Are Doctors Being Exploited?

Shunted Aside by Policymakers

Many physicians feel strongly that policymakers haven't been listening to the physician perspective.

The Affordable Care Act (ACA) is often cited as an example of when policymakers turned a deaf ear to physicians' interests. As many physicians see it, the law lacks substantive tort reform, failed to repeal the sustainable growth rate, and doesn't seem to improve healthcare. In a 2013 survey^[14] by the publishing company Wolters Kluwer, 62% of physicians thought the law would either have no impact or negatively impact patient care and outcomes.

Feeling powerless in the lawmaking process, "physicians fear what the ACA could lead to," said Wayne Lipton, managing partner of Concierge Choice Physicians in Rockville Centre, New York. "They are concerned about more government involvement, such as a mandate for participation in Medicaid or Medicare."

Who's Advocating for Physicians?

If it's true that physicians are getting a raw deal, who can protect them from further abuse? Many doctors have soured on the AMA for supporting the health reform law, though the national doctors' organization did have some reservations.^[15] A 2011 poll^[16] of physicians by the recruitment firm of Jackson & Coker found that 77% disagreed with the AMA's position on health reform, and 74% disagreed with the statement that the AMA is "a successful advocate of physicians issues."

The 166-year-old organization has been patching up relations with its critics, and in the past 2 years it has turned around an enrollment decline that followed passage of the ACA. But Dr. Kagan believes that the organization has enormous challenges ahead. Although he recently became a member, he feels that the AMA would have a hard time improving reimbursements, even though "one role of the AMA is to lobby for higher Medicare fees."

Dr. Kennett fears that many employed physicians might drop membership in organized medicine. He warned that groups like the American Hospital Association (AHA) won't serve them well. "With all due respect to the AHA, they are going to be lobbying first and foremost for hospitals," he said.

By contrast, Alexander Ding, MD, a young radiologist who recently started employment at a large group practice in the Bay Area, believes that employed physicians will stay with organized medicine. In a hospital, "there will be times when employed physicians will butt heads with leadership and will need to go to the AMA or their medical society," said Dr. Ding, who served as a resident trustee on the AMA board and now is on the board of his county medical society.

As physicians look toward the future, Dr. Ding said the AMA's nationwide perspective would serve them well. "Most doctors across the spectrum feel a sense of disempowerment," he said. "They feel like they're running on a treadmill. They don't have the time to step back and view issues at a higher level."

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Cite this: Are Doctors Being Exploited? - Medscape - Feb 13, 2014.