Family doctors are mostly very nice people. They also usually render good medical care. However, they are not accorded a “high status” in the medical hierarchy and in general have little power in medical schools or the research establishment. However, they are well organized politically, and have triumphed in the Obamacare Florida wars.
Approaching the concept of doctor reimbursement as a zero-sum game, their lobby convinced Pelosi and Reid that favoring family practice over specialty care would save money. This may well be true, but every time a pressure group meddles into a complex system, the reallocation of resources results in unintended consequences. Medical research may be one of the first casualties of Obamacare Florida.
Family doctors do not do much medical research.
General practice, with the need to be a “jack of all trades” precludes studying one topic at the depth required to be an original investigator. In addition to the five or so years required to become a specialist, doing basic medical inquiry requires additional post-residency training. It is these highly specialized, non-family doctors, who do the research and teach in the medical schools and universities.
In the power grab that was Obamacare Florida, the family doctors did not consider, and the Congress did not understand, that the high fees paid to medical specialists are a key component to funding medical research. Although laboratories and lab workers are paid for by grants, most physician researchers receive a salary based upon their part time clinical practice and supervision of residents.
Seeing patients, with the help of residents a few days a week, has previously generated enough income to pay the salaries of these academic researchers. Although the incomes were not as high as those of private practice, the system worked well enough to keep medical schools and research positions filled.
The proposed reimbursement reductions to these “overpaid” specialists will impact the academic centers the hardest. Academic physicians, already paid less than their colleagues in private practice, will be faced with substantial reductions. Rules meant to shorten resident hours will further increase the demands on these faculty doctors.
Faced with reduced grants, lower Medicare reimbursement, and increasing costs, the possibility of medical schools or hospitals supplementing physician salaries is not possible.
My guess is there will be an exodus of academic physicians, and a reluctance of younger doctors to enter in to the research world. After years of study and huge student loans, the best and the brightest may no longer be able to afford the academic life.
The American medical research establishment has been the source of incredible discoveries and advances in medical care and knowledge. It relies on the dedication and sacrifice of a large number of very talented individuals, working in hundreds of universities across the country. However, it is based upon a complex and fragile funding system.Read the news coming from http://www.scnow.com/news/business/local/article_40c8b69e-9e20-11e6-810a-d3f82c5cbfbe.html
Obamacare Florida, and it’s financially motivated, politically driven backers, are unwittingly dismantling the infrastructure that has been built over the last 50 years. Like the civilians at ground zero in a bombing run, medical research may well be one of the first victims of collateral damage from Obamacare.