What's the matter with 40-something MD/DO cohort??

Discussion in 'Pain Medicine' started by drusso, 09.24.14.

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  1. drusso

    drusso Moderator Emeritus Lifetime Donor 10+ Year Member

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    http://www.forbes.com/sites/bruceja...s-ok-with-obamacare-while-older-docs-bristle/

    Young Physicians OK With Obamacare While Older Doctors Bristle
    Though U.S. physicians continue to have issues with the Affordable Care Act, it appears to be a generational taste developing of the law making sweeping changes to their profession.

    More than half, or 50.8 percent, of doctors 46 years of age and older give the health law a “D” or “F” while just 37 percent of doctors 45 and younger give the legislation such poor grades, a new survey released last week of physicians commissioned by The Physicians Foundation.

    Meanwhile, nearly 30 percent of the younger doctors gave the health law an “A” or “B” when asked: “What overall grade would you give the Affordable Care Act as a vehicle for healthcare reform?” One-third, or 33.1 percent of doctors 45 and younger gave the law a “C.”
    By comparison, just 22.9 percent of the older doctors gave the law an “A” or “B” with 26 percent giving it a “C,” the survey shows.

    The survey comes as the ACA and other forces are moving doctors away from fee-for-service medicine that allows doctors to order procedures and tests liberally as opposed to more value-based care that encourages evidence-based approaches to treatment and reimbursement for keeping patients healthy.
    A reason for the generational differences could be that younger doctors aren’t as close to the bureaucracy of insurance and changes in reimbursement since more physicians are leaving private practice to become employed.

    “Physicians are younger, more are working in employed practice settings and more are leaving private practice,” said Dr. Walker Ray, vice president of The Physicians Foundation and chair of its research committee
    .
    No matter the age of the doctor, they are feeling the impact of the health law and the more than 8 million Americans who signed up for subsidized private coverage for this year. In addition, millions more Americans are getting coverage via the expanded Medicaid insurance program for the poor.
    These newly insured patients are contributing to a stress on the physician workforce with “81 percent of physicians” describing themselves as “either over-extended or at full capacity,” the foundation said.
    Here are some other highlights of the survey, conducted online of 20,000 physicians from March 2014 through June 2014 for the foundation by physician staffing firm MerrittHawkins.
    • 56 percent of physicians describe their morale as very negative to somewhat negative
    • 17 percent of doctors are in solo practices compared to 25 percent in 2012
    • 39 percent of physicians say they will “accelerate their retirement plans” due to changes in health care
    • 71 percent of doctors say they would still become a physician if they had to do it all over again
     
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  3. emd123

    emd123 5+ Year Member

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  4. drusso

    drusso Moderator Emeritus Lifetime Donor 10+ Year Member

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  5. Prof Moriarty

    Prof Moriarty the Napoleon of Spine 7+ Year Member

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    FWIW- I think Gen X includes the late 40's crowd. I mean, Lloyd Dobler is 48.

     
  6. emd123

    emd123 5+ Year Member

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    Turned into a bunch of rule following, administrator-fellating yuppies.
     
    sb247 likes this.
  7. Ducttape

    Ducttape SDN Lifetime Donor Lifetime Donor 5+ Year Member

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    Gen X is the 40s crowd. the last year of the baby boomers i believe just turned 50.
     
  8. Yo GabbaPentin

    Yo GabbaPentin 5+ Year Member

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    I think I'll start my OWN practice. .. if for no other reason than the benefit of autofellatio.
     
  9. SSdoc33

    SSdoc33 7+ Year Member

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    doesnt work. no matter how hard you try. starting your own practice? that has a slightly better chance....
     
  10. Ligament

    Ligament Interventional Pain Management Lifetime Donor SDN Advisor 10+ Year Member

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    Yep, total sheeple and Comrade freaking marxist Obama worshipers. These new docs have no spines.
     
  11. Ducttape

    Ducttape SDN Lifetime Donor Lifetime Donor 5+ Year Member

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    i would not be so harsh.

    they are brought up in an era where setting up your own practice is not the norm. their forefathers cornered the market, and the market forces along with the political forces have aligned in a way that it is increasingly more difficult to open up private practices.

    as it is now, posters here have stated they find it hard as a solo practitioner competing against the multiphysician groups and the hospital groups. imagine having no viable income, mounds of debt much more than when you were a resident/fellow, having to garner even more debt to get the rudiments of a practice started. that doesnt even include changes in how difficult it is to obtain loans in the first place.

    what would you do? what i suspect most reasonable and financially responsible individuals would do. join a practice or hospital setting.
     
  12. VA Hopeful Dr

    VA Hopeful Dr Senior Member 10+ Year Member

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    Exactly!

    I'm FM, but this all still applies. If you finish training with 200k+ in loans, you can't really afford to start a practice where it might take you a few months to get a decent income going.
     
  13. Silent Cool

    Silent Cool Member Banned 10+ Year Member

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    200K, what about 500K?
     
  14. Ducttape

    Ducttape SDN Lifetime Donor Lifetime Donor 5+ Year Member

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    average medical school tuition has more than doubled since 1996-7. some much more. average at private institutions is $50,078 per year, and median debt for graduates in 2012 was 170K.

    Florida, for example, instate went from $8700 to $28000. out of state $22,000 to $48,000.

    in addition, resident salaries have been stagnant when adjusted for inflation for the past 40 years.

    over a third of residents owe more than $200K when they finish residency.
     
  15. Silent Cool

    Silent Cool Member Banned 10+ Year Member

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    Try 500K:

    https://georgetown.app.box.com/s/hbdpvin1ewimsvze14s5
     
  16. SSdoc33

    SSdoc33 7+ Year Member

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    if you borrow 250, you will be paying back 600 over 25 years....
     

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