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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 17, 2012 at 8:07 am

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."

The Affordable Care Act is the best thing that's ever happened to this country. I am a huge supporter of it.

Why did the autthor of this article wait until the very end to start explaining how positive this is? One in six Americans -- hard workign Americans -- people like me who work 50 horus a week at jobs that don't offer benefits -- need the affordable care act. Thank you Obama.

Drama Drama
November 17, 2012 at 8:04 am

Stop with the negative attitudes!! Please. Read the article again, all the way to the end. This is a good thing for all, the doctors are also very happy about it! Enough with the negative obama care talk....its really silly and getting old.

Mr. Richard
November 17, 2012 at 7:00 am

Yes I know about the disapearance of the Dr.'s already. My Dr. has informed me that he will no longer take medicare folks. And if he can't make it that way, he has told me he's going to retire. At 46 years of age.. WOW His office building and property has to be worth a cool million or more. No worrys here.

Michael Kureticdh
November 17, 2012 at 2:19 am

7 Years ago after working in the summer sun in Phonex Arizonaduring he summer I developed pre cancer Leasons on my fo rheadWhy can I not write on this sie

November 17, 2012 at 12:51 am

Great article. Wouldn't it have been great if all the ones who voted for Obama would have considered this and read this article and had been educated on what will happen to their medical care.
Young people who want to go into the medical field will take another look as all Doctors whether G.P. or Specialist would be paid the same and that is very unfair. Specialists deserve more.
I think in time there are going to be many who will regret their vote. The good news is that perhaps Congress will defund this bill or reform it as 60% of Americans didn't want it nor did we get to vote on it,as it was shoved down our throats.

David Thomas
November 17, 2012 at 12:33 am

None of the doctors I have seen since the 1950's have been "kindly family doctors". Our "kindly family doctor" from those years died an alcoholic, probably from the stress of making house calls and not being part of a group that could provide professional support. It's too bad 90% this article sounds really scary before finally revealing in the last paragraph that, "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." I hope most readers get that far.

November 16, 2012 at 11:04 pm

Yeah! the government will take care of use....I can't take care of myself. Thank god for the government...they know whats best...

November 16, 2012 at 10:31 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??????"

----Dear Jack: We "Tea Bagger "dummys" (aka Tea Bagger Dummies!...) do appreciate your post! We also desire the "people in DC to do there job" (OR "their" job) to get our country back to where it should be (and Jack, in our inferior minds we appreciate your "alternate" spelling of the "King's English" to include "your not included" )
even though most of us would prefer "you're not included", however, as in all things of importance, we will now defer to you "anti-tea-bagging intellectuals!" As for "our boy Bush", I can see via your post, how much basic decency, and education his administration accomplished! As a mother, and a villified Christian, I might add, your final comment to "Just crawl back in your hole" is inspiring, and so Amerian, no? You have totaly convinced me that your side is inspired by Truth, Love for Country, all things good, etc., etc.!! What a coup of the Democrats!! People like YOU posting on the Internet! I know I am swayed by your powerful arguments! I believe YOU stand on the side of TRUTH!
How could ANYONE refute such an argument as "crawl back in your hole?" I know I am NOW anti-Bush, anti-Republican, well, anti anti! Thanks Jack! Your post was Well worth your effort, and your lack of basic grammar!! I just know SO MANY will appreciate your common, disgusting references to "tea-bagging!!" Jack, Project much?

November 16, 2012 at 10:27 pm

We're right here folks the primary care family doctor of the future. the doctor of chiropratic is the future because, as Edison predicted the DC of the future will prescribe no drugs but will educate patients in rest exercise nutrition and care of the human spine. Even if people are slow to notice the disclaimers that so blatently show what kind of damage most of these drugs do to harm the body it is manifesting in other ways like very soon there will be more Davitas around for kidney dialaysis than mc donalds restaurants. The family doctor has been a passafier to the public while doctors pretend they know how to heal the body with drugs. They tell us that every possible condition that is physical emotional or mental or chemical requires a script to heal the patient. This premise is totally unsupported in science and the use of tv commericials to sell known harmfull drugs proves that the underlying purpose for selling drugs direct to the patient proves that the doctors are flunkies and sales agents for the pharmasudical companies

November 16, 2012 at 10:10 pm

Jana (and others):
Yes, President Obama did indeed say those things. He also said that if you want to keep your health care system then you can do it, and that certainly was incorrect. I watched him as he said those things and could hardly believe my ears. And the health care system does indeed have an appointed review board (A.K.A. Death Panel) that is charged with determination of the usefulness of your life when you require medical care to sustain it. Read the bill, as much of it as you can. It is available on line.