National Survey of Physicians Attitudes of Direction of Medicine
REPRESENTATIVE COMMENTS:
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I have been in practice for 28 years and medicine is now the worst for doctors it has ever been and I don't see it getting any better. We needed insurance reform not health care reform, we got neither.
Orthopedist, TX
The most important thing would be to eliminate third party payments. Patients and physicians should decide what tests need to be done and what treatment will be administered. The patient should pay the physician for service. Whether they then get reimbursed is between the patient and the third party payer. This would put patients and physicians in charge…
Cardiothoracic Surgeon, IA
Congress has failed. We need to leave Medicare and band together…When we are referred as providers and not surgeons, the government considers us a replaceable commodity
Ophthalmologist, AZ
Doctors are being forced to join large hospital groups – by economics and regulations.
Dermatologist, NC
Did not go to school for 25+ years to be computer programmer for Federal Govt.
Ophthalmologist, FL
The best chance for controlling cost is limiting government interference and increasing patient responsibility for cost. If the patient pays at time of service and files an insurance claim on their own, it reduces the likelihood of superfluous utilization, AND reduces insurance company denials since the patient is following up on their own claim. Also, removing insurance purchasing from employers makes insurers responsible to policy holder, not employers.
General Surgeon, GA
Insurance companies have too much power and waste too much money.
Primary Care, ME
AMA sold out.
Pain Management, MO
I went to medical school to become a doctor. I did NOT go to "health care provider school". I know how to take care of sick and injured people. PLEASE, let me do my job the way I was trained to do it. I am so sick and tired of people with vastly inferior training, or no medical training whatsoever, telling me how to treat my patients - and all of them have their own agenda: Power and/or money.
Some days I just want to run to Africa or Mexico and just take care of sick people, and not have to explain myself to a dozen bureaucrats who don't even know what I am doing.
"Third parties", whether private (insurance companies) or public (government), have destroyed the physician patient relationship. Obamacare will destroy the best medical system the world has ever seen, and it will bankrupt the nation.
Family Practice, CO
Fear it is too late to save.
Ophthalmologist, ID
Decrease power of insurance companies to dictate health care.
General Surgeon, MN
I would not consider letting my teenagers become physicians. My husband is also a physician.
Anesthesiologist, WI
P[atients] need skin in the game. Nothing else in America exists where a 3rd party assumes responsibility for someone, not even food and shelter.
OB/GYN, NJ
Less government will mean better and less expensive medical care. Government is the problem. Are there any long term Government run programs that aren't riddled with inefficiency and corruption?
General Surgeon, IL
Obamacare will be the ultimate [end] of the solo practitioner and small practices
Dermatologist, MO
I don't know from what source all this foolishness about "uninsured" patients arises. I have never denied standard medical care to a patient in my life based on the family's ability to pay a fee, and I have never seen a hospital refuse to treat a needy patient. Leave us alone and we will take care of all the patients.
Pediatrician, NC
The actions of the health insurance industry indicate that using hassle factor tactics is actually part of their business plan. (hassle ---> frustration ---> patient drops complaint & pays more - and during the period in question, the money in play earns interest for the insurance company)
Geriatrician, NY
Healthcare systems should all be made for-profit to pay fair share taxes.
General Surgeon, NC
The cost of delivering care will decrease when doctors don't have to have so much employee time devoted to billing/complying with third parties etc.
Anesthesiologist, TX
If the government wants to be involved in medicine have them purchase catastrophic insurance for people (the only kind of medical insurance that should be sold) and let all people be responsible for their own medical bills. Vested interest would make them more responsible about their health. Health care is
important but it is not a right just like unlimited food and water is not a right…
Orthopedist, MO
It will get worst before it gets better. Not encouraging to the young doctors.
General Surgeon, NJ
The power of hospitals is huge and has destroyed physician's autonomy and his ability to demand improvements in health care.
General Surgeon, NC
General surgeons are taking a beating financially because of general relatively low reimbursement and large amount of no pay emergency room urgent surgeries with are promoted as safety net and walk in services but no reimbursement for the private surgeons.
General Surgeon, IL
The federal government needs to get the HELL out of the practice of medicine. Here's the bottom line: you cannot give away free medical care. Until they stop entitlements, this whole system is doomed, unfair, and chaotic.
Internal Medicine, WA
We need national tort reform and a medical court system. Also, ER and EMT abuse has to stop. 80% of the people we see would go home and take a Tylenol if they: 1. were charged $10 up front for the EMTALA screening, and 2. were taught general health and first aid in high school with an emphasis on COMMON SENSE.
Emergency Medicine, LA
I am 80% of the way towards being third-party free and am optimistic about my practice's future. The rest of medicine still beholding to the insurance giants are in a straight jacket with no chance for release.
Internal Medicine, IL
Repeal PPACA and EMTALA, establish charity care/government care at all hospitals that train residents. Patients will have access, though it may not be the most convenient.
General Surgeon, LA
There is no incentive for young students to go into high risk but critical subspecialties. Unacceptable liability risks, long sacrificial hours, and now no financial reward! Who would be that stupid? Certainly no longer the best and brightest!
Vascular Surgeon, FL
Patients need to have more control of their health care dollars with price transparency to make their own medical decisions. No mandated insurance coverage-one size fits all. Central management of medical care will be disastrous for patients and doctors, as has been the case in other countries. There are free market solutions to address the cost of medical care. Obamacare must go.
Psychiatrist, NC
I am already a casualty. My best year was 1997 and I have seen my ability to generate income steadily decline since then. Having practiced 20 years I finally shut down my private practice and joined a large hospital system. Erosion in Medicare reimbursement and exponential increase in regulations have
necessitated leaving private practice.
Physical Medicine/Rehab, SC
I am only in the black as I dropped Medicare 4 years ago. Else, I'd be the patient today from burnout/MI/Ulcer or other disease.
Orthopedist, TX
I would be happy to treat indigent patients for nothing if they let me deduct my fair market work product from my income taxes.
Pain Management, NY
Government should be removed from the delivery of health care. Health insurance should be sold like auto or home insurance, covers only catastrophic events not routine maintenance. Should have incentives for individual to live healthy to minimize catastrophic events
Pathologist, OH
The only answer is to get government out of medicine 100%.
Primary Care, MN
When I first began the practice of medicine, there was a law that no-one could practice medicine except a licensed physician. Today, everybody ‘practices’ medicine…What has occurred in medicine over the past forty years has been a gradual and steady plan to use medicine as the catalyst the government needed in order to set themselves up as dictators. The doctors are their pawns. When you control medicine, you have the wedge between government and the people. Medicine…has been turned into a charade.
Family Practice, SC
The major problem is the politicians equating health "insurance" with health "care". I opted out of all insurance 6 years ago and really enjoy practicing medicine again. I have found that many people that do not have insurance are quite happy to pay a reasonable fee for their care.
Family Practice, SC
Medicare and health insurance companies have taken over control of healthcare. I spend 6-8 hours weekly trying to get insurance companies to cover most of the cost of medications that my patients need…Medicare D insurance companies have a vested interest in refusing to pay for psychiatric medication...
Psychiatrist, MA
Free market solutions are our only hope.
General Surgeon, TX
As a solo doc, I am being forced out of my practice by the bureaucracy and regulations we are and will be responsible for. Those that suffer will be the patients.
Ophthalmologist, PA
If the current P[ayer] systems continue & Government continues their legislating more pressures on doctors, medicine in the US will come to a halt. There will be a two tier system: those that can pay for private medical care & everybody else (in the socialized system.) I will not participate in socialized medicine.
Neurologist, FL
I think that the doctors need to stand up and fight with a united front instead of taking these changes lying down. With the direction we are going, we will have the worst medical system in the world where the nurses will rule.
Podiatrist, FL
Unfortunately as regulations have increased there has been a direct impact on the cost of care increasing.
Anesthesioogist, KY
The future is bleak!
Pain Management, CA
It’s becoming cookbook and judgment is no longer valued.
OB/GYN AZ
Patients would be more thoughtful consumers if they had more "skin" in paying for health care. This is why lots of patients who never took generics are now taking them.
OB/CYN, OH
Medicine is circling the drain for a variety of reasons. Heaven help us all as we age.
Sports Medicine, KS
Medicine has become big business and doctors have become workers who are exploited by big business.
Psychiatrist, CT
American healthcare is finished. The damage done by government/corporate control is irreversible…Only the powerful will have decent medical care (government employees)
Neurologist, FL
With our present system,[the patient] has absolutely no control over how that money gets spent…This completely insulates the patient from the costs of care, and now because of the hidden layers of bureaucracy, separating the patient from the care, each layer with its hand in the till..
the result is what we have today: health care is a "right," "I'm entitled to it," and if I don't have the money to pay for the costs [then] oh well, I get it for free anyway.
The end result is those laboring to provide that service…have zero say in it if we want to continue working in a field we passionately love.
Oncologist, MN
129 Medicare should be means tested. It is ridiculous that someone who can afford waterfront condos and late model Mercedes has Medicare. Medicare needs to be separated from Social Security
Anesthesiologist, MD
Patients should be able to buy low cost major medical type insurance, not expensive pre paid medical coverage.
Ophthalmologist, NJ
It's really depressing. It bothers me several to many times every day, "Why the hell did I invest 34 years to be a very low level 99%er?"
Orthopedist, NY
What a mess, it's hospitals that have become corporate and want ALL of the money they can get from EVERY patient at EVERY encounter that is the problem…
Family Practice, FL
…I want to focus on what is best for my patients and not what a government official deems cost effective. I want liability (tort reform). ..I would be willing to do charity care weekly for the poor and underinsured if there was tort reform.
Family Practice, WA
If MD's want to regain control of healthcare they need to resign from all third party payers including Medicare and Medicaid and only accept payment from patients.
Cardiothoracic Surgeon, IA
Government gets away with rationing by making doctors the scapegoats when someone alleges that an ACO made a profit by skimping on care.
Internal Medicine, NH
I was in solo private practice for 20 years before reluctantly taking a salaried job at our county hospital.
General Surgeon, CA
Physicians belonging to large groups seem to be relegating more patient interaction to PAs and other ancillary personnel, often to the discomfort of patients and their families.
Anesthesiologist, CA
Only the free market will fix this mess. We need to eliminate government and government-protected corporate greed from medical care
OB/GYN, TX
Government at any level should have no role in medicine except medical licensing and business licenses. Period!
Orthopedist, MN
Physicians should be independent of hospitals and insurance companies…The government has given the hospitals and insurance companies a protected status by limiting competition and they don't have to improve quality or become more efficient. Doctors have lost control and are being told what to do
by hospitals insurance companies and the govt. who only care about money not patients.
Orthopedist, MN
Judges with legal degrees have no business making medical decisions. Ban ambulance chasing lawyers from advertising and encouraging lawsuits with no risk to plaintiffs… Evidence based medicine should be a guide NOT the only way one may practice. Stop allowing people with no medical knowledge, i.e. politicians, attorneys, and bean counters from dictating how doctors should practice.
Psychiatrist, MA
Billing for an office visit of less than $100 is very inefficient. People pay for car repairs before they get their car without problems. Women spend hundred on hair treatments and give a tip on a regular basis. If
people paid for their care they would get better care…[we] take time away from patient care to do coding for the benefit of insurers.
Neurologist, MO
I own a 4 physican F[amily P[ractice] group; I will be out of business when Obamacare is fully implemented...
Family Practice, TX
Patients need to take responsibility for their own good health. They should not believe that they can live any lifestyle they desire and have others pay for their health misfortunes that result from this lifestyle.
Anesthesiologist, TX
Patient centered healthcare only occurs when patients control the money AND the Dr. ONLY works directly for that patient…
Internal Medicine, MN
ALLEGED "FACTS" ABOUT LOWER CARE IN USA ARE PURE FALLACY. Cancer care, heart disease, infant care in US is second to NONE! Other countries don’t count those who die before they see a doc, or have as many hopeless drug addicted babies due to Maternal Chem depency! The USA Major
media should hang its head in SHAME for lying to US public!
Electronic med records should be trashed or at least not connected to outside electronic world to help avoid confidentiality abuse.
Neurologist, MO
Get back to the doctor patient relationship. Eliminate all the middle men parasites.
Family Practice, AZ
When the airlines were taken over by business instead of being run by pilots, the industry went to hell. Same thing has happened to "healthcare" -- doctors used to run hospitals and their practices. Now they are "providers" and really only make money for Pharma. We need to scrap the entire system and start over. More bandaids is not the answer. Use the ancient Chinese method: Pay doctors
to keep patients WELL and when they get sick, doctors care for them for free.
Family Practice, OH
There should be much less cronyism and favoritism between medical organizations and government. The PPACA is a monstrous bill designed to give government COMPLETE control over our lives…We, as health care professionals, need to STAND UP NOW an UNITE against this power grab…
Endocrinologist, FL
I am optimistic only because I am third party payer free...Patients are constantly complaining about my colleagues being too rushed, looking only at the EMR [electronic medical record], and "not caring" about them…they are just overburdened with things that don't positively impact the patient's experience.
Internal Medicine/Pediatrician, MN
People (patients) need skin in the game. Giving them care or insurance isn't the answer - they need to have a vested interest. Copays, etc. do this.
OB/GYN, NJ
There is nothing to suggest the practice of medicine will improve in the near future. I feel sorry for those who are valiantly trying to practice good medicine in such a dysfunctional system.
(specialty not available), AK
EMRs [electronic medical records] do not improve care. Neither do regulations. Patients do not feel cared for under current climate.
Urologist, TN
A couple small changes would improve the situation: 1-It should be illegal for health care organizations to discount their fees for insurance companies. The discounted fees amount to extortion because if patients do not buy health insurance, they cannot afford health care. 2-Fees should be transparent to doctors and patients. 3-High deductible policies with patients paying out of pocket will naturally rein-in expenditures and obviate the need for pay for performance, or other government oversight. The net savings should be more than enough to be able to be applied to help poor of chronically ill patient's pay their medical bills.
Pathologist, MA
I am opted out [of Medicare & Medicaid] and cash based for 12 years now as an internal medicine
practice. I have never been busier, deliver a high quality consultative product, am financially secure, and cannot wait to go to work every day.
Internal Medicine, MN
