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.
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