nos-trum. pronunciation: \nos'-trum\. noun. Etymology: Latin, neuter of noster our, ours.
1. a medicine of secret composition recommended by its preparer but usually without scientific proof of its effectiveness.
2. a usually questionable remedy or scheme.
See here for more discussion.

Wednesday, March 17, 2010

46% of Family Physicians Will Quit If Obamacare Passes?

The blogosphere is hopping with this statistic, taken from a survey done by The Medicus Firm in December 2009.  Without any sense of shame, I will just point out that I wrote about a similar survey back in November 2008.  That survey of 12,000 physicians by the Physician's Foundation found that almost half of the respondents would consider getting out of medicine over the next three years if they had an alternative.

As with all media publications, we need to read the words carefully, and then check the data.  The survey was reported by the New England Journal of Medicine originally, but the firm that did the survey is a physician recruiting business.  Their version of the study is here;  the raw data is not on the site.

So, first the title, as reflected in the blogosphere:  it refers to family physicians, not all doctors.  Admittedly, that's a crisis:  you don't get to a specialist most of the time without a referral from a family physician, or primary care manager.

Second, the question the survey asked:  would you quit or retire early if a public option is implemented?  Note, we're not talking about "retire now" necessarily, just early.  And second, the question refers specifically to the public option, not health care reform in general.

Third, the data:  the figure of 46% comes from combining two survery answers.  25% said yes to retire early, 21% said yes to quit practicing medicine.  Add 'em up, etc.

Finally, some other statistics:
1.  Only 23.8% support a public option
2.  67.9% agree that some reform is needed.
3.  64.1% think the quality of medicine will decline under health care reform.

There are some more data, but recognize that the company who conducted the survey is in the business of recruiting physicians.  Do I think that almost half of doctors (or family doctors) will quit?  No, as a physician myself,  I recognize the whining I've seen throughout my career.  Mostly we're locked in to what we do, and things have to get a lot worse for us to consider changing careers.

Even if this survey grossly overstates the consequences, it's still a cause for concern.  I know some of my colleagues have about "had it" with the administrative burden, and denied payment--mostly from the government--and are feeling the stress.  How do we add millions to the system under these circumstances?

Access to care is a critical piece of any reform, and the current legislation doesn't give a credible answer to how all the "newly covered" are gonna get seen for their medical needs.





Opinions are entirely my own.

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