New poll indicates 40% of physicians will retire or find other work under ObamaCare

posted at 3:35 pm on December 10, 2010 by Ed Morrissey

During the ObamaCare debate last summer, Investors Business Daily took a survey of practicing physicians to see whether they were contemplating “going Galt” if ObamaCare passed.  Their survey showed that 44% of all doctors would consider retiring or pursuing other lines of work in the new system, but critics widely panned the survey as biased and accused IBD of pushing its agenda through rigged polls.  Today, IBD claims vindication in a new survey conducted by Merritt Hawkins for the Physicians Foundation — which largely corroborates the earlier poll:

Now a Merritt Hawkins survey of 2,379 doctors for the Physicians Foundation completed in August has vindicated our poll. It found that 40% of doctors said they would “retire, seek a nonclinical job in health care, or seek a job or business unrelated to health care” over the next three years as the overhaul is phased in.

Of those who said they planned to retire, 28% are 55 or younger and nearly half (49%) are 60 or younger.

A larger portion (74%) said they plan to make “one or more significant changes in their practices in the next one to three years, a time when many provisions of health reform will be phased in.”

In addition to retirement, and finding nonclinical jobs elsewhere, those changes include working part time, closing practices to new patients, employment at a hospital, cutting back on the number of patients and switching to a cash or concierge practice.

That would exacerbate an expected physician shortage over the next few years, making the goals of ObamaCare even more difficult to obtain.  The main thrust of the program insures more low-income people through Medicaid, an insurance that already has more physicians leaving than joining.  The exodus of physicians from the overall market means fewer choices for all consumers, longer wait times, and a degradation in outcomes.

IBD also notes that the Physicians Foundation is a group whose members are taken from the AMA.  The AMA supported ObamaCare, and the physicians in this sample could be expected to be more supportive as a result than the overall population of doctors, inside and out of the AMA.  IBD’s original survey sample in August 2009 included both, which may be the slight difference between the two polls.

It won’t just be early retirements and practice closings that create problems, either.  The same disincentives driving those decisions will also keep new doctors from providing more supply to the market.  Those coming out of the medical schools and teaching hospitals will find other jobs, especially those who show enough promise to choose their own ticket.  It’s a worrisome scenario for the future of American health care.

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KMC1, that is why the cost of a medical degree should be reduced and tort reform should be passed.

SC.Charlie on December 10, 2010 at 4:29 PM

Charlie, I don’t know how you would propose to reduce the cost of med school, however I would just point out that the cost of med school is NOT the issue that is causing our health care costs to rise, nor does it necessitate us having to live in a Socialist or Autocratic society of any kind.
I do totally agree with you regarding the need for tort reform however. There are numerous examples of doctors ordering tests that probably aren’t needed for the patient, but do so to avoid the potential for a lawsuit. It’s also an amazingly unfair system in regards to punishing people who are doing their best to TRY TO SAVE/TREAT people. Mistakes happen. That’s the human condition. Should a person be ruined for life for making an honest mistake? Should our entire medical industry be burdened with insane costs for preemptive medicine? What about not only the cost, but the timelines for bringing drugs/treatments to market? Should it really cost many billions to create a drug, and keep potential life saving treatment from patients for decades? I think we probably mostly all agree to the answers to these questions.

It’s not limited to the costs of the education…the time invested and required is considerable. Adults have to figure out how to fulfill the years of academic requirements while also supporting themselves and families and still excel at the academics. It’s a very difficult and long haul, very complicated if not impossible for individuals who lose or never create their own families (who then support them usually through their mid-thirties if not longer if they specialize).

Lourdes on December 10, 2010 at 5:38 PM

This is my salient point in the matter. I personally know several doctors who do not have children of their own, simply because their careers are too demanding. Great women who would be fantastic parents, pillars of the community who are childless. But WHO ARE THE PEOPLE HAVING MULTIPLE CHILDREN?????? WHAT IS OUR CURRENT SYSTEM PROMOTING???? Certainly NOT rewarding hard work and sacrifice. Certainly not incentive to contribute and be responsible.

Anyway, I think most of us agree on all these points. What I don’t understand is how the Left can see things SO incredibly differently on these kinds of issues.

KMC1 on December 10, 2010 at 6:56 PM

No doubt that some docs who are able to retire early will choose to retire early.
And no doubt that some docs will change careers where there is an opportunity to do so.
Likewise, many talented people will choose careers other than medicine.

But there will always be plenty of people willing to be docs.

The problem is much more insidious than not having enough bodies to act as doctors.

The problem is going to increasingly be one of quality rather than quantity. It already is. It’s just that most people aren’t consciously aware of the degradation of quality. And as things slowly worsen, they will forget the past and become accepting of the new reality of low quality docs.

In a global view, what else would one expect to happen to the quality of physicians?
Take a profession- any profession- and makes the rewards lower and the hassles greater.
What do you get?
Lower quality practioners in that field.
And an infinitely lower level of dedication to excellence in the field as the job becomes just that- a job.

justltl on December 10, 2010 at 7:24 PM

I posted this a while back on The American Thinker. Here’s why I wouldn’t encourage my kids to go into medicine:

April 05, 2010

What Obamacare will cost doctors

Chris Link, MD

One of the most interesting, if unanticipated, effects of posting YouTube videos is managing the “comments” section. I have a serie s of politically oriented song parodies that I have posted over the past eight months. The first, “One Single Payer System”, has more than one million views (thanks to links posted in blogs such as The American Thinker). However, I did not realize I would be taking up the job of de facto moderator for a running debate with more than 1,200 entries in the case of “Single Payer”.

One post asked a very good question: “Why can’t we just put everyone in the country on Medicare?” Aside from the problem of a huge expansion in the unfunded obligations for the Medicare program, currently estimated to be $89 trillion, my immediate thought was that you can’t stay in business as a physician at Medicare reimbursement rates.

I used my specialty, anesthesiology, to illustrate the problem. Using the best information I could find and the example of my own solo practice, I came up with some sobering figures.

Anesthesiologists bill for most surgical cases with a combination of base units depending on the particular surgery (e.g. cardiac bypass has a higher base value than a hernia repair), plus one time unit for every 15 minutes. The average anesthesiologist bills 10,198 units in a year. Medicare pays, on average, $20.925 per unit. Now $213,393 a year sounds like a pretty decent living for most of us and it certainly would be until you start backing out expenses.

A billing service is in the neighborhood of 6% ($12,804) and average malpractice is about $23,000. I’m paying around $15,000 a year for health insurance for a family of four. Various expenses for continuing education, computers, cell phone, office supplies, etc. adds up to around $5,000. AMA, state and local medical society and American Society of Anesthesiologists dues add up to $1,700, if one chooses to join. I’d like to retire someday, so I put away 10% for retirement. Self-employment taxes take $17,154. And I have no employees or office. Most medical practices have a much higher overhead both in real terms and as a percent of revenue.

So what’s left?

$117,753, but without the “doctor fix” it would be $85,770. All that in exchange for 50-60 hours a week (including being on-call), coming out of school with an average student loan debt of $156,000 with a payment of over $1,000 per month, and putting your life on hold until at least age thirty. Suddenly it doesn’t look like such an attractive option.

And then there’s the guy you knew in college who coasted through studying sociology and went to work for the US Department of Health and Human Services right after graduation. He’s had eight years to climb through the bureaucratic ranks and is now one of the 19% of the federal workforce that makes over $100,000 and that’s before bonuses and overtime. And you always thought he was kind of an idiot.

The average pay of a federal worker in now $71,206, compared with $40,331 in the private sector. Excellent fringe benefits widen the gap even more.

Most of my colleagues are similar to me in coming from middle class backgrounds. I worked to go to school and probably paid for half of my education at a state university. I borrowed money for medical school. Another significant number of doctors are second or third generation physicians, but very few come from well-to-do non-medical backgrounds. And what will happen when medicine is no longer an attractive option for bright motivated youth to move up the socioeconomic ladder?

See that assistant supervisor at your local DMV? The guy sitting in the office drinking coffee, shuffling reports and playing solitaire on the computer?

Meet your heart surgeon.

misterdregs on December 10, 2010 at 7:24 PM

“Now $213,393 a year sounds like a pretty decent living for most of us and it certainly would be until you start backing out expenses.” gee misterdregs, if your biggest concern is how you can get by on a measly $213,393 dollars a year, remind me not to have you as my anesthesiologist…

pm123 on December 10, 2010 at 7:39 PM

That would exacerbate an expected physician shortage over the next few years, making the goals of ObamaCare even more difficulteasier to obtain.

That is, it will make it easier once they bring in doctors from the Third World willing to work long hours for little pay. Granted, the new doctors will be of sliiiightly lower quality, but you can’t make an omelet without breaking a few eggs, you know.

tom on December 10, 2010 at 7:43 PM

pm123 on December 10, 2010 at 7:39 PM

Learn to read. He pays out nearly 50% in taxes and fees. With the expiring of the ‘doc fix’ boondoggle, that jumps to 60%. When you have a federal worker making the same base salary would pull in substantially more net income.

kerncon on December 10, 2010 at 9:04 PM

Yep, the usual socialist country’s solution, call up Fidel and import some of those crack Cuban doctors. That’s the ticket.

slickwillie2001 on December 10, 2010 at 9:28 PM

Great, our feet will be safer then. Barry is really looking out for us. It is really a messaging problem, and that WILL be corrected with BJ speaking for Barry.

bayview on December 10, 2010 at 10:30 PM

pm123 on December 10, 2010 at 7:39 PM


El_Terrible on December 11, 2010 at 12:36 AM

PM123 it’s pretty obvious that you didn’t bother to actually read misterdregs post and try to understand it. In fact, you sound an awful lot like one of those people who sit back and talk about how” lucky” or “fortunate” someone is to have a “good” job like he does. One of those people who while misterdregs was pulling 40 hour shifts through residency, was out swilling PBR’s and trying to get laid in between working serving ice cream down at the shore.
You know, there’s a saying that’s used quite often on this board…”elections have consequences”…. you may have heard this used? Well, life choices have them as well. And IF you were willing to live a lifestyle devoid of any frivolity, burdened with incredible responsibility where ONE bad day can cost you not your job, but your entire life’s work….put off having a real relationship, children and putting down roots…not to mention working 80+ hour weeks for YEARS ON END….then you would be “lucky” too.
Honestly, people who believe its their “right” to dictate to others what their income should be, absolutely disgust me. Freeloader Communists.

KMC1 on December 11, 2010 at 2:29 AM

Actually kerncom, the only tax included is the self-employment tax as to equalize the comparison with someone who is employed. So this is not the net after federal income tax, state and local taxes or FICA and Medicare payroll taxes.

And the example I use is a ridiculously low overhead practice. Most physicians have office space, nurses, receptionists, billing personnel, medical supplies, etc. that I don’t.

Obviously, the guy didn’t read the whole piece.

misterdregs on December 11, 2010 at 8:18 AM

One big thing that could be done to increase supply is to no longer require foreign doctors to complete a residency in the US before they practice here.

Jimbo3 on December 11, 2010 at 10:28 PM

Proof that the democrat party is anti-life. The party of death.

Inanemergencydial on December 11, 2010 at 10:50 PM

Worked out so great for the British, right jumbo?

Inanemergencydial on December 11, 2010 at 11:59 PM

pm123 on December 10, 2010 at 7:39 PM

This is exactly the thinking the Democrats depend upon as they attempt to soak the “rich”. Look at the gross and say “hey, that person is really rich!”

And misterdregs didn’t even factor in the reduced earnings he had to endure during his time in school — which income lack he has to make up for with both purchases and retirement contributions. If the feds still had income averaging, he’d be in good shape, but they did away with that a long time ago.

unclesmrgol on December 12, 2010 at 12:47 AM

It seems to deserve being said that, to my knowledge, no one who had anything to do with writing and passing the bill has lost life, limb, or even teeth as a result. In general, I’m amazed when I consider the extent to which one can render men and women docile, largely by letting them vote now and then. “I had my say at the polls, and now all I can do is go home and wait for whatever comes.” It seems as if every voter has agreed to become 1/100,000,000 of a whole person.

Kralizec on December 12, 2010 at 1:11 AM

Perhaps we should pass a new law that says that everyone who attains the age of 65 should be put to eternal sleep. That would solve the medical cost problem and the underfunding of Social Security and government pensions. Also, it would eliminate many of the old farts in Congress/s

SC.Charlie on December 12, 2010 at 6:09 PM

if your biggest concern is how you can get by on a measly $213,393 dollars a year, remind me not to have you as my anesthesiologist…

pm123 on December 10, 2010 at 7:39 PM

Boy you just don’t get it, did you read the entire post? You don’t have a clue what it takes to get where this man has gotten. I do, have several docs in the family and it is brutal. We will all lose the good ones. It is not for the money, because they are all going to get screwed.

wi farmgirl on December 16, 2010 at 8:34 AM