Unfortunately, this story will be repeated in each small town across the U.S.
Expect to see rapid changes in medical practice in less than one year. This would include diminishing employment positions for docs in hospitals. Hospitalists would be the worst hit. Downsizing of hospitals and lean-and-mean operations will mean squeezing more from smaller workforce and dismissal of redundant staff.
Medicare is slowly caving in and is not likely to survive in its present form for more than a few years. There will be a temporary surplus of doctors and jobs for para-clinical staff such as nurses, nurse practitioners and physician assistants will nosedive as no one can afford to hire them at the salaries they are used to. Most of the medical, imaging, and nonacute surgical care will be delivered in cash for service type of centers or office-based surgical centers at considerably lower fees, lower overheads and hopefully not lower quality. With the 10.6% slammer from Medicare, the previously favored business models will rapidly unravel.
The insurance, pharmacy benefit-management and electronic medical-record industries and Big Pharma, which have fought so hard to cheat doctors, will eventually reap the bitter fruits of their labor. When money or lack of it starts talking, the tsunami that is now brewing in the halls of the Senate will clean up the third party quagmire that has eroded the sacred trust between the doctors and patients. Then we will all go back to practicing medicine as in the old days.
Narayanachar Murali, M.D.Gastroenterology Associates of Orangeburg (S.C.)Digestive Endoscopy Center
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