Anger over the American Medical Association’s support of the healthcare reform bill has slowed the Louisiana State Medical Society’s membership renewals, a sign of physicians’ growing frustration, officials said.
“Physicians are concerned about the changes that are occurring around them. They feel like they’re no longer in control of their destiny,” said Dr. Patrick Breaux, LSMS president. “Their attitudes range from anger to frustration to despair because they’re losing control of their practice, and their practice expenses are spiraling out of control, their reimbursements for their services are fixed at best and declining at worst.”
Doctors have seen cuts to their Medicaid and Medicare reimbursements, as well as continuous short-term solutions from Congress when it comes to a permanent fix for the Medicare payment system, known as the sustainable growth rate formula, Breaux said.
In exchange for its support of the healthcare legislation, the AMA cut a deal with Congress to rescind the scheduled cuts in Medicare, 21 percent for 2010, and replace the SGR with a more favorable formula. The AMA had spent tens of millions of dollars in the last three years lobbying Congress for a permanent fix, and the early version of the healthcare bill was seen by many as a victory for the group.
There’s an ever-worsening shortage of doctors, which is estimated to reach 90,000 nationwide by 2020, Breaux said. Meanwhile, Louisiana has a lower-than-average doctor-to-patient ratio of 18 practitioners for every 1,000 people, a large uninsured population, and escalating expectations for healthcare.
“The reality is that there are greater expectations for demand for services. That’s the concern our doctors have and I think it’s a legitimate concern,” Breaux said.
If that were not enough, add in the slumping economy, which affects physicians along with everyone else, Breaux said.
“I think the attitude that physicians have is the same attitude that the rest of the general public has. I think the general public is confused and frustrated and sometimes angry at the way things are going for the nation and in their personal lives,” Breaux said.
The society’s members are feeling the squeeze as far as money is concerned, Breaux said. Members have to be more conservative and do cost analyses to decide whether membership is worth the investment.
Breaux said he is biased but believes it is.
Still, there’s not denying there are a lot of reasons for physicians, not to mention the general public, to be angry, Breaux said.
Unfortunately, a lot of doctors think of the AMA and LSMS as one and the same, Breaux said. They are not.
“I think we’re seeing some of the anger toward the AMA has spilled over onto the State Medical Society,” Breaux said.
That anger has been evidenced by a slowdown in membership renewals, Breaux said.
LSMS has a little under 7,000 members, including residents and medical students. The active paying members, working physicians, make up about 4,000 of the total.
Cathy Thompson, LSMS manager of member development, said by May, there are usually around 250 physicians who haven’t renewed, but this year there are around 400 members who have yet to renew.
Dr. Keith Desonier, chair of the LSMS AMA delegation, said he expects a big drop off in the state’s AMA membership.
“The problem is that a lot of people get confused (and think) that if you join the State Medical Society you also have to be in the AMA,” Desonier said.
Desonier said the LSMS helped lead the opposition to endorsing the bill during a day-and-a-half long debate.
At the end of the discussion, the LSMS thought the AMA was not going to support the legislation but that position obviously changed, Desonier said.
“That frustration with the AMA rolled over to a lot of people who said, ‘Hell, I’ll get out of LSMS, too,’” Desonier said. “We said, ‘Wait a minute, wait a minute. We’re the guys who were in the debate to fight to stop that thing. Don’t confuse one with the other. Stick with us, we’re going to take it up again, we’re going to fight it again, and see what we can do.’”
Desonier said in the week or two after the AMA announced its endorsement, the society and officers fielded a lot of phone calls from angry members, but efforts to explain the situation have helped.
The message he and other LSMS officials keep putting out is that physicians need to understand that the AMA and the Medical Society are different, and that the Medical Society’s representatives voted differently than the AMA.
“We debated policies and we lost that debate. Ok, now it’s time to move on. What do we do next?” Desonier said.
People are starting to see that the healthcare bill is very large, very cumbersome and can be very oppressive, Desonier said.
Rep. Nancy Pelosi, D-Calif., speaker of the House, was right when she said, sign the bill and find out what’s in it later, Desonier said.
“We’re finding out about it. We’re going to be learning for the next three, four, five years,” Desonier said.