US Healthcare reform and specialty choice

Discussion in 'Medical Students - MD' started by gg_the_gorilla, Jul 30, 2015.

  1. gg_the_gorilla

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    With the ongoing health care reform experiment it is safe to say that the salary, lifestyle, and most importantly, the day-to-day work of a physician can significantly change over the next 40-50 years.

    One of the fears of consolidating payors (mergers of mega insurance companies, Universal Health Care/Medicare-for-all) is that physicians be forced to accept whatever payment is offered to them, and will be forced to document and work in the method that the payor demands. I am particularly concerned about payors affecting the day-to-day work of a physician: for example putting physicians in more of a managerial role over mid-levels, excessive documentation/billing/coding, and indirectly setting the pace and length of time a physician can reasonably spend with a patient. With this understanding in mind, I have a few questions for attending physicians in the USA:
    1. How real/significant are the fears listed above?
    2. Which specialties are more immune to such changes?
    3. What are surgeons doing in anticipation? What are their options for the future?
     
  2. IlDestriero

    IlDestriero Ether Man
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    1. Real.
    2. None
    3. Prep for a pay cut.
     
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  3. olivarynucleus

    olivarynucleus Membership Revoked
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    If you look at threads from ten years ago, midlevels were suppose to take over and docs in the poorhouse by now in 2015. Things are still ok. Attendings profess doom and gloom, every year pay rises. American medicine is too powerful to bring down, the fact that we are a capitalist society built on competition gives you the power to opt out of whatever federal government BS is coming up next.
     
  4. gg_the_gorilla

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    Are there any physicians & surgeons that can opt out of taking insurance and still have a viable practice?
     
  5. TwinsFan

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    Cash psych/cosmetic plastics/derm?/concierge FP in the right markets
     
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  6. Stagg737

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    Physicians: yes. Surgeons: no. It's feasible for someone in family med or psych to go into concierge medicine or use a direct pay model. There are several groups, like AtlasMD, who use a model like this where individuals pay a monthly fee to unlimited access of care. Implemented correctly, it can be very profitable without needing to bill any insurance companies or Medicare/caid. A model like that isn't feasible for most surgeons because of how expensive surgery is and the very limited number of people capable of shelling out that kind of cash. The only exception for surgeons is plastic surgery, as the rich are always willing to shell out big cash to satiate their vanity.
     
  7. Psai

    Psai Snitches get zero vicryl
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    if you take a good look at their training, you will see why. they cost less but are they worth it? that's the real question. medicine isn't about healing anymore, it's about documentation and testing
     
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  8. gg_the_gorilla

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    That's depressing... Anyone else with ideas?
     
  9. Kaustikos

    Kaustikos Archerize It
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    Become a hospital administrator.
     
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