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[quote=Anonymous]We have a broken healthcare system and doctors are reaching the breaking point in many cases:

Since Obamacare, many more people have insurance, so many people are using the system and getting appointments.

Many more people are doctor shopping, looking for doctors who will prescribe self-diagnosed treatments.  During the opioid epidemic, the number of people who started doctor shopping, looking for the doctors who would prescribe opiods.  That then started the trend which continued during the pandemic with people looking for doctors who were willing to prescribe pandemic related medications.  The upshot is that with insurance, many more people were willing to pay a co-pay just to see a doctor and try to get what they wanted.

Insurance is paying lower rates that do not keep up with inflation.  For every insurance holding patient, doctors get paid less and less per hour due to the rates that insurance companies are paying for similar service.  Worse, insurance companies require extensive documentation and so the doctors have to work more to document everything for the insurance companies, which again decreases their hourly income because they are getting less money for more work.  I know some doctors who have added 2-3 hours of documentation to every work day.  So they see patients for 8 hours and then spend 11 hours working every day.

Doctors have more and more no-shows and a no-show is essentially lost money.  So, to combat no-shows, doctors add 2-3 more patients in an hour to ensure that when a patient fails to show, that they definitely have aother patient waiting and ready to see, so they don't lose money for lost time.  This, however, increases the wait time for patients due to multi-booking.  The alternative is not to overbook, but then to charge penalties to patients who no-show, but many patients complain about that, too.  No-win situation for doctors.

More doctors are leaving private practice and looking for positions that pay more consistently and better.  So, many doctors have left private practice and gone into hospital practice.  I know several who created doctor services who provide specialty consulting for local hospitals, especially ones that do not have that specialty in their hospital.  For example, my twins were delivered and monitored by a NICU practice that had 7 neonatologists who supported three hospitals that did not have on-staff neonatologists.   The hospitals were spread around and they doctors rotated around and each essentially covered 3 days in each hospital, had a day or two off, then rotated to another hospital.  With the doctors and the rotation, they had a more normal work schedule and they as a team covered the three hospitals which found it easier to contract out that work than to have doctors on staff.  The contract agency handled all of their benefits and assorted staffing overhead.

I know several doctors who left private PCP to become concierge doctors.  The concierge fees cover their basic expenses and ensure that they aren't making less and less per patient and per hour due to the overhead of insurance costs.  They can spend more time per patient and not lose income.  It's a much better deal for patients.

Essentially without fully socialized healthcare, the impact of Obamacare type insurance is more care available for more people at the expense of doctors.  Doctors are finding ways to not bear the brunt of this and as a result, care for the masses is getting harder and harder to come by. [/quote]

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