Posts Tagged SGR

Why the “Doc Fix” debate matters to all of us

There is once again lots of discussion in the healthcare community over what we lovingly call the “Doc Fix.” The doc fix is that annual struggle in Congress to un-do the automatically triggered reduction in physician payment based on the entirely UN-sustainable “Sustainable Growth Rate” (SGR) formula. I am not the person to explain that formula, but feel free to read all about it on your own. My message today is less about formulae and policy, and more about what it means to you and me.
So, for those who are NOT regularly tuned in to healthcare issues beyond the fact that you or someone you know is occasionally a patient, google “doc fix” and read the most recent news — or just read the article at the link at the bottom of this page. Once you have read a bit on the topic, it will be easy to dismiss this as “rich” doctors complaining. That’s reasonable, but consider this: We KNOW (lots and lots of data support) that where there is a strong primary care infrastructure, where primary care docs are an integral part of the healthcare team (where patients have a “patient centered medical home”) healthcare costs go down and health outcomes improve (the system spends less to keep you healthier). Now consider that your son or daughter (or YOU) are considering going in to medicine, and really wants to be a family physician and deliver the kind of high quality primary care that our country so desperately needs. They (or you) can do that and all it will take is about $200k in debt – or the equivalent in personal wealth, willingness to work harder and less family-friendly hours than most of your physician colleagues, start the “earning” portion of their (or your) career in your 30s making barely enough to cover that debt…and never approach the salaries earned by your anesthesiologist, dermatologist, or almost any other “ologist” colleagues (in many cases earning 50% or more LESS) and have the additional pleasure of being told by the government that their (or your) pay will be arbitrarily reduced by 30% — and even if the self-important (er…I mean “well-intentioned”) politicians to whom we entrust our government DON’T do that, your paycheck is going to be held hostage for 10 days or so while those same “well-intentioned” Congressional representatives bicker over politics.
A person capable of being accepted in to medical school is clearly smart enough to be a doctor, or for that matter any other thing they may choose to be. So ask yourself, would you choose the path of a primary care physician? WHY would you want your son or daughter to choose that path?
If we want the kind of healthcare we deserve then this annual exercise of the “doc fix” must end once and for all with a new formula that replaces the SGR, and our system that rewards procedures at the expense of coordinated care MUST change. If not; if we don’t force our representatives to make difficult choices based on what is right rather than on how to keep all “voting blocs” happy, I fear that there will be no one left to provide the primary care that we deserve.
As always — and perhaps even more than always — these are my opinions and not necessarily the opinions of my employer (although I’d be willing to bet that most of my members agree).

The article I mentioned on the “doc-fix:”

Info on the PCMH:


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