Let the Medicare physician payment cuts take effect

by Stella Fitzgibbons, MD, FACP

You know what? I think the AMA should tell Congress to just go ahead and let the Medicare pay cut go into effect.

Doctors will, of course, be squeezed further than we already are, and more outpatient practices will shut down or stop accepting new Medicare patients. More hospitals will close, and ER crowding will get worse — maybe causing some of the primary care docs who close their practices to go to work in ER’s or public clinics, discovering the wonder of getting to go home and turn off the beeper at the end of a shift.

And maybe some people will choose not to apply to med school. This will include those guys — you remember who they were — who viewed a medical degree as a license to print money and drive expensive cars. Their spots can go to people who love the work and want to do some good.

Waiting lists for elective procedures will get longer. People who demand an MRI today for that disc they popped out yesterday, and a neurosurgery appointment tomorrow, will find that they just have to do the physical therapy instead, and the surgeries that don’t happen will mean fewer deaths from unanticipated operative complications.

The American public has spent the last several decades learning that you can get any medical care you want when you want it, paid for by somebody else, if you holler loud enough or pull the right strings. But the first wave of hospital closures has already started, and the AMA’s statistics on retirements and reduced physician hours make it clear that Atlas is ready to start shrugging.

It will be a painful learning experience, but one that Canadians and Europeans have already handled. We will likely lose a few stars on our patient satisfaction ratings.  But continuing as we’ve done for the last thirty years is only going to bankrupt the country.

Go ahead, Congress, do your worst — and watch what doesn’t happen when you do.

Stella Fitzgibbons is an internal medicine physician who blogs at the Placebo Journal Blog.

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