As of Monday, March 1st, 2010 physicians across the United States will have a 21% payment reduction in fees for procedures paid for services provided to Medicare patients. The formula in place which calculates how physicians are paid by medicare is based on a flawed system and there has been ample opportunity to fix this problem. Medical associations have been trying to have this fixed but there has been little support to the physician. It simply hasn’t been an important problem to congress or the President and now it will have a destructive impact on the medical system. This is an unacceptable change which will be burdensome to many, if not all physicians. This will directly affect American access to medicare care and should be a wake-up call to anyone advocating the current Obama healthcare plans.
As a plastic and reconstructive surgeon I am fortunate to not have my entire income dictated by an income source such as insurance, but it certainly affects my practice www.delawarevalleyplasticsurgery.com. I make a good living performing cosmetic procedures and thus insurance cases such as Medicare breast reconstructions are performed to help people who truly need a reconstructive procedure. I perform these procedures to help people, even if the reimbursement was already laughable. At the current rates, after costs such as overhead, malpractice insurance, office staff it will actually cost me money to provide services such as flap reconstructions for wounds, skin cancer reconstructions, breast cancer reconstruction, etc. While at this point I have not decided to stop providing these services, something needs to done to correct the problem! I may very well review all of the options and simply stop providing these needs.
As a plastic surgeon I was trained in all aspects of Plastic Surgery, not just cosmetic surgery. When payors such as medicare make 21% cuts in reimbursement it becomes cost prohibitive to provide these services. I currently do procedures other than just cosmetic surgery including breast reconstruction, cancer reconstruction, ER trauma, and complex woundcare. Many plastic surgeons will make the decision to stop doing anything non-cosmetic, and the patient will be the one to suffer here. While my practice will likely be safe as a result of the diversity of procedures I perform, a plastic surgeon performing only reconstructive surgery will not survive. They will be driven to perform more cosmetic surgery over reconstruction which is simply not the forte (or interest) of some purely reconstructive surgeons. I consider myself lucky to not be dependent on insurance companies or medicare, but not every physician is in this position.
News outlets aren’t out there screaming about this 21% reduction. It is unpopular to publicize physicians complaining about their income. Physicians are typically viewed as “rich” and thought to be able to afford the loss in income. Nobody seems to remember the residency years where they were paid virtually nothing nor the hundreds of thousands of dollars of debt many accrue during training. No other group would accept a 21% reduction in their pay overnight. Salaries of their staff will not change. Overhead will not change. Insurance costs will not change!
What about the cardiologists dependent on medicare? The internists? The family doctors? What will they do? 21% income reductions to practices that largely treat the elderly will be devastated. This will result in support staff losing jobs, fewer patients having access to care, and an overall destruction of the medical system in the United States.
A 21% reduction to most physicians will destroy many practices already struggling in this economy. If this is the type of “Change” that our government sees fit, it will destroy medicine. Fewer and fewer patients will have access to medical care as doctors will simply stop accepting medicare. Any healthcare “CHANGE” that does not adequately reimburse physicians for the care they provide and adequately address costs such as tort reform is unacceptable.
