To no one’s surprise, specialists are already drawing the line at taking income cuts to help fund primary care:
Expanding and improving primary care physician payment will itself be controversial. I am writing this blog from the American Medical Association’s House of Delegates meeting, where primary care and medical homes are both major topics being discussed. Many of the physicians lining up at the microphones have expressed support for primary care – as long as it doesn’t involve redistribution of dollars among physicians.
It is not a good sign that some physician specialty societies already are drawing such lines in the sand.
It is highly unlikely that primary care will be able to be saved without some amount of income redistribution. The arguments that primary care physicians “don’t work as hard,” or “didn’t undergo as intense a training” will inevitably be entered into the physician payment reform dialogue.
Class warfare is going to hit the medical profession real soon, and it’s going to be ugly.
The civil war has already started in the medical blogosphere.
Internist Robert Centor: “I hope that we get earth shattering payment reform. I may not even mind hearing proceduralists whine.”
Cardiologist Dr. Wes: “Most of us already know what the Robin Hoods of bureaucracy are going to do: steal from the rich (specialists) and give to the poor (generalists). After all, that’s what ‘budget neutrality’ is all about.”