The ACA is crushing the morale of our medical professionals

As the new administration develops and implements its health care agenda, the best case against the Affordable Care is not a political or economic one. It’s a medical one. The arguments should focus on patients, physicians, and the side effects they have experienced from a wrong prescription for our health care system.

There is a reason why the ACA was unpopular at its inception and remains unpopular today. Exit polls from the election found that 45% thought the law went too far. Doctors also have serious concerns about the law. In September 2009 IBD/TIPP polled 1,376 practicing physicians. They found that 65% of physicians polled opposed the law and 45% would consider leaving their practice or retiring early if it passed.

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The results were shocking, but not surprising. The ACA and the HITECH Act have hamstrung doctors already drowning in stifling red tape with complicated new mandates, regulations, and bureaucracy.

These have taken their toll on the doctor-patient relationship. I am sure far too many know the feeling of seeing the back of the doctor’s head as he or she faces the computer screen.

These new mandates have also compelled providers and health systems to devote more time, energy, and resources to other initiatives besides the direct delivery of high quality patient care.  These endeavors designed to lower health care costs ironically have been quite costly. This is particularly important given the already high operating costs of a medical practice and dwindling reimbursements.

Under the status quo, doctors find themselves working for and often against a system that puts the needs of patients and doctors in the backseat. Doctors, nurses, and patients are the nucleus of health care. Other stakeholders are certainly important. Yet, without the investment, skill, hard work, and dedication of providers there would be no practice of medicine.

Parenthetically speaking, as a patient what is more important to you: the practice of high-quality medical care or the documentation, billing, and coding of medical care?  For far too long, the emphasis of policymakers, regulators, and administrators has been on the latter at the expense of the former. It’s time to buck this trend and return health care to doctors and patients.

The relegation of physicians and patients in our health care system started long before the passage of the ACA, but has gotten significantly worse in recent years. The ACA with 2900 pages of statute, thousands of pages of regulations, and 159 committees, agencies, and programs has certainly played a role. 

We are already starting to see the deleterious effects of this bad medicine. In just several years under the ACA, physician dissatisfaction and burnout have exploded. Mayo Clinic Proceedings research found that from 2011 to 2014 physician burnout had increased from 45.5 percent to 54.4 percent.  No doubt these numbers will continue to worsen in the future as the law and its unintended consequences become more ingrained.

Policymakers should find this rapid, decline in doctor morale extremely troubling. After all, physicians and their wellbeing are integral to high-quality care. Physician dissatisfaction has the potential to translate into compromised patient care and restricted access, particularly if older doctors retire early and the best and brightest decide to use their education and training to do something else. It could also deter exceptional young college students from pursuing a career in medicine in the first place.

Rather than having doctors working for the system, patients would be best served, if the system worked for them. The goal of the system should be to leverage the incredible education, training, and experience of physicians to best meet the unique, complex needs of patients. The next administration should enact legislation and regulation to remove barriers and facilitate a system that works for patients and doctors as opposed to one that works for the system.

Now is the time for true health care reform: reform that puts patients and doctors in the driver’s seat.

Jason D. Fodeman, MD, MBA is a practicing primary care physician. He specializes in delivery systems and health policy


The views expressed by authors are their own and not the views of The Hill.