Doctors are becoming increasingly concerned that the hidden and explicit costs of Obamacare will have a devastating effect on Medicare. In 2010 many doctors barely break even when treating their Medicare patients and the situation is getting worse. The following is a brief list of options facing private practice physicians as we move into the Obamacare era:
- Refuse to treat Medicare patients: I predict that physicians exiting Medicare will soon become a stampede. The stampede will precipitate a national crisis. In a utopia the government would respond by increasing physician compensation under Medicare. In the economically fragile America of the 21st century this will not happen. It is more likely that our government will explore ways to force doctors to continue treating Medicare patients and require physicians to endure the resulting reduction in income.
- Retire: Some older physicians are considering this but “getting out while the getting is good” is not an option for many early and mid career doctors.
- Move into an exotic practice: There are a number of fields that will be insulated from the coming compensation crunch: botox clinics, concierge medicine, sports medicine and so on. Many doctors are either not qualified to enter these fields or they find such exotic practices unattractive for a variety of reasons.
- Move to affluent communities: There are many communities in America (mostly large urban centers) that have affluent, well-insured populations. Unfortunately the stampede out of Medicare will very likely become a stampede into affluent communities. These may well become islands of medical “hyperservice” with an abundance of well qualified competing medical practices.
- Flee the country: It is a big world and many developing economies are desperate for Western medicine. Some of these places are also nice locales in which to live (Brazil for example). Although the compensation crisis and the diminished incomes it produces may lead to a medical brain drain, emigration is such a major disruption of a person’s life, that it will probably not be a serious option for most doctors.
- Adjust the patient mix: This, I believe, is the winning solution. Doctors need to consider adjusting the “mix” in their patient populations to enhance the number of well insured patients they treat. This will require marketing and that is an area with which many physicians have little experience. An inexpensive, easy and surprisingly effective marketing tactic is to use social media (examples of social media include: Facebook, Twitter, and Blogging). Subsequent articles in this series will explore the tactics of using social media to market medical practices to upscale clientele.
Several articles already posted in the Bradford Report may also be useful:
- Should Doctor’s Tweet?
- The Role of Social Media in Attracting Web Site Traffic
- (For the ambitious reader) Twitter–Facebook’s Ugly Sister
For advice on using social media to market your specific practice please feel free to contact me at: www.meditechfirst.com
~Jim Bradford, Ph.D.
