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Physicians Prepare To Deal With Increased Demand, Strain On Practices Under Obamacare

In 2011 Nearly One-Third Of Physicians Said They Would Not Accept New Medicaid Patients, But Rising Fees May Help

Decotiis says that if reimbursement rates under ObamaCare are too low, she may need to stop practicing internal medicine and instead focus only on the weight loss and hormonal-treatment facets of her practice, for which she receives direct payment from patients instead of reimbursements from insurance companies. If those reimbursement rates go way down, it might not be worth my while, Decotiis told We have rent to pay, salaries, more administrative, my overhead will probably go up to do that. If Im making less and overhead goes up I may have to say, I dont know if I can do this. Meanwhile, physicians in rural areas of the country who act as the primary health care providers for entire communities will have to make adjustments as well. One of the most immediate changes that physicians in these areas expect to see is an increase in patients seeking preventive health care something many avoided when uninsured. A lot of patients that went down to emergency rooms wont be getting care in the emergency room anymore. Well be doing more preventive care, more screening, Dr. Charles Cutler, a private practitioner in Norristown, Pa. and chair of the American College of Physicians, told However, scheduling more routine check-ups and screenings may place a strain on already short-staffed practices in rural areas. As a result, some doctors are considering handing over some basic aspects of patient care and education to nurses, nurse practitioners, or physicians assistants in order to treat patients more efficiently. Dr. Jason Marker, of Wyatt, Indiana, who sees 100 people a week and provides health care to about 2,000 people in his small community every year, is already looking to hire additional staff members in order to meet the increased needs in his community. With that will come additional overhead, but hopefully I will be able to balance that against volume changes in patient care, Marker, a member of the American Academy of Family Physicians Foundation, said.

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The Physicians’ Crusade Against Abortion


The historians argued that since these reasons now were obsolete or not credible, the Court should reaffirm the constitutional right to abortion it had announced in Roe v. Wade. The brief relied heavily on Mohrs book. In truth, however, Abortion in America actually showed that almost all of these physicians opposed abortion because they saw it as the killing of a living human being. In his book Mohr acknowledged that the sincere belief of physicians that abortion was morally wrong helps to explain the intensity of their commitment to the cause. Mohr wrote, The nations regular doctors, probably more than any other identifiable group in American society during the nineteenth century, including the clergy, defended the value of human life per se as an absolute. Scholars interested in the medical mentality of the nineteenth century will have to explain the reasons for this ideological position . But whatever the reasons, regular physicians felt very strongly indeed on the issue of protecting human life. And once they had decided that human life was present to some extent in a newly fertilized ovum, however limited that extent might be, they became the fierce opponents of any attack upon it. Mohr went on to note, Physicians who personally believed abortion to be morally wrong and their many fervent writings on this subject must be taken as evidence of their sincerity must have been frustrated by the persistent lack of public support for their position. However, Mohr provided almost no examples of these fervent writings in his book. In his chapter, The Physicians Crusade against Abortion, he provided a single extended quote from an Illinois physician, James S. Whitmire, written in 1874: Many, indeed, argue that the practice is not, in fact, criminal, because they argue that the child is not viable until the seventh month of gestation, hence there is no destruction of life. The truly professional mans morals, however, are not of that easy caste, because he sees in the germ the probable embryo, in the embryo the rudimentary foetus, and in that, the seven months viable child and the prospective living, moving, breathing man or woman, as the case may be. Actually, a more typical and certainly more fervent passage from Whitmire can be found in the same article: Persons who engage in this crime, whether they are professional or self-abortionists, have lost all the natural instincts of humanity; they have neither principle nor good morals, and are, hence, an eyesore to society, a plague-spot upon communities where they exist lepers, whose infectious breath undermines the very foundation of the morals of the people, and should not be tolerated for a single day, when and where they are known. Another typical example was a long letter published in the Boston Medical and Surgical Journal in January 1851. In it, Rhode Island physician John Preston Leonard wrote, Besides these bills of mortality, the records of criminal courts will furnish sufficient proof that this crime is every day becoming more prevalent. It is humiliating to admit that there are a class of physicians who, Herod-like, have waged a war of destruction upon the innocent. Dr. Storer himself penned many eloquent statements in opposition to abortion. In the January 1859 issue of North-American Medico-Chirurgical Review, he wrote, If we have proved the existence of foetal life before quickening has taken place or can take place and all by analogy, and a close and conclusive process of induction, its commencement at the very beginning, at conception itself, we are compelled to believe unjustifiable abortion always a crime. Unfortunately, later in his book, Mohr confused the issue by discussing physicians professional reasons for opposing abortion before their personal reason of defending the unborn.

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Decker (sdecker{at} is an economist at the National Center for Health Statistics, in Hyattsville, Maryland. Abstract When fully implemented, the Affordable Care Act will expand the number of people with health insurance. This raises questions about the capacity of the health care workforce to meet increased demand. I used data on office-based physicians from the 2011 National Ambulatory Medical Care Survey Electronic Medical Records Supplement to summarize the percentage of physicians currently accepting any new patients. Although 96percent of physicians accepted new patients in 2011, rates varied by payment source: 31percent of physicians were unwilling to accept any new Medicaid patients; 17percent would not accept new Medicare patients; and 18percent of physicians would not accept new privately insured patients. Physicians in smaller practices and those in metropolitan areas were less likely than others to accept new Medicaid patients. Higher state Medicaid-to-Medicare fee ratios were correlated with greater acceptance of new Medicaid patients. The findings serve as a useful baseline from which to measure the anticipated impact of Affordable Care Act provisions that could boost Medicaid payment rates to primary care physicians in some states while increasing the number of people with health care coverage. Health Aff August 2012 vol. 31 no. 8 1673-1679 Abstract

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This entry was posted on October 8, 2013 by .
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