Nearly two-thirds of U.S. doctors surveyed fear healthcare reform could worsen care for patients, by flooding their offices and hurting income, according to a Thomson Reuters survey released Tuesday.

The survey of more than 2,900 doctors found many predict the legislation will force them to work harder for less money.

“When asked about the quality of healthcare in the U.S. over the next five years, 65 percent of the doctors believed it would deteriorate with only 18 percent predicting it would improve,” Thomson Reuters, parent company of Reuters, said in a statement.

The U.S. House of Representatives began debate Tuesday on efforts to repeal President Barack Obama’s overhaul of the U.S. healthcare industry.

Repeal of the bill is likely to fail in the Senate.

Also Tuesday, the Health and Human Services Department released a study predicting that up to 129 million Americans under 65 who have a pre-existing health condition would risk losing health insurance or be denied coverage if the bill is repealed.

Polls show consumers are divided about the impacts of healthcare reform and the House debate has presented an opportunity for many groups to make their arguments for or against it.

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MOUNT DORA — A doctor who considers the national health-care overhaul to be bad medicine for the country posted a sign on his office door telling patients who voted for President Barack Obama to seek care “elsewhere.”

“I’m not turning anybody away — that would be unethical,” Dr. Jack Cassell, 56, a Mount Dora urologist and a registered Republican opposed to the health plan, told the Orlando Sentinel on Thursday. “But if they read the sign and turn the other way, so be it.”

The sign reads: “If you voted for Obama … seek urologic care elsewhere. Changes to your healthcare begin right now, not in four years.”

Estella Chatman, 67, of Eustis, whose daughter snapped a photo of the typewritten sign, sent the picture to U.S. Rep. Alan Grayson, the Orlando Democrat who riled Republicans last year when he characterized the GOP’s idea of health care as, “If you get sick, America … Die quickly.”

Chatman said she heard about the sign from a friend referred to Cassell after his physician recently died. She said her friend did not want to speak to a reporter but was dismayed by Cassell’s sign.

“He’s going to find another doctor,” she said.

Cassell may be walking a thin line between his right to free speech and his professional obligation, said William Allen, professor of bioethics, law and medical professionalism at the University of Florida‘s College of Medicine.

Allen said doctors cannot refuse patients on the basis of race, gender, religion, sexual orientation or disability, but political preference is not one of the legally protected categories specified in civil-rights law. By insisting he does not quiz his patients about their politics and has not turned away patients based on their vote, the doctor is “trying to hold onto the nub of his ethical obligation,” Allen said.

“But this is pushing the limit,” he said.

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Nearly one-third of all practicing physicians may leave the medical profession if President Obama signs current versions of health-care reform legislation into law, according to a survey published in the latest issue of the New England Journal of Medicine.
 
The survey, which was conducted by the Medicus Firm, a leading physician search and consulting firm based in Atlanta and Dallas, found that a majority of physicians said health-care reform would cause the quality of American medical care to “deteriorate” and it could be the “final straw” that sends a sizeable number of doctors out of medicine.
 
More than 29 percent (29.2) percent of the nearly 1,200 doctors who responded to the survey said they would quit the profession or retire early if health reform legislation becomes law. If a public option were included in the legislation, as several liberal Senators have indicated they would like, the number would jump to 45.7 percent.
 
The medical journal published the results in its March and April edition, saying: “While a sudden loss of half of the nations physicians seems unlikely, a very dramatic decrease in the physician workforce could become a reality as an unexpected side effect of health reform.”

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None of the health-care reform proposals advancing in Congress address a fundamental problem that will soon face this country: a critical shortage of doctors. There were reform ideas put forward in Congress that would have addressed this problem. Most notably, Rep. Joseph Crowley (D., N.Y) and Sen. Bill Nelson (D., Fla.) have proposed training an additional 4,000 new physicians to add to the 25,000 entering the profession each year. But their proposals haven’t made it into the bills on which congressional leaders hope to vote.

If the doctor shortage is not addressed and health-care reform is signed into law, millions of Americans will likely find themselves able to obtain insurance for the first time—but may be unable to find a doctor without a long delay. Why? Because expanding the number of insured patients but not the number of doctors will only increase the demand for services that already must meet the demands of an aging population. We must make sure there are enough health professionals to meet those new demands.

Even in the absence of health-care reform, according to the American Association of Medical Colleges, the U.S. will face a shortage of at least 125,000 physicians by 2025. We have about 700,000 active physicians today. One factor driving this shortage is that the baby-boomer generation is getting older and will require more care. By 2025 the number of people over 65 will have increased by about 75% of what it is today—to 64 million from 37 million today.

Doctors are also aging. By 2020, as many as one-third of the physicians currently practicing will likely retire. If health-care reform adds millions of people to the health-care market, the shortage of doctors will be even greater than it is projected to be now.

It is important to note that the shortage the country will soon face isn’t just of primary-care physicians. It is true that there aren’t enough primary-care doctors and nurse practitioners. But it is also true that we need more cardiologists, neurologists, general surgeons, pediatric subspecialists, urologists and other highly trained specialists.

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On October 19th, sixteen highly regarded physicians representing many fields – cardiology, oncology, ophthalmology, general surgery, internal medicine, and others – assembled to discuss the impact of the currently proposed health bills on their patients.

A recent IBD/TIPP Poll showed two-thirds of physicians opposing Congress’ proposed reforms, and warning of dire consequences. Now, a forum of prominent doctors has amplified those concerns.

Of 1,376 doctors responding in late August, 65% opposed Congress’ reform plans; 45% said enactment would make them consider leaving their practice or take early retirement; and 67% expected fewer students to apply to medical schools.

Some 65% also felt seniors would end up with lower-quality care under a government plan; 71% didn’t think it possible for the government to cover 47 million more people and cut costs while also delivering better quality care; finally, 60% of physicians didn’t think that under a government plan, drug companies would have incentives to continue developing as many lifesaving new medicines.

America’s doctors know their patients better than politicians do. And the hostility seen in these poll results was mirrored by virtually all of the 15 esteemed physicians from the New York metropolitan area gathered by former New York state Lt. Gov. Betsy McCaughey for a Forum on Medical Excellence Monday evening.

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‘We must ensure that well-intentioned efforts to bring about “change” are not exploited to create a federally controlled system that promises health care for all, but creates an oppressive bureaucracy hostile to human life and to the integrity of the patient physician relationship…’

Two of every three practicing physicians oppose the medical overhaul plan under consideration in Washington, and hundreds of thousands would think about shutting down their practices or retiring early if it were adopted, a new IBD/TIPP Poll has found.

The poll contradicts the claims of not only the White House, but also doctors’ own lobby — the powerful American Medical Association — both of which suggest the medical profession is behind the proposed overhaul.

It also calls into question whether an overhaul is even doable; 72% of the doctors polled disagree with the administration’s claim that the government can cover 47 million more people with better-quality care at lower cost.

The IBD/TIPP Poll was conducted by mail the past two weeks, with 1,376 practicing physicians chosen randomly throughout the country taking part. Responses are still coming in, and doctors’ positions on related topics — including the impact of an overhaul on senior care, medical school applications and drug development — will be covered later in this series.

Major findings included:

• Two-thirds, or 65%, of doctors say they oppose the proposed government expansion plan. This contradicts the administration’s claims that doctors are part of an “unprecedented coalition” supporting a medical overhaul.

It also differs with findings of a poll released Monday by National Public Radio that suggests a “majority of physicians want public and private insurance options,” and clashes with media reports such as Tuesday’s front-page story in the Los Angeles Times with the headline “Doctors Go For Obama’s Reform.”

Nowhere in the Times story does it say doctors as a whole back the overhaul. It says only that the AMA — the “association representing the nation’s physicians” and what “many still regard as the country’s premier lobbying force” — is “lobbying and advertising to win public support for President Obama’s sweeping plan.”

The AMA, in fact, represents approximately 18% of physicians and has been hit with a number of defections by members opposed to the AMA’s support of Democrats’ proposed health care overhaul.

• Four of nine doctors, or 45%, said they “would consider leaving their practice or taking an early retirement” if Congress passes the plan the Democratic majority and White House have in mind.

More than 800,000 doctors were practicing in 2006, the government says. Projecting the poll’s finding onto that population, 360,000 doctors would consider quitting.

• More than seven in 10 doctors, or 71% — the most lopsided response in the poll — answered “no” when asked if they believed “the government can cover 47 million more people and that it will cost less money and the quality of care will be better.”

This response is consistent with critics who complain that the administration and congressional Democrats have yet to explain how, even with the current number of physicians and nurses, they can cover more people and lower the cost at the same time.

The only way, the critics contend, is by rationing care — giving it to some and denying it to others. That cuts against another claim by plan supporters — that care would be better.

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From Sermo.com; the group responsible for the petition:

Join Sermo to add your signature to the Physicians’ Appeal below. And let lawmakers know that you want to contribute to the reform process. After the August recess, the signed Appeal will be delivered to Senators in every state. Each Senator will then be invited to speak with the Sermo community about the real issues at the root of spiraling healthcare costs.

To the American People,

We, the physicians of this country want to reform healthcare to improve the quality and access to care for our patients while reducing costs. True healthcare reform will only succeed if:

• Unnecessary tests and procedures are reduced through tort and malpractice reform
• Doctors are allowed to spend more time with their patients and less time on paperwork by streamlining billing and making pricing more transparent (create an alternative to CPT codes).
• Medical decisions are made by physicians and their patients, not insurance company administrators.
• Adequate supply of qualified physicians is assured by revising the methods used for calculating reimbursements.

We invite policy makers to work directly with the men and women who are on the frontlines of healthcare each and every day caring for the citizens of this country.

We pledge to be partners in true healthcare reform, improving the healthcare delivery system in this country while honoring the Hippocratic oath that we all have taken.

Respectfully Yours,

America’s Physicians