Could 'reform' drive doctors out of medicine?

The New England Journal of Medicine cites interesting poll numbers on the reaction of physicians to proposed federal legislation that would greatly expand the government's role in medicine. At a time when the Bureau of Labor Statistics is predicting 22 percent growth in demand for physicians by 2018, "24.7% of physicians stated that they would 'retire early' if a public option is implemented, and an additional 21.0% of respondents stated that they would quit practicing medicine, even though they are nowhere near retirement.   This brings the amount of physicians who would leave medicine to a total of 45.7%"

In the case of passage of the current health care "reform" bill without a so-called public option, the number of physicians planning to flee medicine drops -- to "only" one-third.

The NEJM (which is not known as a free-market mouthpiece) notes that not all docs who express a desire to leave medicine after the passage of unwelcome legislation are likely to follow-up on their threats, but "even if a much smaller percentage such as ten, 15, or 20 percent are pushed out of practice over several years at a time when the field needs to expand by over 20 percent, this would be severely detrimental to the quality of the health care system." Demoralization of the remainder could also cause problems in terms of numbers of patients seen and the quality of medicine provided.

Why are docs unhappy? Says Medicus, the company behind the survey:

Over 50% of physicians who responded predict that a health reform would cause the quality of medical care to deteriorate in America.  When asked how health reform could affect the quality of medical care, 40.7% stated it would "decline or worsen somewhat," while another 14.4% stated that the quality of medical care would "decline or worsen dramatically".  If a public option is implemented as part of health reform, 64.1% of physicians predict that the quality of medical care in general will decline.

"Many physicians feel that they cannot continue to practice if patient loads increase while pay decreases. The overwhelming prediction from physicians is that health reform, if implemented inappropriately, could create a detrimental combination of circumstances, and result in an environment in which it is not possible for most physicians to continue practicing medicine," states Kevin Perpetua, Managing Partner for The Medicus Firm's Atlanta division.  "With an average debt of $140,000, and many graduates approaching a quarter of a million dollars in school loans, being a doctor is becoming less and less feasible.  Health reform, and increasing government control of medicine may be the final straw that causes the physician workforce to break down."

Instead of the proposed legislation, the NEJM says the surveyed physicians have alternative ideas: "Tort reform appeared repeatedly, as did patient responsibility and ownership in their health care and costs. Additionally, many physicians emphasized a need for addressing specific issues with separate legislation, as opposed to one sweeping, comprehensive bill."

The survey of a random sample of 1,195 physicians was conducted by The Medicus Firm, which specializes in physician recruitment.