“Things just aren’t working out between us.” That’s what some doctors are saying to the practice of medicine as the federal government marches forward with implementation of the Affordable Care Act. Over at the National Journal, Megan McCarthy takes a look at how a number of physicians–faced with the prospect of being held accountable for the job they do–are thinking about calling it quits. They don’t want to spend a bunch of time documenting the quality of care they provide, only to find that the quality of that care is suboptimal and have their paychecks docked because of it.
Hey, listen, I understand. If I were accustomed to doing just about whatever I wanted and getting paid for it, I’d be reluctant to embrace the change. But this actually tells me that some real change is about to happen in our health care system. Sure, the prospect of physicians leaving the practice of medicine in droves and exacerbating current workforce shortages is alarming, but I choose to look at the glass as half-full rather than half-empty. For me, the fact that the rules of the game are about to change significantly enough to make some people think about no longer playing is a great sign. There will be others who want to practice medicine. I say let them do it. Let the market principles we abide by do their thing.
Who will leave? Most likely it will be older practitioners, or those who–for a variety of reasons–were already considering leaving the field before the ACA. Who will stay? Physicians who provide high quality care. Sure, there will still be plenty of variation from doc to doc, but a system that rewards good outcomes and punishes bad ones should, over time, improve the overall quality of our providers and our health care system. If we could just solve the access problem, that’d be something we could all benefit from.