If you believe the critical battles over implementation of the Patient Protection and Affordable Care Act (aka Obamacare) are being fought among politicians, you're wrong. The real fight is taking place in doctors' lounges at hospitals across the country. The outcome will determine the future quality of healthcare in the U.S. because it will define for the next generation the very essence of what it means to be a physician.
That Obamacare is causing turmoil among physicians is not news. Late last year, it was widely reported that doctors and hospitals are at war with one another all over the country. The reform law is changing the economic model in healthcare, and soon the vast majority of doctors are expected to become hospital employees—a seismic shift from the long-standing tradition of doctors owning or working at independent practices.
What's new is that while the outward conflict appears to be between doctors and hospital administrators, the actual battle is among the physicians themselves. The fight isn't about status or money. It's about patient care and a real threat to the long-held belief that medicine isn't like other businesses because people's lives are on the line.
During the past year, I was a party to a major university academic study of physicians in a large metropolitan setting to determine the human impact of healthcare reform on their psyches. According to the study findings, doctors are being threatened at a deep, emotional level, and it's beginning to affect their performance because they are worried about the future of patient care.
The physicians in the study were openly divided into two warring factions—independent and employed doctors—and visibly split along generational lines. The baby boomer doctors are rebelling against the coming new order. They value the personal relationships they have with their patients and the independence of their medical decisions.