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Where did our family doctor go?

By Jay MacDonald ·
Friday, November 16, 2012
Posted: 10 am ET

While we were all watching the fireworks surrounding last summer's Supreme Court battle over President Barack Obama's historic health care reform, more than a few of our family doctors were quietly boxing up their belongings and heading to greener pastures, if not out to pasture.

One of the unfortunate side effects of the Affordable Care Act is that the investment it requires in health care communications, quality documentation and patient management may prove beyond the means of the kindly family doctor you've known for years.

"Probably the most dramatic effect on primary care physicians as fallout from the Affordable Care Act is that they no longer want to continue in small private practices and instead are joining larger physician groups or becoming attached to hospitals," says Dr. Ron Greeno, who chairs the public policy committee of the Society of Hospital Medicine, a trade group for hospital-based health care providers.

According to Greeno, about 50 percent of physicians in this country now work for hospitals, while only 12 percent consider themselves sole practitioners. "Independents have trouble making the economy of scale work to stay in business," he says.

No, family doctors are not disappearing, exactly. In fact, they're in demand like never before. The Association of American Medical Colleges says we could be short 21,000 primary care doctors by 2015.

But the growing demand today is coming from large physician groups that are staffing up to form health care networks called "accountable care organizations," or ACOs. With a little patient management and coordination with other providers, ACOs are poised to share in the money they save Medicare, the 800-pound gorilla and No. 1 payer in America's waiting room.

"One of the reasons for the exodus is, if you look at the ACO regulations under Medicare, one of the requirements is that they have to have a primary care component," says Dr. Greeno. "They don't have to have a hospital or specialists, but they do have to have primary care physicians."

All this sudden consolidation will eventually be good news for your family, your health insurance and taxpayers in general if health care reform achieves its goal of containing medical costs while rewarding quality, not quantity, of care.

In the meantime, be sure to ask your family doctor to notify you in case of any change of address.

Follow me on Twitter: @omnisaurus

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November 16, 2012 at 5:53 pm

Hey Sheleah Mccarthy. You mention that folks should "digest" the ACa? I suggest that you read and "digest" the word of God for yourself. Nothing to do with the "Romneys" or "Obamas"..They both are only self serving humans..Digest GODS word and pray. The heck with all of the political hatred eveyone has for each other.

November 16, 2012 at 5:50 pm

If Shealah has read the ACA, good for her - because NO ONE ELSE HAS, INCLUDING CONGRESS!

Sheila Shaw
November 16, 2012 at 5:49 pm

As a senior, I am appalled at the mis-use of Medicare...but lets
speak truth about a lot of things. Medicare is NOT free, we paid
into Medicare with OUR hard-earned money...for 50 working years
of OUR life. Social Security was the same way...we PAID into
SS for 50 working years of our life.
When Carter chose to "borrow" from Social opened the door for all kinds of "misuse by OUR government.
And to the lady with all the slurs and catergorizing of people
groups....(YOUR ignorance shows) get educated and stop and listen
to what some of these groups are saying....Most of them are speaking truth or partial educate your mind
and grow...maybe grow UP!

lee alban
November 16, 2012 at 5:30 pm

Honest discussion of changes in health care are important to discuss, but someone like Shealah McCarthy loses all credibility. I wouldn't put much intellectual weight on anything someone says when they use words and phrases such as "fear mongering ignorance" "right wingers" "Romneys and Ryans and lunatic Christians" "walk over dead and dying babies" "bible thumping" "quit babbling, whining" She has revealed herself to be a bigot and unworthy of serious consideration.

November 16, 2012 at 5:19 pm

As a reader above nothing is free.... we will be paying for it through our taxes!

November 16, 2012 at 5:13 pm

Be ware what you wish for in life, for you are about to get it. nothing is free in life, so all you people out there think you are getting "free" health care, better start reading the facts. you are going to be forced to buy health care, and the irs will be here to help take your money if you don't. employees that receive and/or pay into health care at work, well that is about to be taxed as income now. ask people living in canada or europe how they like their heath care. the last laugh will be on all you people who can't wait to get your "free stuff" from the government with all your strings attached.

November 16, 2012 at 5:03 pm

There is something going on behind the scenes that many almost all people do not know about. Over the years there has been a practice of Doctors billing in a bundle form. I heard of bundles before it hit the TV ads for insurance companies. You see if a woman has a baby, medicare or medicaid has a set price for that child. What has been going on is the Doctors have been adding extras or double billing their services of a normal birth. Result Medicare or Medicaid paid the higher amount till the Government got smart and started to spot audit through insurance companies. The Insurance companies ended up getting a windfall of $$$ in the millions that they paid out returned to them or if it was paid by the government , to the government. Now all Doctors are looking for protection from interference to do their jobs and the hospitals provide it because of massive billing. Plus the income isn't that great. Auditors for insurance companies audit about 5% or less of actual medical billing. And now add to that the Hospitals with the most wealth and best care are monopolizing into an LCC thereby combining all of the hospitals within a very large area to gain more strength in what is and can be done. Sound a little RICH to me. What do you think???

Shealah McCarthy
November 16, 2012 at 4:52 pm

Honestly, the fear-mongering ignorance by the right-wingers continues on and on and on, the "blah, blah, blah"...The Affordable Health Care Act is law, thankful, so now the Romneys and Ryans and their lunatic Christian base won't have to walk over the dead and dying babies, toddlers, children, teenagers, young adults, adults, and the elderly anymore...they won't have to yell "Let Him Die" -- those lovely God bible-thumping insurance in this country is unaffordable, not only for the poor, but for most of Middle America. On the backs of 50 millions Americans, the insurance industry profits have risen from 3 to 4% to almost 30%...NO, this country needs healthcare for all. READ THE ACA, READ IT, LEARN...DIGEST IT...quit babbling and fear-mongering...our way of life, honestly, our way of life is to batter the poor, the uninsured working two jobs but not able to afford $10,000 in health premiums annually on a $25,000 part of the solution, quit whining.

Randy Allen
November 16, 2012 at 4:40 pm

Its too bad supreme court judges are not elected. I still can't believe these 9 suposedly intellegent people let Obamacare pass.
This is going to do more harm to our country and way of life than all other things the democrats have done.

Nancy Fuller
November 16, 2012 at 4:28 pm

Is this the beginning of Boiling-A-Frog-101? Simple, careful, non-threatening steps to Socialized Medicine for the good ol'e USA?