Saturday, September 15, 2012

Is There a Future for Catholic Doctors?

Following are two articles I ran across concerning Catholic Doctor’s and Obamacare. I thought you would find it interesting and informative.

From the National Catholic Register

Is There a Future for Catholic Doctors?
BY JOHN F. BREHANY Tuesday, Aug 07, 2012 12:29

Daniel Henninger’s recent Wall Street Journal column, “Obamacare’s Lost Tribe: Doctors,” outlined the deleterious effects of Obamacare on physicians and the implications for patients.

At issue, Henninger writes, is not merely if patients will be able to keep their doctors, as Obama promised, but, rather, if physicians will be able to keep their patients — or even stay in the practice of medicine.

The questions Henninger raises about physicians under the president’s Affordable Care Act are even more applicable to Catholic physicians.

Doctors just want to take care of patients. Catholic doctors, in addition, want to take care of patients in a way that is consistent with their faith. But both of these desires have been increasingly difficult to fulfill in recent years, and the future is looking bleaker than ever.

For years, financial and legal pressures have made the climate for medical practice stressful for physicians. In America, payment for health-care services is made overwhelmingly by third-party payers — government (Medicare, Medicaid, State Children’s Health Insurance Program and Veterans Affairs) and health-insurance companies — rather than by patients and individuals.

To prevent fraud and reduce costs, these third-party payers create increasingly complex regulations and demand discounts wherever possible. Doctors have been forced to hire ever more support staff to deal with the bureaucracies and to work harder, seeing more patients and performing more procedures, to make up for the expenses and reductions in reimbursement.

While American physicians earn more than their counterparts in other countries (and specialists can make from 60% to 90% more than primary-care physicians), they also have unique and expanding expenses to cover, not only support staff and malpractice-insurance premiums, but large loans from medical school.

Even before the passage of Obamacare, many doctors were struggling.

In a 2008 survey by the Physicians Foundation, less than 20% of physicians reported that their practices were healthy and profitable; the remainder had either low profits, were breaking even, or were losing money. That same survey reported that 78% of physicians said medicine is either “no longer rewarding” or “less rewarding”; 76% said they are either at “full capacity” or “overextended and overworked”; and 42% said the morale of their colleagues is either “poor” or “very low.”

Obamacare has made everything much worse. 

Read the rest here.

And this commentary to the above article:

Catholic Doctors in the Age of Obamacare

Comment by Russ Rentler, M.D.

John Brehany, PhD, president of the Catholic Medical Association has an interesting article [see above] in the National Catholic Register. Here is my response: 

As a Catholic doctor who is 53 years old practicing geriatrics, I agree that Obamacare has the potential to make it exceedingly more difficult to practice medicine according to the dictates of our conscience. It will also be more difficult to be profitable and stay in business given the cuts in Medicare which have already occurred over the past 10 years. 

As a geriatrician, 99 percent of my income is derived from Medicare payments. Over the past ten years, even before the threat of Obamacare, yearly Medicare reductions now have us getting re-imbursed for only 50% of what we bill for. Malpractice rates continue to rise. In one year in my state, they doubled. Also, I am not compensated for the hours on the phone with family and loved ones that are an essential aspect of geriatric care. Fortunately, at this point, I am an “employee physician” and the hospital system that employs me is taking these cuts “on the chin.”  However, it’s only a matter of time when my employer realizes they can’t maintain the luxury of paying geriatricians who don’t generate anything close to their salary because of the massive reductions in Medicare payments. This is in spite of the fact that geriatricians are a most-needed specialty given the retirement of the baby-boomers and the care they will require. 

The other aspect of this “perfect storm” for Catholic physicians is the pressure to cut costs at the end of life and to “end the suffering.” We are practicing in an era when the concept of redemptive suffering has no meaning to most patients and many families think the purpose of hospice and palliative care is to provide a quick and painless end to their loved one’s suffering.  As a medical director in a nursing home, I am regularly asked to stop tube feeds by families and push the morphine to lethal doses. Thankfully, in my state, it is still illegal for doctors to kill people and my nursing home, though not Catholic agrees with the basic Catholic concepts of appropriate end-of-life care and my administration rarely questions my decisions to continue or initiate artificial nutrition and hydration. However, with the advent of Obamacare, institutions will eventually be pressured for financial reasons to withdraw and limit care and we will definitely see more euthanasia being performed than it is even now, in covert and subtle ways. The public’s acceptance of physician assisted suicide and euthanasia will increase as the costs of a fully implemented Obamacare drain the already insolvent coffers of Medicare. 

Read the rest here.

No comments: