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Sonnabend
04-04-2010, 10:47 AM
http://www.washingtontimes.com/news/2010/apr/04/obamacares-doctorless-world/

Physician shortage will get worse under 'reform'

By Dr. Jason D. Fodeman


In rural areas of the country, obtaining a doctor's appointment is practically mission impossible. Even in cities such as Boston and Manhattan, it can be very difficult for patients to attain the medical care they badly need, particularly for Medicare and Medicaid patients. From New York's Upper East Side to the heartland to San Francisco's Haight Ashbury, a striking physician shortage exists in this country. The reasons for the dearth of doctors are complex, but one thing is certain: The "health care reform" that President Obama ardently pushed down the public's throat and recently signed into law will not increase the scant supply of doctors. In fact, it will make the problem worse.

There is a huge investment in both time and money before one is qualified to practice medicine. Medical school, which future doctors complete after four years of undergraduate studies, is another four years of expensive schooling. Then, to be able actually to practice and make a living, doctors must complete a rigorous residency program ranging from an additional three to six years of training, depending on the specialty. The majority of physicians do a fellowship on top of that, which is another two to three years. By the time most doctors start their careers, they are in their 30s and have accrued more than $150,000 in education-related debt.

It is true that in every profession one must pay one's dues, so to speak. Yet, the "dues" in medicine considerably trump those of any other field. Medicine is not only mentally challenging, but incredibly physically and psychologically demanding as well. The training is brutal - 30-hour shifts, 80-hour-plus weeks, four days off per month, lunch breaks nonexistent. The salary, which hovers just above minimum wage on an hourly basis throughout the training marathon, bears no relationship to the responsibility, education and skill set. While contemporaries move on with their lives, buy homes and take vacations, a vacation for a young doctor often is merely the opportunity to sleep in his or her own bed and not at the hospital. A break on a 30-hour shift can be little more than five minutes to scarf down dinner, praying you are not interrupted by a page. You usually are.

It takes tremendous sacrifice to become a physician. If anything, doctors should be rewarded to give up so much to pursue this noble calling. They certainly should not be disincentivized, which is precisely what the newly passed law will do.

Obamacare is brutal for physicians, and the detriment transcends dollars and cents. The law establishes approximately 159 new committees, agencies and bureaucracies, each with incredible power and flexibility to dictate physician decisions and burden an industry already regulated to death with even more red tape. This will further strip doctors of their autonomy and drown them in ever more bureaucracy and paperwork. It will make doctors even more beholden to the whims of unaccountable bureaucrats and lawyers than they already are, at the expense of the patients' best interest. Doctors will have to waste valuable time complying with inane regulations that are superfluous and sometimes harmful to patient care. This will result in physicians having even less time to administer to patients. The problem will be magnified as declining reimbursements compel doctors to see more patients to maintain the same income. It will hamstring a physician's ability to practice good medicine and will drain job satisfaction.

Obamacare will dissuade bright young minds from entering medicine in the first place, while many doctors already practicing will either retire or switch careers. New patients will be unable to find doctors, and many patients content with their health care will eventually encounter similar difficulty. Obamacare is certainly bad for doctors. Ultimately, however, it is the patient - haplessly facing restricted access, long waits and rationed care - who suffers the most.

Mr. Obama has correctly noted the shortage of primary care physicians, but his prescription to resolve the problem will only exacerbate it. Furthermore, there are shortages in many specialties and subspecialties as well. A policy of "Regulate more, pay less" will prove a very difficult recruiting motto.

Dr. Jason D. Fodeman is an internal medicine resident at the University of Connecticut and a former health-policy fellow at the Heritage Foundation. He is the author of "How to Destroy a Village: What the Clintons Taught a Seventeen Year Old." (Publish America, 2003)

namvet
04-04-2010, 11:18 AM
and in comes the millions of dead beats wanting their deathcare from an already overloaded system. now what???? med students will be promoted to docs/surgeons before finishing school.

so a good chance a med student will do you heart bypass. so the new surgeon general of the country, Osama, will decided who lives and who dies.

marv
04-04-2010, 11:20 AM
This lends new meaning to "jobless recovery".........

wilbur
04-04-2010, 12:00 PM
That read like a speech - not one single ounce of specificity for one to sink some teeth into. Just vague assertions, that really just appear empty.

I'd like to understand the details - why, as he argues, would Obamacare, strip doctors of their autonomy? He doesnt give us a substantive answer, but instead just leaves us with some oblique references to the establishment of some new committees. Just how and what they will do to interfere with doctors, he doesnt reveal - perhaps he doesnt know himself.

Sonnabend
04-04-2010, 12:08 PM
- perhaps he doesnt know himself.

Dr. Jason D. Fodeman is an internal medicine resident at the University of Connecticut and a former health-policy fellow at the Heritage Foundation. He is the author of "How to Destroy a Village: What the Clintons Taught a Seventeen Year Old." (Publish America, 2003)I'd say he knows far more than you do. So now you have a medical degree and one in climate sciences?Just what IS your background in health services?Hm?

Sonnabend
04-04-2010, 12:11 PM
Incidentally, wilbur, speaking as one who lives under the system Obama has foisted upon you, what he has described is what is happening here.

Going to tell me I don't know anything about OUR health system now? You're, it seems, an expert in everything..so again, what makes you qualified?

Long waiting lists, Overflowing hospitals, overworked emergency rooms, doctor and nurse shortages, bed shortages, impossible paperwork forced upon health professionals, endless regulations and laws....all coming to you...soon.

BET ON IT.

Sonnabend
04-04-2010, 12:16 PM
Here is the entire list. (http://www.gop.gov/blog/10/02/25/159-ways-the-senate-bill).and here's part of it.


1. Grant program for consumer assistance offices (Section 1002, p. 37)
2. Grant program for states to monitor premium increases (Section 1003, p. 42)
3. Committee to review administrative simplification standards (Section 1104, p. 71)
4. Demonstration program for state wellness programs (Section 1201, p. 93)
5. Grant program to establish state Exchanges (Section 1311(a), p. 130)
6. State American Health Benefit Exchanges (Section 1311(b), p. 131)
7. Exchange grants to establish consumer navigator programs (Section 1311(i), p. 150)
8. Grant program for state cooperatives (Section 1322, p. 169)
9. Advisory board for state cooperatives (Section 1322(b)(3), p. 173)
10. Private purchasing council for state cooperatives (Section 1322(d), p. 177)
11. State basic health plan programs (Section 1331, p. 201)
12. State-based reinsurance program (Section 1341, p. 226)
13. Program of risk corridors for individual and small group markets (Section 1342, p. 233)
14. Program to determine eligibility for Exchange participation (Section 1411, p. 267)
15. Program for advance determination of tax credit eligibility (Section 1412, p. 288)
16. Grant program to implement health IT enrollment standards (Section 1561, p. 370)
17. Federal Coordinated Health Care Office for dual eligible beneficiaries (Section 2602, p. 512)
18. Medicaid quality measurement program (Section 2701, p. 518)
19. Medicaid health home program for people with chronic conditions, and grants for planning same (Section 2703, p. 524)
20. Medicaid demonstration project to evaluate bundled payments (Section 2704, p. 532)
21. Medicaid demonstration project for global payment system (Section 2705, p. 536)
22. Medicaid demonstration project for accountable care organizations (Section 2706, p. 538)
23. Medicaid demonstration project for emergency psychiatric care (Section 2707, p. 540)
24. Grant program for delivery of services to individuals with postpartum depression (Section 2952(b), p. 591)
25. State allotments for grants to promote personal responsibility education programs (Section 2953, p. 596)
26. Medicare value-based purchasing program (Section 3001(a), p. 613)
27. Medicare value-based purchasing demonstration program for critical access hospitals (Section 3001(b), p. 637)
28. Medicare value-based purchasing program for skilled nursing facilities (Section 3006(a), p. 666)
29. Medicare value-based purchasing program for home health agencies (Section 3006(b), p. 668)
30. Interagency Working Group on Health Care Quality (Section 3012, p. 688)
31. Grant program to develop health care quality measures (Section 3013, p. 693)
32. Center for Medicare and Medicaid Innovation (Section 3021, p. 712)
33. Medicare shared savings program (Section 3022, p. 728)
34. Medicare pilot program on payment bundling (Section 3023, p. 739)
35. Independence at home medical practice demonstration program (Section 3024, p. 752)
36. Program for use of patient safety organizations to reduce hospital readmission rates (Section 3025(b), p. 775)
37. Community-based care transitions program (Section 3026, p. 776)
38. Demonstration project for payment of complex diagnostic laboratory tests (Section 3113, p. 800)
39. Medicare hospice concurrent care demonstration project (Section 3140, p. 850)
40. Independent Payment Advisory Board (Section 3403, p. 982)
41. Consumer Advisory Council for Independent Payment Advisory Board (Section 3403, p. 1027)
42. Grant program for technical assistance to providers implementing health quality practices (Section 3501, p. 1043)
43. Grant program to establish interdisciplinary health teams (Section 3502, p. 1048)
44. Grant program to implement medication therapy management (Section 3503, p. 1055)
45. Grant program to support emergency care pilot programs (Section 3504, p. 1061)
46. Grant program to promote universal access to trauma services (Section 3505(b), p. 1081)

Sonnabend
04-04-2010, 12:19 PM
Health and Human Services Coordinating Committee on Women’s Health (Section 3509(a), p. 1098)
51. Centers for Disease Control Office of Women’s Health (Section 3509(b), p. 1102)
52. Agency for Healthcare Research and Quality Office of Women’s Health (Section 3509(e), p. 1105)
53. Health Resources and Services Administration Office of Women’s Health (Section 3509(f), p. 1106)
54. Food and Drug Administration Office of Women’s Health (Section 3509(g), p. 1109)
55. National Prevention, Health Promotion, and Public Health Council (Section 4001, p. 1114)
56. Advisory Group on Prevention, Health Promotion, and Integrative and Public Health (Section 4001(f), p. 1117)
57. Prevention and Public Health Fund (Section 4002, p. 1121)
58. Community Preventive Services Task Force (Section 4003(b), p. 1126)
59. Grant program to support school-based health centers (Section 4101, p. 1135)
60. Grant program to promote research-based dental caries disease management (Section 4102, p. 1147)
61. Grant program for States to prevent chronic disease in Medicaid beneficiaries (Section 4108, p. 1174)
62. Community transformation grants (Section 4201, p. 1182)
63. Grant program to provide public health interventions (Section 4202, p. 1188)
64. Demonstration program of grants to improve child immunization rates (Section 4204(b), p. 1200)
65. Pilot program for risk-factor assessments provided through community health centers (Section 4206, p. 1215)
66. Grant program to increase epidemiology and laboratory capacity (Section 4304, p. 1233)
67. Interagency Pain Research Coordinating Committee (Section 4305, p. 1238)
68. National Health Care Workforce Commission (Section 5101, p. 1256)

Speedy
04-04-2010, 01:39 PM
And the good doctor wrote this article, probably believing that Barky gives a shit.

Rockntractor
04-05-2010, 01:20 AM
http://i686.photobucket.com/albums/vv230/upyourstruly/kakistrocracy-corrupt-morally-bankr.jpg?t=1270432101

wilbur
04-05-2010, 07:37 AM
Incidentally, wilbur, speaking as one who lives under the system Obama has foisted upon you, what he has described is what is happening here.

Going to tell me I don't know anything about OUR health system now? You're, it seems, an expert in everything..so again, what makes you qualified?

Long waiting lists, Overflowing hospitals, overworked emergency rooms, doctor and nurse shortages, bed shortages, impossible paperwork forced upon health professionals, endless regulations and laws....all coming to you...soon.

BET ON IT.

Coming to us soon? Its been that way for years here already. Been there, done that.

wilbur
04-05-2010, 07:39 AM
I'd say he knows far more than you do. So now you have a medical degree and one in climate sciences?Just what IS your background in health services?Hm?

I'm sure he does - however, he didnt share any of that knowledge with us in that article.

I admit a high degree of ignorance on the matter, which is why I was disappointed there werent any specifics, and instead just boiler plate ideological talking points ("Doctors will lose their freedom!", "The system is going to suck!" - Yea, fine, but how exactly?)

And I'm not sure what your copy'n'paste of the committee names is supposed to prove - as if reading the names of the committees makes it obvious that how they will interfere with 'doctor autonomy'.

Sonnabend
04-05-2010, 08:50 AM
I'm sure he does - however, he didnt share any of that knowledge with us in that article.It was an article. Why don't you write to him and ask?


I admit a high degree of ignorance on the matter, which is why I was disappointed there werent any specifics, and instead just boiler plate ideological talking points ("Doctors will lose their freedom!", "The system is going to suck!" - Yea, fine, but how exactly?)See above.


And I'm not sure what your copy'n'paste of the committee names is supposed to prove - as if reading the names of the committees makes it obvious that how they will interfere with 'doctor autonomy'.A doctor has better things to do, i.e treating patients, than spending his time fighting through reams of red tape and bureaucracy.

He or she is to make DECISIONS based on the patients welfare, not tied down by layer after layer of regulation and paperwork.

I know you confess to a "high degree on ignorance" so let me lay it out for you, as someone who has WORKED in health, both as an emergency services officer and in at least a dozen hospitals, and has seen firsthand the horrible workload doctors have...my own GP is a stellar example. The paperwork he is required to do is beyond belief, and he works sixty hour weeks PLUS housecalls.

His surgery is wall to wall forms and papers. I offhandedly remarked that he seemed to have a lot of forms to do, and his response was that the Government seemed to spend time finding new ones for him to do...rather than do his job. Dozens of doctors have quit, or gone overseas owing to this insanity.

My previous GP took early retirement, fed up with the governments over regulation. I know interns and others who have simply taken their degrees and gone overseas, where they can be doctors, not some government clerk's secretary.

Ever met any interns? Residents? ASK THEM.

His or her autonomy is to do whats right for the patient, not to deal with interminable Caspar Milquetoasts who wouldn't know a scalpel from a scampi....having some pencil pusher who doesn't have any form of medical knowledge second guess their decisions is unacceptable. And dangerous.

I've seen it here, time and time again.

Sonnabend
04-05-2010, 08:56 AM
Coming to us soon? Its been that way for years here already. Been there, done that.

Obama's "care" will exacerbate the problem. Watch and see.