No, If You Like Your Patients, You Can’t Keep Them..But, You Can Be There If They Return Someday

Obamacare is destructive to the patient-physician relationship at its very core.

No, if you like your health plan, you cannot keep it.

No, if you like your doctor, you cannot keep her.

Unless, of course, she agrees to do exactly what the Secretary of HHS, a non-doctor, partisan political presidential appointee, requires- even if that requires abandonment of medical ethics and violation of the Hippocratic Oath.

I close out the week signing  requests for medical records from 10 of my patients  who I have cared for from 10 to even  20 years, operated on, come in after hours for, and developed patient-physician relationships with. I know them, their families, their medical histories, their physical findings, and their dispositions. To say this is hurtful is an understatement. I try not to take it personally, realizing that under Obamacare, they are mandated to go on or buy a healthcare plan that has restrictions, such that I am an “out-of-network provider.”

In other words, because of Obamacare, the government –subject and insurance company-customer relationships supersede the patient-physician relationship. This was the intent all along. We have come to the point in the U.S.A. that money and power supersede what is best for individual patients (AKA, the “common good” supersedes the individual needs),  and no one can argue this. Anyone who thinks they can rightly defend the current unethical state of affairs in American medicine can contact me right now, and let’s debate it.

What’s saddest, is when the records must be sent to another physician who I know will not care for the patient the way I do- someone who has compromised their medical ethics and violated the Hippocratic Oath, someone who has stopped operating because it doesn’t pay well enough anymore, someone who will run patients through like cattle checking off EMR checklists instead of examining and communicating, and someone who does what government says instead of what is best for the individual patient in order to stay in the most deadly game and avoid a penalty in pay.

And there’s nothing I can do but send the records on.

Patients are smart. I pray they will recognize something is wrong as they go forward year after year with successive new doctors, each year seeing a new  “in-network-provider” per the insurance companies’ networks instead of the doctor they choose, know, and trust, and with whom they share a long-term, ongoing patient –physician relationship. Patients will suffer. Maybe they will realize that there was some value to our relationship and my commitment to my medical ethics and the Hippocratic Oath. Maybe they will see that there is value in the reality that I will do what is best for each of them individually, not just what I need to do to get a merit-based incentive plan’s positive adjustment factor and higher Composite Performance Score from the Secretary of HHS. I will be here plugging away as long as I am able preparing to welcome each patient back should they choose to return.

In the meantime, I have boundless gratitude and appreciation for the cherished patients who have chosen to stay with me. I will serve them to the best of my ability. It is my privilege and pleasure. I am humbled and blessed to do so. I will provide state of the art, innovative, and personalized care while doing this at the lowest possible cost and helping them file for “out-of-network benefits” with their insurance companies and Medicare secondary insurers. I am happy to explain and discuss this with each and every patient. With the current state of high deductibles, high co-pays, and high out of pocket expenses, many find they save money to see me with my transparent, reasonable fee schedule rather than utilize their health insurance’s highly restricted and regulated network. I’m here to help and serve my patients. I’m not here to abandon my principles and serve government.

Government run medicine is destructive to the patient-physician relationship.

No. If you like your patients, you cannot keep your patients.

But, you can create a way to stay in business under existing conditions should they choose to return to your care.

And, then you can be there waiting to welcome them back with open arms.

In the meantime, sign off and forward the records. Don’t take it personally. Have faith and pray the prodigal patient may return to you someday.

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