Here Comes the Health Care Bill ... There Go the Doctors

With passage of the health care overhaul looming, many physicians are really getting nervous because of the potential for disaster that this bill poses to the American health care system. Sure, reform is needed - no one denies that. But I have some concerns in the short term with the possibility that this bill could be signed as soon as Sunday.

1. Doctor shortage. I truly believe that we don't have enough health care practitioners to deal with the influx of patients that are going to be so quickly added to the insured pool of Americans. Why? Because I can hardly find a physician in the tri-state area that has an open panel available to take new Medicaid patients, and if you don't believe me, try it yourself.

2. There is no "doctor fix" in the language of this bill. What does this mean? Since the late 1990s, there has been an option for the federal government to cut back on reimbursement for Medicare, meaning that in times of significant deficits, the government can cut back 5, 10, even 15 percent from what currently reimburses doctors accepting Medicare. Physicians can not have any kind of realistic expectations to adjust their income based on inflation and operational cost, because at any moment, our revenue could decrease significantly.

3. No tort reform. Many physicians will continue to practice defensive medicine or leave medicine all together because of the lack of tort reform in the current health care bill. For most doctors, we'll be adding 30-40 million new potential clients for the American Bar Association, so unless they add in some significant tort reform, many high-risk specialties - including OB/GYN and surgery - will be hard to find in this country.

For example, the statute of limitation for physicians in my specialty is 21 years. That means that it is not out of the realm of possibility that a parent could find a lawyer to represent them when their child doesn't get into Harvard and they decide that something went wrong during delivery that caused a learning disability. I know it's a far reach, but these are the realities that doctors in high-risk specialties have to deal with every day.

Click here to read about the changes to the health care bill.

Trying to attract doctors into this field is going to be difficult, and there will be a push for more physician extenders. That means patients will only get to see a physician assistant or nurse practitioner because the doctor will not have enough time to see all patients unless they have a serious problem.

At the end of the day, we're talking about a 900+ billion dollar health care bill that will change the face of this country. If this bill is passed on Sunday, come Monday morning, we're going to wake up in a completely different world.