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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 7:54 pm

This type of propaganda will continue and media outlets (like this one)will give them a voice. This is a health care provider organization, who may finally have to control health care costs and be a part of the solution and not be the problem!

November 17, 2012 at 6:55 pm

Well the moochers voted and any doers remained home so here's just a small piece of what happens thanks to BoboCare... 400+ jobs will relocate from Western PA out of the US. Average age of those employees - 52. Doubt many will EVER find employment again except in McDs or Wal-Mart. All Clinical Trials using our products ends Nov 30. That too is moving offshore. That's millions in cutting edge treatments... We will no longer offer our products at reduced rates to Medicare/Medcaid patients. Why? Because none of the Providers we work with will accept Medicaid patients after Jan 1 and 80% will no longer accept Medicare. Just around here we have a rush of new PRIVATE hospitals being built. They advertise that they do NOT accept Medicaid. So all these "Poor Folks" ran to vote to save Bobo... What happens when they find themselves sitting in a dirty clinic for 16-18 hours only to see an EMT? Or better yet told they need to see a specialist only to find that they not only had to wait a year but also had to travel hundreds of miles to one that agreed to accept Medicaid.

November 17, 2012 at 12:51 pm

I have been Republican all my life, and until recently I felt that being conservative was good for the Country, but now that I see that people who vote republican are after personal agendas and self wealth, Not at all interested in the mass amount of people who are Middle Class, and are the People that pay for everything that this Country is involved in. My Personal Physician is probably just above middle class, and makes a comfortable living, My point is, when middle class people get to the point that we can't afford to go to our family physicians, then it wont matter who they work for, be it a Hospital, or in a family practice, they wont make enough money to stay in business. The majority of people demonstrate that the Republican party is like the Dinosaurs, quickly becoming extinct, and the people have shown this for 5 years now, showing that the republican party is on its way to being dissolved, and only one party the Democrats will prevail and the price for everyday services and consumable goods will be more fairly priced, and the so called Poverty level will cease to exist and jobs will be more available, and the Country will see that all the REPUBLICAN party was only striving to have the same conditions as the 3rd Worlds have, which is Extremely Rich or Extremely Poor. The Majority of the people, which has been HEARD for 4 going on 5 years now is the Middle Class America, Saying that we will not sit idol and let a handful of Very Wealthy people continue to strip us of what is rightfully ours, That Being The very fabric that holds this USA together, and paves the way. How many Rich Republicans or their children do you see going to fight for this country, or even serving in the Armed Forces, so that this Country remains Free, The Chinese are slowly buying out our country, and the Republicans are more than willing to sell it out, to line their pockets with riches, but what they dont realize is that when China Takes this country over their riches will be confiscated by the Chinese Emperor and they will be just like the rest of us, poor and starving and wondering how this happened in their perfect little Rich world. The Democrats are fighting for the rights of all the people, rich and poor, This is the concept the Original founding fathers had in mind not what the rich Republicans are trying to acheive, which is wealth for them and the downfall of the American middle class , which if ever dissolved, will be the DEATH of America as we know it. So that is my concept of what is about to happen, had the soon dying Republican party won the ELECTION. THE AMERICAN HAVE SPOKEN AND ARE STANDING UP SO THAT WE ALL CAN HAVE A GOOD LIFE, NOT JUST THE SPECIAL PEOPLE THAT THINK THEY ARE ALL THAT SHOULD MATTER. THANKS BWWOODY

Mr. Working Man
November 17, 2012 at 10:23 am

Maybe the people that love Obamacare would not mind in 2014 to pay for my health Insurance that I am beimg droped, because of Mr. Obama." I think the lights are on but nobody is home" when it comes to thinking that medical cost will be better. The USA is filled with Clowns that never work for a living, and had to pay the cost of health Ins. And yes Doctors are leaving and not covering people!!!!!!

john sanders
November 17, 2012 at 10:14 am

I love my doctor but I might be dead now if it hadn't been for
a spealist. we need them both.

sanganur mahadevan
November 17, 2012 at 10:08 am

The affordable care act is a 1400 page document that was passed with few people ever reading it. Even today no one can certainly say all the ramifications in it. Even though it was passed in 2010, it was not going to be implemented till 2014. The true effects, good or bad , will be seen only after few years of its implementation.

November 17, 2012 at 9:49 am

My husband is a Family Physician and has been in practice for 23 years. Four years ago, he became a hospital employee. I believe that what many are unaware of is that the insurance companies and the government have set up huge hoops for Primary Care docs to jump through and so much of their time has to be devoted to paperwork that they are unable to see the number of patients that they would like to see in any given day. In addition, Family Physicians are the lowest paid physicians so many medical students do not choose that field. The shortage of Family Physicians is here already. It will only get worse as people around my husband's age start to retire. Until the insurance companies and the government value the work of Primary Care Physicians and reimburse them at a higher rate, I do not believe that this shortage will ever change.

John Yarbrough
November 17, 2012 at 9:20 am

Apparently, the people who think Obamacare is wonderful, don't work for Papa Johns, Denny's or one of the many businesses that are cutting back employee hours to make part-time jobs and firing employees to avoid the huge costs and /or fines they will be hit with under Obamacare.

November 17, 2012 at 9:06 am

Really. The government isn't the one taking care of you, it iall of us who work and pay taxes. There are alternatives for you to purchase insurance the way healthcare is now. Check with people from other areas of the world. Do they like ther socialized medicine? How much does it cost them? Reform is being handled all wrong. Reducing coverage is not the answer. Reducing cost would better suit the situation.

November 17, 2012 at 8:07 am

"ACOs are poised to share in the money they save Medicare, the 800-pound gorilla and No. 1 payer in America's waiting room"

In other words... all of those people who think they are going to get whatever care they need/want are in for a rude awakening. The only way to get the savings to deny care. It's all going to be about percentages. If it is determined that you only have x% chance of living, then here's some pills to make you comfortable while you die.