Side Effects of ObamaCare on Physicians: Are doctors’ earnings in jeopardy?

$156,456. The average doctor graduates medical school with $156,456 of debt, according to the American Medical Association (not including possible debt from undergraduate years). One may expect these new doctors to eventually make as much as two or three times over this initial debt after they are settled and open a private practice; however, is this orthodox expectation consistent with President Obama’s new healthcare policy? Economists, congressmen, and doctors think not.

Before one delves into the potential flaws in physician compensation with the new healthcare plan, one should take a look at the current state of how physicians are paid with the US’s public insurance policies—Medicare and Medicaid. The health insurance for the elderly, Medicare, pays physicians 81 percent of what a private visit would usually cost as opposed to Medicaid—the health insurance for the impoverished— that pays on average only 56 percent of private payment. As a result of essentially cutting doctors’ pay, a common sight in primary care practices is a chronic denial of Medicaid patients and spotty access (at best) for those on Medicare. In fact, a recent survey conducted by Opinion Research Corporation, shows over two-thirds of primary care physicians said that under current conditions new Medicaid enrollees would not be able to find a “suitable primary care physician” in their area.

The Health Care and Education Reconciliation Act of 2010, which was signed to law this March 2010, will, for the most part, be phased in by 2014, but will begin affecting physicians’ compensation by 2012. Though aimed at paying doctors with quality of care provided over quantity of patients seen, the current plan has some holes in truly rewarding physicians who adhere by these government policies.

With ObamaCare, doctors will almost be forced to take any and all Medicare and Medicaid patients if the procedure is merited in accordance to the new government health policy. Though the policy advocates doctors to be compensated a higher percentage for seeing the new 34 million people that qualify for Medicaid, the Center for Economic and Policy Research estimates that physicians will still lose over twenty percent of what they are currently bringing in. Bottom line: physicians will generally have to work harder and receive less in terms of actual capital.

An amalgamation of other policies included in the ObamaCare Act including the requirement to digitize entire offices and large fines for not keeping records completely in check will probably lead to a shift of private practices joining into much larger ones to alleviate overhead costs. The result will probably be a much tighter office schedule with more hours for each physician, but almost certainly less monetary reward.

As pointed out by Representative Michael Burgess (R-Texas), ObamaCare adds little protection for doctors with respect to malpractice. And with the constant rise of malpractice insurance one can certainly sympathize with doctors who see medicine as a profession with too much government red tape and liability to be as attractive as it used to be. The less-than-promising realities of the prospective future have left nearly eighty percent of physicians less optimistic about the future of medicine, according to a poll conducted by Athena Health and Sermo.

Of course, there are proponents who believe doctors are currently being paid too much anyway, and though specialists like cardiologists and neurosurgeons do take a hit, primary care physicians will be bearing, at the very least, a plurality of the burden. This means that the plastic surgeons on Nip/Tuck (whom these proponents point to) will most likely continue to get with women way out of their league and blow their money on Gucci apparel even after ObamaCare is exercised fully.

So what does this mean for pre-meds? The possibility that all of this speculation may be in vain should definitely be considered. We will not know precisely how a doctor’s earnings vary for at least a few years—that is, when the healthcare policy phases-in completely. That being said, if acquiring the MD suffix is sheerly for a fiscal fix, one may want to rethink her career path. Regardless, the medical field will change—for better or for worse—in the years ahead, and success (at least financially) in this new era will require more than just hard work.

Bayan Misaghi ’14

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One response to “Side Effects of ObamaCare on Physicians: Are doctors’ earnings in jeopardy?

  1. Pingback: Bayan Misaghi | The HPS Student Guide to Premed Life

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