COSM14: Healthcare Reform Expected to Impact Physician Demand, Hiring

Dr. Couch pointed out a paradox: Providing better, smarter care might, in the end, boost costs. “As people live longer, it may cost more to the federal government,” she said. “So the only thing you could to do to reduce the federal spending on healthcare is, unfortunately, [to] reduce physician reimbursement and administrative costs. So, I think we have to be ready for that.”

Dr. Johns said that rural hospitals might really feel a squeeze, because many barely get by now. Half the hospitals in Georgia, he said, operate at a loss. Large, integrated systems might actually expand to meet demand, but academic centers might not. “I do think that there will be physician hiring in our big systems, selectively, where needed,” he said. “But, as far as the academic side [goes], I’m not sure that we can afford to expand and then subsidize our faculty. We have to educate, of course, but it’s going to be a battle there.”

Dr. Arjmand echoed comments made in prior presentations by Dr. Johnson and Dr. Johns that it was important not to “fear change,” and that physicians should feel empowered to help lead change. “These are things we’ve been talking about: measuring quality, measuring safety, measuring cost,” he said. “There will now be structures in place that will require us to do those things.” As the old model of how payments flow is replaced by a new, more complicated one, it’s unavoidable that there will be an abundance of questions. So doctors may as well confront them, he said. “We’re introducing a lot of new players, we’re introducing the insurance marketplace, we’re introducing accountable care organizations, and we don’t have systems in place to manage them,” he said. “So these things are going to happen. Nobody knows what this is going to look like.”