cut of medicare is a very large loss of revenue flow for HCPs
 

Impromptu

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We took big hits. There are so many ridiculous tax increases included. You know how every proposal the democrats put forth during the last couple of years has always been funded by increasing the taxes on the rich? Well, you are all rich, and your taxes are now going to skyrocket.

The cuts in payments will also be significant for us. Insurers and Hospitals came out pretty well. The major cuts in payments will be to providers, which means doctors.
 

sexyman

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Higher cost of school + more loans, more taxes on income AND investments (your house if you can afford one), less reimbursements...proclaiming that physicians in the US states will always be well off might not be a safe statement.


I rotated with a neurologist a few weeks ago that just recently had to leave private practice to work for the VA because he was working more than he was when in residency and could barely keep the lights on in his house for his wife and kid.

He told me that he would make more money waitering at outback or working in Walmart than he would taking on new medicare and medicaid patients...and this was before Obama's deal.
 

sexyman

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azadre i dont think impromptu plans on being in residency forever.
 
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This bill will definitely cut physician salaries. I really don't see what the incentive is to become a doc nowadays, considering the huge sacrifice in training, decreasing reimbursement every year, lack of tort reform, increasing overhead and bureaucracy, and lack of an effective lobby.
If you're in med school, its still not too late to reconsider professions - maybe dentistry or nurse anesthetist (surely, they'll be making more than most of you with less hours), or something outside of medicine like law, business, or banking.

Personally, I'm finishing my training in a few months and going to practice in plastics. One bit of advice, be very wary of these institutional advisors (med school, premed college) that offer you career advice - they're out for their interests, not yours. Also, med schools have been funded to brainwash you to buy in to these utopian ideals that have nothing to do with reality and to steer as much of you into primary care. There is a huge difference between a practicing physician and an administrator physician. Good luck with your futures - you'll need it.
 

bronx43

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Funny thing is, even if you look at systems where a doctor makes a lot less, the competition is fierce. Try getting into a Canadian or UK medical school...
Not sure about the UK, but I don't believe there are as many lucrative opportunities in Canada in business for the fresh college grad. As far as I know, there aren't too many investment banks, hedge funds, consulting firms, or PE shops going around with the lure of big bucks.

But then again, in the US, only students who went to top national universities have a shot at landing a job at one of these companies. So that means the majority of students will still compete for spots in medical schools.
 
Oct 19, 2009
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Funny thing is, even if you look at systems where a doctor makes a lot less, the competition is fierce. Try getting into a Canadian or UK medical school...
could be a respect thing. doctor prestige is going down in this country at an exponential rate imo. it's the moolah (and lifestyle specialities) that dictate competition here.