Now that everyone's over saying "Happy New Year" for the past week and you're back to your routine, the assualt on our profession continues.
The question is "What will you do about it?" Will you just sit there and take the licks and bury your head in the sand, or will you take action this year?
Here are just some of the new issues affecting physicians recently:
1. Medicare has started to penalize hospitals for readmissions
This started a few months ago and right now only applies to patients who are admitted for MI, CHF, and pneumonia, but the health care police will expand that to a whole host of new diagnoses over the next few years. On top of that the percent and dollar amount of the penalties are scheduled to escalate over the next 2 years.
Here's what I think will eventually happen. The penalty applies to hospitals, but think about this. If you're a surgeon, hospitalist, or anyone who has a hospital based practice of any sort, it doesn't take a genius to figure out that eventually the hospitals will come cracking down on physicians and blame us for readmissions and threaten us with paycuts or else!
It's nuts because let's face it the volume of patients we have to see is already too high. And statistically some patients will run into complications after being discharged from the hospital--something beyond our control.
2. We're faced with constant paycuts
We keep hearing about the annual 30% Medicare cuts to physician pay that tends to not happen at the last second before the new year begins. Now there's another 2% cut in the works where the deadline is March 1. This was part of the automatic government spending cuts which were supposed to happen on January 1 but which are temporarily halted due to the tax legislation that just passed.
It's yet another example how physicians have essentially become government employees.
3. We'll pay more taxes
The new tax legislation-- ironically called the American TaxPayer Relief Act-- causes payroll taxes to rise on everyone. I'm not sure how that's a relief, but then again I guess I don't know the definition of that word since I went to a public elementary school.
For doctors not only will we pay more payroll taxes but many of us will be forced to pay an additional 0.9% on our wage income and another 3.8% Medicare tax on investment income. And for the higher paid medical specialists, you'll get slapped with a higher federal income tax rate, higher dividend tax rate, and higher capital gains tax rate.
So why am I telling you all this?
Because this is the year you need to take action. By that I mean take action with your personal finances. And I don't mean just any type of action. I mean MASSIVE action.
When you have your financial life in order and you've achieved a certain level of financial independence and freedom, you have the ability to walk away if you want to. Medicare cuts and readmission penalties won't matter much to you anymore. Income taxes--well that's a bit more complex.
You'll stop screaming "I have to work!" to rejoicing "I don't need to work!" and put up with the nonsense that's thrown at you.
Make this the year where you shout as loud as you can "Enough!"
Instead of watching football and pretending everything's OK, do something about it. Because it's only going to get worse, and it looks like physicians are being blamed for part of the health care problems instead of being praised for all the valuable service we provide.