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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 9:53 pm

to jana lionberger and Jack: here are the direct quotes from obama.

"he's on tape saying he favors a single-payer health care system:

"maybe she should take a pill" instead of getting a pacemaker

November 16, 2012 at 9:52 pm

Here's a fact - Obama did indeed state he is a proponent of single payer health care...and I believe his eventual goal with Obamacare is to make it the only viable option. That's the only way Obamacare can survive in the long run....because it won't survive unless most of us are participating. Say goodbye to choices.

November 16, 2012 at 9:45 pm

Jack and others are living proof that liberaism is
1.a mental disorder
2.another name for socialism/progressives/marxists/etc
3.a means to sit and receive
4.and with the media,hollywood,education,science,research,being
bought by the goverment there will never be a conservative in
the WH and our counrty will be as california and new york.

November 16, 2012 at 9:03 pm

Yes, he has said numerous times he favors a single-payer system. I'm from Illinois, and when he was running for state office he said in a speech he was for it. This video clip from a speech to the AFL-CIO was made after he was elected to the Senate. He is honest about his beliefs when talking with his niche-support base. But when addressing the general public he lies to hide his true intent, choosing rather to pit one group against another, dividing the population, and turning attention away from what he is doing. I've watched politics for over 30 years. This man is more than a pro at deception; he is an artist. Lots of people say "Oh, he's such a nice guy." No he isn't. He is quite the opposite. He's just very good at convincing people that he is.

November 16, 2012 at 9:03 pm

Hey Fisheye, get out from under that bubble ya live in along with the rest of your Tea Bagger dummys. Time to join the USA and let the people in DC do there job to get our (your not included) country back to where it should be after your boy BUSH tried to destroy us... JUST CRAWL BACK IN YOUR HOLE??????

November 16, 2012 at 8:42 pm

Right On Educate!!

November 16, 2012 at 8:29 pm

NO Jana, you love Obama so much you can no longer see the truth. We are headed in a very bad direction. If you knew the truth you would see this and you would have also educated yourself as to the problems every socialist country is having with their medical. Rich people from these countries come here cause no one can get good care in Franc or Canada. People are dying in line. and others if old or handicapped get no care at all. Read up!!!!! learn something. don't just listen to Obama speeches/lies/manipulation.....

November 16, 2012 at 8:22 pm

Why don't people realize why there are no internists (you call them "family physicians) to take care of patients? Due to the restrictions put on primary care physicians by the government, Medicare, insurance companies, liability insurance skyrocketing, being forced to lower their charges (never that high to begin with), hospitals forcing them to see a new patient ( take an 80 year old with heart problems, being a diabetic and has cancer and see if you could perform a new patient physical in the fifteen minutes an insurance company demands) do a plan of care write up, fill out the necessary forms to get medications, etc. So the doctor has to hire twice as many enployees to take care of all these restrictions.

No wonder nobody wants to be a primary care physician. Specialits are not required to do much of any of this. Fair? There is going to be nobody to take of the again baby boomers in the years to come.Steph, Administrator of a "Primary care physician" office for 28 years.

jana Lionberger
November 16, 2012 at 8:00 pm

fisheye you are so wrong, Obama never said that, you have to be one of those Republican losers that is saying all these lies. I suppose you still believe that Obama was not born in the united states. If you are going to make a point please do some fact checking because almost everything you stated is a lie......

November 16, 2012 at 7:43 pm

Welcome to Obamacare! Welcome to socialism. The drive-by media didn't do their job-they went all-in for Obama both times, and now we all have to eat it! Obama is a socialist, and everything in his past shows it. He's on tape as saying he favors a 'single-payer' health care system. Private employers will kick all their employees into the government plan, because it will be the cheapest one-size-fits-all plan, and if you're older, good luck! As Obama said to one woman about her mother, maybe she should take a pill instead of getting a pacemaker (again, on tape)! It's the libs who fear-monger, and Obama DID give 'gifts' to buy the votes of women, liberals, immigrants, and anyone getting a govt. check. They could care less about the Constitution because they've all been brainwashed b y an education system run by libs.