Survey: Doctors don't like Obamacare

A survey of American physicians released this week paints a restless picture of the nation’s doctors—especially when it comes to Obamacare.

“The system is broken and I am out of here as soon as I can,” one doctor wrote. “I am tired of being used, abused, and lied to. Has anyone here woken up to the fact that we are always the last ones to be considered in the equation of change?”

Roughly 20,000 of 650,000 doctors responded to the Physicians Foundation’s survey, and voluntary surveys are prone to finding those with strong opinions. But of those strong opinions, 46 percent of doctors gave the Affordable Care Act (ACA) a “D” or “F,” while only 25 percent gave it an “A” or “B.”

The data goes beyond Obamacare to the overall “health of healthcare,” and the data tell some odd stories.

For example, 72 percent of doctors agreed there is a doctor shortage, but 44 percent of often overworked physicians planned to cut back on hours or patients in some way. And many doctors exhibited ignorance about health insurance. Roughly 29 percent of doctors didn’t know if their practice or employer participated in Obamacare exchanges.

The data also showed accelerating trends in the way doctors practice. Doctors complained about spending 20 percent of their time filling out paperwork and said Obamacare rules often turn the patient-doctor relationship into a factory-based formula. Owners of their own practices—those who deal most directly with paperwork and insurers—were 56 percent more likely to grade the ACA poorly than other doctors.

Some of those disgruntled doctors have responded by leaving their practices for hospitals. Roughly 53 percent of physicians described themselves as employees of a hospital or medical group, up from 44 percent two years ago. But nearly 63 percent of doctors don’t think that trend bodes well for healthcare quality and cost.

Others are have headed the other direction—off the insurance grid altogether. Plastic surgery specialist Dr. William Wennen told The World and Everything In It’s Jim Henry that he plans to close his Fairbanks, Ala., practice because of Obamacare and meager Medicaid and Medicare reimbursement payments.

“For the last several years I have been having to write off upwards of $750,000 in free, uncompensated care,” said Wennen, who hasn’t taken a paycheck since February. He specializes in reconstructive surgery for cancer patients, and by going cash-only from now on, he said he can lower his overhead and his fees.

In fact, the Physicians Foundation said 13 percent of doctors—and 17 percent of those under 45—are exploring a cash-only or other concierge-type practice, like the Boylan Clinic in Raleigh, N.C. The primary care concierge practice started this year, and patients pay a flat fee of $1,650 for 24-7 access to a doctor for a year. One of the doctors, Todd Helton, cited “changes in medicine” and “more uncertainty ahead” for the business move.

And just as doctors are abandoning insurance, some insurance companies are abandoning Obamacare.

Last week, Minnesota’s largest and cheapest Obamacare insurer announced it will end its coverage at the end of this year. According to The Wall Street Journal, about 13 insurers nationwide have decided to pull out of exchanges. Citing a semblance of stability in the exchanges, though, 77 insurers applied to join. Only California will see a net decrease in available plans, though as in Minnesota, the prices likely will be higher.

Obamacare administrator Marilyn Tavenner told Congress recently that more than 6 million people signed up for Medicaid and other poverty-related programs under Obamacare. But she has admitted that roughly 700,000 people on the exchange marketplaces have dropped their coverage.