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Physician Job Market – Obamacare’s Impact on Your Decisions

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There are so many conflicting opinions circulating the web about the state of physicians under healthcare reform. What doesn’t seem to provoke any dispute is that the rollout of Obamacare has been bumpy at best and disastrous at the very, very worst.

Reform was already having a particularly horrendous impact on the ability of physicians to remain independent, and as physicians looking for jobs, you are no doubt trying to grapple with the direction in which you should take your career.

Out of all of this noise and talk and media, however, what’s most clear beyond a shadow of a doubt is two things:

1.) Physician hospital employment, for all of its pros and cons, is the definite direction in which the physician marketplace is headed.

We’ve covered the reasons for this before, but a rather brief article in Becker’s Spine Review underscores this point. Reporter Helen Adamopoulos gives six reasons why physicians are entering into employment or quasi-employment arrangements with hospitals and health systems.

To quote her, they are: 1. Declining reimbursement rates and decreased bargaining power with commercial payers; 2. Lifestyle considerations; 3. Reports of positive benefits from other physicians who have transitioned to employment; 4. Seeking an exit strategy, for practices with more senior founders; 5. The perception that employment offers the opportunity to "lock in" compensation at existing levels; and 6. Uncertainty about future reimbursement and delivery models enacted by the Patient Protection and Affordable Care Act.

The particulars of each of these reasons could be debated, of course, but this is why physician hospital employment is a legitimate trend. Physicians see hospital employment as a way to survive and possibly flourish.

2.) Independent physician practices are in danger, no matter what anyone says.

In line with our first fact comes this article from the conservative opinion site, Townhall.com. Whatever your political leanings may be, this article presents undeniable proof that one physician, who is probably representative of many more, is shutting down his practice on Dec. 31, 2013, because of Obamacare.

Kentucky-based physician Stephen Kiteck, MD, recently took out an ad in his local paper that simply read: “Due to the policies of Obamacare, Stephen Kiteck, MD, will be closing his medical practice on December 31st, 2013. Patients may pick up their charts at the office…Dr. Kiteck wishes to thank all his patients that have visited his office over the past 20 years, and apologizes for this inconvenience.”

In a statement to Townhall, Dr. Kiteck explained his difficult position:

“It’s pretty basic really. The reason is that Obamacare requires electronic medical records and electronic prescribing and I simply don’t have the finances at this time to go into debt to provide that for my office, it would just be a complete new transfer of electronic equipment in my office for that.

“So for me, at my age, I’m just not ready to go into financial debt. Of the 20,000 pages in there, probably up to 1,000 pages are about doctors' offices….

“…I’ve got 6,000 records, some of them are two inches thick. It would just be basically impossible to scan all of these and put them on electronic medical records and very expensive, by the way…

“It’s a solo practice, I’m just a very small solo practice. I call myself a mom and pop practice, so I’ve had it for about 20 years here in Somerset, Kentucky.”

As physicians looking for a job, how do these two factors impact your job search? Are you one of the many physicians who are leaving a small practice to go into hospital or group-practice employment? What helped you arrive at that decision?

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