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Dubious 03-17-2010 12:22 PM

Physician's opinions on health care
 
Here is a sobering poll from the doctors who take care of us. From the New England Journal of Medicine:

http://74.125.155.132/search?q=cache...&ct=clnk&gl=us

Jomar 03-17-2010 05:22 PM

another link with more of the article is here-
http://www.themedicusfirm.com/pages/...-health-reform


IMO - the doctors polled may "say" they will quit or retire early but... I don't really believe they would give up the income & other perks.:rolleyes:

Dubious 03-17-2010 07:10 PM

Quote:

Originally Posted by Jo*mar (Post 633747)
another link with more of the article is here-
http://www.themedicusfirm.com/pages/...-health-reform


IMO - the doctors polled may "say" they will quit or retire early but... I don't really believe they would give up the income & other perks.:rolleyes:

And straight from the publishers of the NEJM...


http://www.nejmjobs.org/content/rpt/pdf/marapr_10.pdf

Makes you wonder where it all goes though, does it not?

fmichael 03-18-2010 10:35 PM

Quote:

Originally Posted by Dubious (Post 633772)
And straight from the publishers of the NEJM...


http://www.nejmjobs.org/content/rpt/pdf/marapr_10.pdf

Makes you wonder where it all goes though, does it not?

Dubious -

A couple of things. When I opened the "revised link" in your first post on the thread, this is what now comes up first:
March 18, 2010

RECRUITING PHYSICIANS TODAY

Recruiting Physicians Today is a free advertiser newsletter published by the Worldwide Advertising Sales and Marketing Department in the publishing division of the Massachusetts Medical Society. Each issue of the newsletter features research and content produced by physician recruiting firms and other independent groups involved in physician employment.

On December 17, 2009 The Medicus Firm, a national physician search firm based in Dallas and Atlanta, published the results of a survey they conducted with 1,000 physicians regarding their attitudes toward health reform. To read their survey results at The Medicus Firm website, click here.

The opinions expressed in the article linked to above represent those of The Medicus Firm only. That article does not represent the opinions of the New England Journal of Medicine or the Massachusetts Medical Society. [Emphasis added.]
It would appear that someone at the NEJM decided today that a qualification was in order concerning the source of the study.

Secondly, the detailed survey results and methods just became available today. (My email request yesterday went unanswered.) To reach it, you have to link to the article on the Medicus site at http://www.themedicusfirm.com/pages/...-health-reform and then click on the pop-up at the bottom of the page maked "For more information on the study’s methodology, click here."

Personally, I was most struck by the responses to one question, which was only hinted at in the article, where the latter reads, in pertinent part:
Skeptics may suspect that physicians exaggerate their intent to leave medicine due to health reform. Some experts point to the malpractice crisis of years ago, when many doctors also expressed a desire to leave medicine. Some did quit; many did not. However, health reform could be the proverbial “last straw” for physicians who are already demoralized, overloaded, and discouraged by multiple issues, combining to form the perfect storm of high malpractice insurance costs, decreasing reimbursements, increasing student loan debt, and more.
And the question?
How do you think the passage of health reform (with or without the public option) would impact your thoughts on recommending medical practice as a career to others, such as your kids, or a friend?

I would not recommend medicine as a career, regardless of health reform: 36%
I would recommend medicine as a career, regardless of health reform: 25%
I would recommend medicine as a career now, but not if health reform passes: 27%
I would not recommend medicine as a career now, but would recommend it if health reform passes: 12% [Emphasis added.]
Translation: over of third of the 53% of the polled doctors who chose to respond to the mailed questionnaire would not recommend others going into the profession, whether or not health care passes! And although an addtional 27% said they would recommend it now, but not if health care reform passed, 12% came out the other way entirely: they would be more likely to recommend it with health care in place. Thus the net effect of health care reform on the likelihood of recommending medicine to others was -15%.

Yet as to the effect of health care reform without the public option (the case at hand) there is the very curious reponse:
How do you think the passage of health reform WITHOUT a public option would affect your professional/practice plans, if at all?

No change: 70%
I would try to retire early: 22%
I would try to leave medical practice even if not near retirement age: 8%
I would go back into practicing medicine (if non-clinical or semi-retired now): 1%
And as to the effect on professional plans IF the public option was included, the results were even more dramatic:
No change: 53%
I would try to retire early: 24%
I would try to leave medical practice even if not near retirement age: 21%
I would go back into practicing medicine (if non-clinical or semi-retired now): 2%
Accordingly, even though an aggregate of only 15% of those responding said that the passage of health care reform would impact their recommendation of medicine to others as a career, between 31 and 47% (twice to three tines as many) of those polled indicated that the passage of health reform would have a negative impact on their own decision to stay in the profession.

What could that possibly mean? Or is if that old Hypocritic Oath again? :winky:

Mike

Dubious 03-18-2010 11:06 PM

Quote:

Originally Posted by fmichael (Post 634190)
Dubious -

A couple of things. When I opened the "revised link" in your first post on the thread, this is what now comes up first:
March 18, 2010

RECRUITING PHYSICIANS TODAY

Recruiting Physicians Today is a free advertiser newsletter published by the Worldwide Advertising Sales and Marketing Department in the publishing division of the Massachusetts Medical Society. Each issue of the newsletter features research and content produced by physician recruiting firms and other independent groups involved in physician employment.

On December 17, 2009 The Medicus Firm, a national physician search firm based in Dallas and Atlanta, published the results of a survey they conducted with 1,000 physicians regarding their attitudes toward health reform. To read their survey results at The Medicus Firm website, click here.

The opinions expressed in the article linked to above represent those of The Medicus Firm only. That article does not represent the opinions of the New England Journal of Medicine or the Massachusetts Medical Society. [Emphasis added.]
It would appear that someone at the NEJM decided today that a qualification was in order concerning the source of the study.

Secondly, the detailed survey results and methods just became available today. (My email request yesterday went unanswered.) To reach it, you have to link to the article on the Medicus site at http://www.themedicusfirm.com/pages/...-health-reform and then click on the pop-up at the bottom of the page maked "For more information on the study’s methodology, click here."

Personally, I was most struck by the responses to one question, which was only hinted at in the article, where the latter reads, in pertinent part:
Skeptics may suspect that physicians exaggerate their intent to leave medicine due to health reform. Some experts point to the malpractice crisis of years ago, when many doctors also expressed a desire to leave medicine. Some did quit; many did not. However, health reform could be the proverbial “last straw” for physicians who are already demoralized, overloaded, and discouraged by multiple issues, combining to form the perfect storm of high malpractice insurance costs, decreasing reimbursements, increasing student loan debt, and more.
And the question?
How do you think the passage of health reform (with or without the public option) would impact your thoughts on recommending medical practice as a career to others, such as your kids, or a friend?

I would not recommend medicine as a career, regardless of health reform: 36%
I would recommend medicine as a career, regardless of health reform: 25%
I would recommend medicine as a career now, but not if health reform passes: 27%
I would not recommend medicine as a career now, but would recommend it if health reform passes: 12% [Emphasis added.]
Translation: over of third of the 53% of the polled doctors who chose to respond to the mailed questionnaire would not recommend others going into the profession, whether or not health care passes! And although an addtional 27% said they would recommend it now, but not if health care reform passed, 12% came out the other way entirely: they would be more likely to recommend it with health care in place. Thus the net effect of health care reform on the likelihood of recommending medicine to others was -15%.

Yet as to the effect of health care reform without the public option (the case at hand) there is the very curious reponse:
How do you think the passage of health reform WITHOUT a public option would affect your professional/practice plans, if at all?

No change: 70%
I would try to retire early: 22%
I would try to leave medical practice even if not near retirement age: 8%
I would go back into practicing medicine (if non-clinical or semi-retired now): 1%
And as to the effect on professional plans IF the public option was included, the results were even more dramatic:
No change: 53%
I would try to retire early: 24%
I would try to leave medical practice even if not near retirement age: 21%
I would go back into practicing medicine (if non-clinical or semi-retired now): 2%
Accordingly, even though an aggregate of only 15% of those responding said that the passage of health care reform would impact their recommendation of medicine to others as a career, between 31 and 47% (twice to three tines as many) of those polled indicated that the passage of health reform would have a negative impact on their own decision to stay in the profession.

What could that possibly mean? Or is if that old Hypocritic Oath again? :winky:

Mike


Naw Mike,

I think you are reading too much into it.

First, the link (just checked it)

http://www.nejmjobs.org/content/rpt/pdf/marapr_10.pdf

goes straight to the newsletter for which states is "From the publishers of the New England Journal of Medicine" (just cut and pasted that from the newsletter, nifty, eh?). Not the disclaimer. All the other links go to that as of 11 am yesterday.

I found it very curious that yesterday all the links except this one (can't find it anywhere) have dissappeared even though the newsletter exists. Clearly, there are those that don't want others to read this. As for the disclaimer? Go figure. The disclaimer wasn't there until yesterday around 11 am. Hmmm...think there is any relationship with the timeliness of impending vote? Wouldn't want people to know what docs really felt about reform, would we now?? :eek:

And it wouldn't matter anyway, at least to me. The Medicus Firm performed a well-constructed survey for which the "trend" not surprisingly, showed docs convincingly don't want this particular bill. Health care reform, yes....this bill, no!

Love ya like a brother, though! :hug:

fmichael 03-18-2010 11:55 PM

But seriously, I was troubled by the high rate of discouragement, with or without healthcare reform:
I would not recommend medicine as a career, regardless of health reform: 36%
Maybe it's nothing more than sampling bias, where these folks are already in a headhunter's database. What do you think?

bobber 03-19-2010 10:58 AM

Very good points indeed,
But I Tend to agree with Jo-Mar
There will always be Dr's..I think their just blowing smoke,,their not going to turn down 6 to 7 figures over doing a few freebee's,,they are by law to do so anyway,,My mother and both sisters are in the medical field,,they inform me to that the hospitals have to do so many charity cases as well,,they do not adveryise this of course for obvious resaons,but it is the Law,,,and my opinon is they took an oath,to help people,,but alot of them now,run people thru like a drive thru fast food joint or conveyor belt,,thats why all the mis-communications,wrong dignostics,poor patient DR relations,ect ect and one of the reasons for the insurance to go up,,Ive personally have had to see a DR numerous times before he would help me or listen to me,when he couldve done it right the first visit and not making me comeback umpteen times,,,to me thats neglagence incompedence {sp],,and so on,,,, to sum it,,I think money is a big issue,and pride gets in the way,,a man or woman knows their body and the signals it sends,,,A good DR will listen,,but they are few,,,I dont think a Dr is going to retire early..you may see one or two,,but like a boxer who retires early,,they rifle thru their cash due to their high liveing styles and back into the Ring and out of retirement they come,,but they are not the fighter they once were when they left,,,,,and I believe that the DRs that do leave[let them go] I think that they will probually be the bad ones with the arrogant attitudes anyway,,,they wont just set home and stew either andThey arent going to settle for a lesser job ,,[ like hanging out of a drive thru widow,asking you if you want fries with that.......,,so thinning the herd,might be a good thing..allow room for the new ones who have empathy and are hungry to come in,,,,,bobber

dreambeliever128 03-19-2010 12:27 PM

Hi Bobber,
 
I live in a small town near a town a little larger and people go there for the Drs. Last year we had 7 Drs. to retire in that town and people around here are having a tough time already finding a PCP. I have people tell me this often and have had people ask me if I knew of a good PCP around. There are 3 in our small town and they are no longer taking patients.

They don't get enough from Medicare already and it will be cut again. I do believe a lot of Drs. will retire after the healthcare goes in.

A question people should be asking themselves is will they fall into a bracket where they are fined if they don't get insurance.

Ada

Dubious 03-19-2010 01:07 PM

Quote:

Originally Posted by fmichael (Post 634209)
But seriously, I was troubled by the high rate of discouragement, with or without healthcare reform:
I would not recommend medicine as a career, regardless of health reform: 36%
Maybe it's nothing more than sampling bias, where these folks are already in a headhunter's database. What do you think?

Mike,

I think it comes down to an increasing restriction of a doc's ability to treat a patient the way they learned in school and the increasing feeling of dissatisfaction and helplessness as such. Now, a doc must always use a particular insurance company's guidelines, codes, be subject to utilization and peer review and follow ever changing rules or risk not getting paid.

All these negative aspects for practitioners already exists because of HMO's, UR, etc., and if/when national health care hits it will be like an HMO on steroids, run by the government, where there will be no incentive for a doc to practice what he learned, rather just follow the rules on how to restrict and reduce care based on cost, or risk financial and/or professional sanctions.

Jimking 03-19-2010 02:30 PM

Quote:

Originally Posted by Dubious (Post 634389)
Mike,

I think it comes down to an increasing restriction of a doc's ability to treat a patient the way they learned in school and the increasing feeling of dissatisfaction and helplessness as such. Now, a doc must always use a particular insurance company's guidelines, codes, be subject to utilization and peer review and follow ever changing rules or risk not getting paid.

All these negative aspects for practitioners already exists because of HMO's, UR, etc., and if/when national health care hits it will be like an HMO on steroids, run by the government, where there will be no incentive for a doc to practice what he learned, rather just follow the rules on how to restrict and reduce care based on cost, or risk financial and/or professional sanctions.

I hope this doesn't happen. Having said that it is happening now, I've seen it, but through the private sector instead. It can also be argued that the Fed empowered the HMO years ago. What to do? You can lobby congress, rally folks to a cause and apply pressure on congress. How do you do that with well placed huge insurance companies? You don't.


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