My prediction: Trump has a populist mandate to turn our country away from Obama-care's ill-conceived, socialized/one-size-fits all model of health care, to claw back the egregious cash transfers that went from the US Treasury to large hospital networks (causing market disruption by direct physician employment, practice acquisition, and the corporate practice of medicine), unburden the insurance industry vis-a-vis deregulation (no more one-size-fits no one Obama-care insurance products), allow insurance to be sold across state lines, reform medical malpractice laws, and allow patients and employers to use pre-tax money for health saving accounts any way they please.
Health system based physician employers will be taking a hard look at their employed physicians' productivity and their entire Medicaid "book of business" to determine if the financial juice is worth the squeeze. Those working in that kind of system will be told to do more with less. And, after the Republican Congress and Trump execute their vision of health care reform, it will be a very bad time to be a Medicaid Doc-in-a-Box working for McHospital. No more cross-subsidies from bloated HOPD "facility fees" to support above MGMA-market salaries. This morning I opened my email and found a forwarded message from a colleague employed by a large physician employer in my region--I excerpted the following:
"We’re doing what we can to minimize the impact. We are not filling open positions that are non-critical. We are reducing other costs across our regions. For our caregivers in transition, we are supporting them by:
• Offering them hiring priority within our organization. We are closing most positions to external applicants through the end of the year (exceptions will be critical positions affecting patient safety and quality care).
• Providing guidance and job search resources
• Developing support tools needed to apply for a new position, e.g. resume, LinkedIn profile, etc.
• Providing 60-day notice and severance based on years of service"
In other words, "thank you for your service to McHospital and Doc-in-the-Box." Here's your LinkedIn account. The lesson for new graduates is, "Beware: When you abrogate your professional autonomy as a physician in order to do the bidding of your employer, don't expect a return in loyalty when the rules of the game change."