Does it Matter if Your Doctors Oppose ObamaCare? Part 1

August 21st, 2013 By Steven Knope, MD

This will be the first of a two-part newsletter. In Part 1, I will explain why many doctors are leaving medicine. Next month, I will explain why some of us have decided to stay – not only in body, but in mind and in spirit.  

So that my comments today are not interpreted as sour grapes, understand that ObamaCare has not been bad for my practice. In fact, patient-concern over ObamaCare has caused my practice to grow. Patients are worried about the looming doctor shortage and concierge practices across the country are filling rapidly. However, the majority of doctors will be impacted by this law. I take no pleasure in the fact that ObamaCare has caused my practice to thrive, while my colleagues are suffering. Indirectly, ObamaCare will affect all of us.

Since many physicians strongly object to ObamaCare, it is reasonable to ask the question, “Does it matter?” Putting aside your own politics for a moment, left or right, should it matter to you that many of your doctors and specialists oppose this law?

Doctors understand that their professional autonomy will be diminished by ObamaCare. They also know that their incomes will drop. This will affect their personal lives. In anticipation of these changes, many physicians have already sold their practices to hospitals. Many have decided to retire early. As an example, one of my colleagues, a 44-year-old specialist in his prime, has already implemented an early retirement plan. Last year he cut back to part-time. In his words, he is now “semi-retired.” He will leave medicine all together in 3 years. This doctor is board-certified in three different areas of medicine and has 15 years of clinical experience. That kind of doctor cannot be replaced. This is a profound loss to the community. It doesn’t matter if you are a Democrat or a Republican, whether you support ObamaCare or oppose it. If you get sick, you will no longer have the benefit of this physician’s unique skills and judgment.

ObamaCare Health Care Bill SigningWere Doctors Ever Asked?

With all of the talk about how ObamaCare might affect patients, insurance companies, employers and the pharmaceutical industry, there is one group that was never consulted: Doctors. Sure, there were appearances made. Politicians claimed that doctors were backing the law, because the AMA supported ObamaCare. However, most people are not aware that less than 16% of physicians belong to the AMA. In a survey done by Jackson & Coker in 2011, 70% of physicians disagreed with the AMA’s position on ObamaCare.

How Many Doctors Will Leave Medicine?

It is unclear just how many doctors will quit medicine as a result of ObamaCare, but in a recent survey, 6 in 10 physicians said they believed many doctors will retire earlier than planned. If true, this will exacerbate the current shortage of physicians.

Atlas Shrugged:

Ayn Rand’s epic novel, Atlas Shrugged, was written in 1957. For those who have not read this classic, the storyline is eerily similar to present life in America. In the novel, the federal government has become corrupt and incompetent. Medicine has been nationalized. The economy is faltering. People cannot find jobs. A previously thriving city that produced motors, like Detroit, has gone bankrupt. The government, under the guise of “fairness” and “justice,” imposes increasingly oppressive laws on the successful. Wealthy and successful people are vilified. Ultimately, business leaders, doctors and other professionals silently leave their posts and disappear from society.

In Atlas Shrugged, there is a prescient monologue from one of the characters, Dr. Hendricks, on the issue of nationalized medicine. Dr. Hendricks, a neurosurgeon, describes why he left medicine:

“I quit when medicine was placed under State control, some years ago,” said Dr. Hendricks. “Do you know what it takes to perform a brain operation? Do you know the kind of skill it demands, and the years of passionate, merciless, excruciating devotion that go to acquire that skill? That was what I would not place at the disposal of men whose sole qualification to rule me was their capacity to spout the fraudulent generalities that got them elected to the privilege of enforcing their wishes at the point of a gun. I would not let them dictate the purpose for which my years of study had been spent, or the conditions of my work, or my choice of patients, or the amount of my reward. I observed that in all the discussions that preceded the enslavement of medicine, men discussed everything – except the desires of the doctors. Men considered only the ‘welfare’ of the patients, with no thought for those who were to provide it. That a doctor should have any right, desire or choice in the matter was regarded as irrelevant selfishness; his is not to choose, they said, only ‘to serve.’ That a man who’s willing to work under compulsion is too dangerous a brute to entrust with a job in the stockyards – never occurred to those who proposed to help the sick by making life impossible for the healthy. I have often wondered at the smugness with which people assert their right to enslave me, to control my work, to force my will, to violate my conscience, to stifle my mind – yet what is it that they expect to depend on, when they lie on an operating table under my hands? Their moral code has taught them to believe that it is safe to rely on the virtue of their victims. Well, that is the virtue I have withdrawn. Let them discover the kind of doctors that their system will now produce. Let them discover, in their operating rooms and hospital wards, that it is not safe to place their lives in the hands of a man whose life they have throttled. It is not safe, if he is the sort of a man who resents it – and still less safe, if he is the sort who doesn’t.”

And now life is imitating art. Real doctors are following the lead of Dr. Hendricks. What should concern people is that the sentiments from this fictional character represent precisely how many doctors feel today. My 44-year-old colleague could have written this monologue. Doctors feel that they are being enslaved. They are now, in the words of Dr. Hendricks, “withdrawing their virtue.” When doctors – not just one, but many – begin withdrawing their virtue from society it is an ominous sign. Something is terribly wrong. This is more than a political issue.

Why Weren’t Doctors Ever Asked About ObamaCare?

I suspect the reason that doctors were never asked for their opinion on ObamaCare is that this law was written by politicians; politicians who are also lawyers. Trial lawyers follow a cardinal rule, which is that you never ask a question of a witness unless you already know the answer. The politicians never asked doctors how they felt about ObamaCare because they already knew the answer.

You Could Just Get an Exemption!

To inject a little comic relief into this gloomy subject, you may have read that Congress exempted themselves and their staff from ObamaCare two weeks ago. Interestingly, the rationale for this exemption was that if Congress had to follow their own law as it was written, they would lose valuable members, which would create a “brain drain” in the Capitol. Really?! Congress has an approval rating of 15%, which is astounding when you consider that over 30% of Americans believe in UFOs! So we are to believe that if Congress were forced to follow the law that they themselves wrote, they would lose some of the great minds that make up this august body. Meanwhile, these politicians have expressed no concern over the fact that ObamaCare is causing a very real “brain drain” in medicine – a profession where most would agree that having a brain actually matters.


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