Friday, December 5, 2014

Alaska Doctors Overwhelmed By New Federal Rules

More consequences of various government mandates on physicians: "Alaska Doctors Overwhelmed By New Federal Rules".

From the article:
Dr. Oliver Korshin, a 71-year-old ophthalmologist in Anchorage, is not happy about the federal government’s plan to have all physicians use electronic medical records or face a Medicare penalty...

EHR,  ICD-10 and PQRS may sound like alphabet soup. But most doctors around the country know exactly what those acronyms stand for. They are programs championed by the federal government to improve quality and bring medicine into the electronic age. But in Alaska, where small medical practices and an aging physician workforce are common, the new requirements can be a heavy burden...

He says for his tiny practice, an electronic medical records system would cost too much to set up and to maintain.  “No possible business model would endorse that kind of implementation in a practice situated like mine, it’s crazy,” he says.

Korshin will lose another 1.5 percent of his Medicare payments next year for failing to enroll in PQRS, a federal program that requires doctors to report quality data.  And then there is ICD-10, a new coding system for medical bills — also set to take effect in the fall of 2015.

“This flurry of things one has to comply with,” Korshin says, “means that unless you work for a large organization like a hospital that can devote staff and time to dealing with these issues, there’s no economy of scale, I can’t share these expenses with anybody.”
The government is driving smaller independent physicians out of business, essentially forcing those who wish to practice to join large provider groups or to become hospital employees.

Why is this happening?  From an earlier piece I wrote for PJ Media on the rise of "Big Medicine":
Nor is this centralization of health care some “unintended consequence” of ObamaCare. Rather, it is an explicitly desired goal. In 2010, Obama health advisor Nancy-Ann DeParle wrote in the Annals of Internal Medicine that the health law will “accelerate physician employment by hospitals and aggregation into larger physician groups” and that “physicians will need to embrace rather than resist change.”

This consolidation of American medicine is merely a continuation of a much older strategy. In his book Liberal Fascism, Jonah Goldberg described how the Roosevelt administration sought similar consolidations of American agriculture and business during the New Deal:
[I]f you… want to use business to implement your social agenda, then you should want businesses themselves to be as big as possible. What’s easier, strapping five thousand cats to a wagon or a couple of giant oxen?
Similarly, it will be much easier for the federal government to regulate 1,000 large hospital groups and ACOs than 10,000 small private practices and independent hospitals. The New York Times notes that after physicians become hospital employees, they become much more accepting of government controls than their counterparts in private practice.
Unfortunately, physicians like Dr. Korshin and his patients will pay the price.