I just read an article in the July 22, 2013 issue of American Medical News about the need for doctors to “brace” for the tide of job offers coming as the Affordable Care Act (ACA) takes hold of the American health care system, Physicians get many job overtures and should brace for more – amednews.com. Change is coming fast.
I’ve noticed that my snail mailbox as well as my email inbox contain more job offer messages, the vast majority of them from headhunters. They all sound too good to be true:
- Employment opportunities with high six-figure salaries
- Sign-on bonuses that could be a down-payment on a house that any bank would accept blindfolded
- White sandy beaches
- No state income tax
- Short drive to the state penitentiary
- $500 per case incentive for making a DSM-5 diagnosis of Intermittently Politicized Polypolemical Patheticism with Extra Cheese
- Only state medical board requirement is to learn how to say “y’all”
All I would have to do is change my way of living. I suppose I could do that. My wife is already training me by changing my wardrobe. She bought me a pair of red pants, thinking I would wear them to work. We compromised when I said I’d wear them around the house. She’s bought me several items of clothing over the years that have found permanent places in my closet.
Seriously (but not for long!), the integrative care models for psychiatry will no doubt change the way psychiatrists live, according to some practitioners who wonder if the models will further marginalize them. Dr. Jurgen Unutzer, MD, clarified some of the issues in the July 19, 2013 issue of Psychiatric News, PsychiatryOnline | Psychiatric News | News Article Integrated Care.
It sounds like care managers will be doing most of the work, carrying primary care patient caseloads of up to a 100 patients to discuss with psychiatrists every week. Case managers will probably have to change their way of living too, such as cutting back on a just a few minor things like food, bathroom breaks, and social life. I take that back; they can wear adult diapers.
However, there’s going to be a shortage of primary care physicians too, with the influx of new patients into state Medicaid systems, at least the states which allow expansion of Medicaid rolls, and if the ACA funding doesn’t get de-funded.
And those of us who didn’t get grandfathered out from under the Maintenance of Certification (MOC) but who are old enough to know that MOC can’t solve the problem of incompetent doctors and are also skeptical enough of so-called non-profit boards to doubt their motive for promoting MOC other than cash–we’ll have to change our way of living too. Retirement is a change that can take quite a bit of adjustment–for all of us.