Physicians ‘going Galt’

Hot Air has a thread up on a 63-year old dermatologist (a low-burnout specialty, mind you) in Scottsdale, AZ, who announced on his office door that he would retire before BHOzoCare went into full effect. There’s an interesting, lively discussion in the threads that suggests he’s just the tip of the iceberg.

In case you think a dermatologist mostly deals with teen acne anyhow, think again:

The man is in Arizona, skin cancer capital of the US and home to lots and lots of elderly people; he’s been in practice since the 70s; he’s talking about Medicare patients.[…] One Arizona retirement community can provide (or could previously provide) enough Medicare customers to keep several dermatologists in business.

The phenomenon of physicians refusing to accept new Medicare patients is not new. Now, apparently, another phenomenon begins: ‘cash-only practices’, where health care providers do not accept insurance of any kind but only ‘cash on the barrel’. If you can get a refund from the insurance company yourself, more power to you; if not, it’s your problem.

Also, get this nugget from the comments:

If the 63-year-old deciding to retire doesn’t bother you, maybe a 47-year-old deciding to will? My sister-in-law is 47, and is overworked in her practice under the current system. She hates to think of giving up the work she trained for so many years to do, and has spent nearly two decades becoming a respected professional in.

But there is a strong probability that she will do just that if Obamacare isn’t repealed. The rewards would no longer outweigh the expense and aggravation. Her good friend and partner (in a multi-physician practice) is also looking at the same thing. If they quit the practice, it will almost certainly have to break up, and its partners reevaluate their professional arrangements and even life choices.

My brother and sister-in-law aren’t sure what they’ll do. He’s an electrical engineer, and the two of them would be employable overseas, which is something they’ve been seriously considering. They hate to uproot the kids, but what matters is opportunity and a promising future.

What they will not decide is that Lynne will remain in practice in the US, under the worse conditions that are inevitable with Obamacare. It’s not even just workload and pay. As the Arizona doctor’s comments make clear, it’s loss of professional discretion while still being stuck with all the liability, and higher penalties. It just won’t be worth it. A very large number of those who have the option of dropping out will.

In the past, professionals would seek to immigrate to the USA in search of oppostunities. Now we have some seeking to emigrate to do so. The world is standing on its head.

And here is a cold shower for those of us who thought that NPs (nurse practitioners) are always a ‘good enough’ replacement for MDs:

I went to the doctor for what I thought was just a chest cold. Certainly that’s all that the signs pointed to. The nurse did a quick check and made a few notes. My doctor, an amazing woman, spent time with me and asked several dozen questions while giving me an increasingly serious set of tests.

Finally , she called for her nurse and told her to get a wheelchair, and get me straight to the (attached) hospital. The nurse looked as confused as I was. The doctor made a call to the emergency room and off I went for a battery of tests and treatments I was sure were a waste of time.

Sometimes the body can’t recognize an infection, gives up fighting an infection, or simply doesn’t know how to do so. You’ve probably heard of similar things, though often described incorrectly with such terms as “walking pneumonia”, etc

Hours later in the ICU, oxygen on high and a mix of powerful IV antibiotics and steroids pumping into my arms, I found out how close I had come to dieing. I still have some scarring and reduced lung function, and take medication to this day.

My doctor saved my life, the nurse would have given me a z pack and sent me home. That is why you use a GP. They can find that 1 out of 100 case. Sure, a nurse might get 99 right, but what if it’s your turn to be the outlier? Maybe your son, or daughter? Will you still feel that doctors aren’t really neccesary?

I, through experience, disagree.

Also from the comments, an interesting link on hidden (de facto) rationing in 0bamacare


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