Doctors Don't Like ObamaCare...

Now a report says that 83% of all doctors have considered leaving their practice because of ObamaCare.  This jibes with what I've heard from doctors I know, every one of whom is wondering what their future holds under ObamaCare, and whether that future will be in U.S. medicine.  Some are considering leaving the country, to practice where they can make more money.  Others are considering changing careers.  None – not one – believes that they have a viable career as a doctor being paid under ObamaCare.

This flight of doctors to higher-paying careers is actually not new – it began years ago with Medicare and Medicaid, two government programs that pay fixed (and very low) fees to doctors.  That flight, though, was to private medicine: an increasing number of doctors, over the years, refuse to take Medicare/Medicaid patients for the simple reason that they don't pay enough.  Under ObamaCare, however, that choice is removed – and now to make more money, they have to make a more drastic career change.

I would like to live out my years in a country where I at least have the choice to obtain the services of a great doctor, even if I have to pay for that choice myself.  If our great doctors tend to switch to another career, or move to another country, that's going to get a lot harder.  It's going to make options like traveling to India, Estonia, or Brazil for medical care look a lot better.  Some countries are already thinking about encouraging “medical tourism” like this as a major policy effort, most especially Israel, China, and India.  To them, ObamaCare is an enormous opportunity.  Good for them! But not so good for us...

How Doctors Die...

A thought-provoking piece by Ken Murray, a retired M.D.  The assertions he makes will be a topic the next time I meet with my doctor; I'd like to know whether he agrees with them.  From our own experiences with our animals at the ends of their lives, I find this entirely plausible.  The intro:

Years ago, Charlie, a highly respected orthopedist and a mentor of mine, found a lump in his stomach. He had a surgeon explore the area, and the diagnosis was pancreatic cancer. This surgeon was one of the best in the country. He had even invented a new procedure for this exact cancer that could triple a patient’s five-year-survival odds—from 5 percent to 15 percent—albeit with a poor quality of life. Charlie was uninterested. He went home the next day, closed his practice, and never set foot in a hospital again. He focused on spending time with family and feeling as good as possible. Several months later, he died at home. He got no chemotherapy, radiation, or surgical treatment. Medicare didn’t spend much on him.

It’s not a frequent topic of discussion, but doctors die, too. And they don’t die like the rest of us. What’s unusual about them is not how much treatment they get compared to most Americans, but how little. For all the time they spend fending off the deaths of others, they tend to be fairly serene when faced with death themselves. They know exactly what is going to happen, they know the choices, and they generally have access to any sort of medical care they could want. But they go gently.