Dr. Manny: Now that you have insurance, will you be able to see a private doctor?

I’m still reacting to President Obama’s vision of overhauling healthcare.  Now that “Obamacare” is the rule of the land, I think that many people – maybe not today but in three or four years – are going to wake up to the realization that the way they used to think about medicine has dramatically changed.

First, a couple of simple facts.  There are approximately 209,000 primary care doctors currently practicing in the United States, and surveys have determined that in many states, there will be a significant doctor shortage by 2020.  Not only are populations aging, but population concentrations in many big cities are increasing, making the balance of physician-patient ratio difficult to maintain. In states like Nevada, Arizona, Florida, Texas, and Idaho, many people believe that there will be challenges in finding primary care doctors.

In 2008, one-third of physicians worked solo or worked in two physician practices.  In addition, 56 percent were full or part time owners of their own practices, while 44 percent of physicians were employees.  Well that balance is quickly changing, and most likely, physicians in America will end up becoming employees of hospitals or multi-specialty groups of over 50 doctors.  And that’s just physicians – imagine the problems we will have in getting nurses into these major cities.

If you examine the prospective patient groups who will become add-ons to the states’ current Medicaid patient volumes, in many areas that could mean 20 to 30 percent of new patients enrolling now on Obamacare.  So I ask you: Do you think you’re going to be able to find your private doctor whom you want to see in his private office or the doctor that took care of your mother, father, you and your children?  No, I don’t think so.

I think what we’re going to see perhaps in five years are health centers in many areas of our country that very much resemble the DMV office, the social security office or the post office.  And you know how efficient they can be.  You will need to get up early in the morning so you can get a good spot in a very long line, just so you can get your annual physical.

Let’s face it – federal agencies get a ‘stellar’ performance for quality, efficiency and customer satisfaction.  At least that’s what the government wants you to believe.  So I guess health care centers will soon join the ranks of these illustrious agencies.