83% of US doctors considering quitting because of Obamacare

[Dreadnought]

@ only 669 out of 16, 227 responses being included in the final calculation.

I normally try and write detailed, sensical rebuttals but bwahaahahaahaahahahahaahaha what a worthless survey. No point even discussing this thread really.

Can't even get past the thread title before...





...oh god wait you actually believe that title?



BEAR RUN AWAY

Really the mental gymnastics required to turn that premise into something that begins to make sense is astonishing. Color me impressed.

Thanks for the post!

This thread.... mmmm. So delicious.


If I were to encapsulate the entire spirit of Off-Topic in one thread, this would be the thread. Something stunningly absurd, and then grabbing some popcorn so I can watch other folks (Form, for example) use logic against it. Always a one-sided match.

OM NOM NOM NOM NOM

Care to post out Form's deliciously logical counter to the survey?

Because, quite frankly, I find it depressing that you didn't instead name BvBPL, with his beautiful response. Sad.

The OP has practice; he is a traitor, after all.

Oh, you silly goose. Is it that time of month again for you?

Having a 4.7% response rate for an unsolicited survey of this nature isn’t bad. In fact, it can be quite a good number in some cases. That said, there are a number of flaws in this survey that invalidate it, especially compared with the 2008 Health Tracking Physician Survey.

For one, the demographics are not representative of the US population of doctors. 80% of respondents say they belong to a single doctor or small practice, however upwards of 50% of medical practices are now in hospital or other large practices and only one third are in single doctor or small practices and another 15% were in 3-5 member group practices. In addition, the years in practice are not representative of the general physician population; in this study only 8.3% of respondents were in practice less than 10 years whereas 29.3% of US physicians report this level of seniority.

The survey’s questions are completely loaded. The first question is “How do current changes in the medical system affect your desire to practice medicine?” which might be a valid question, however the only responses are “I’m re-energized,” “I’m thinking about quitting,” and “no opinion.” Where’s the option for folks who are half-heartedly going along with it? There’s a huge gulf between being re-energized and thinking about quitting that isn’t reflected on the survey. While the survey reports that 82% of docs are thinking about quitting, it doesn’t provide any explanation for why that is when the 2008 study showed 43% of physicians where somewhat satisfied with their careers and 39% were very satisfied. Can we really assume that all of those doctors are now thinking about quitting when the majority of the ACA reforms haven’t even come into effect yet?

The findings of the survey are equally spurious. The survey’s authors highlight that two thirds of the respondents report “just squeaking by or in the red” in terms of their practices’ finances. First off, we have to question whether the ~20% of respondents who are part of large practices are even in a position to know how well their practices are doing. Secondly, an examination of the actual question shows that 32.5% of respondents say their practice is “in the black” full stop, 37.3% that their practice is “in the black, but just squeaking by,” 12.3% are “breaking even” and only 14.5% report that they are in the red. That may seem a little damning, but that doesn’t mean that doctors themselves are going broke. It is the responsibility of a practice, even a single-doctor private one, to pay out doctors’ salaries, so any practice that is in the black, squeaking by, or breaking even is still paying its doctors with no significant problem. Suggesting that two thirds of the doctors are squeaking by or worse ignores the fact that ~70% are operating in the black. Similar chicanery of findings is used on other issues as well.

In short, this survey isn’t worth the paper it was printed on.

Demand increases, but the ability to charge fair price doesn't. Government insurance pays out the lowest return of any insurance program. Many have criticised current government Medicare as "deadbeat" - sometimes it doesn't pay at all.

Doctors will indeed work harder, especially if those statistics about future medical professional shortages are true. But these doctors will not be able to set their own prices, Obamacare will decide embursement, and it will be bargain-basement.

Where I work, the hospital is delighted, it means more customers and business for the corporation; but the doctors are not - more work but diminishing returns. Doctors already face sky-high malpractice insurance premiums, and now the payment they recieve from Obamacare patients will be the lowest, which will drive the private insurance industry to lower their payments as well to remain competative.

It's perhaps too early to tell how it's all going to work out. Canadian doctors make about the same as US counterparts, but only because their malpractice insurance is so much lower there.

Well, I highly doubt that 83% of doctors will end up quitting their jobs. It's worth noting that the sample size isn't gigantic, so I'm skeptical the percentage would be nearly as high if the survey cast a wider net.

There is an issue for doctors in that generally, private-pay patients pay the most, followed by insured patients, followed by Medicare. So I suppose if you theorize that the influx of lower-end patients might push your primary care doctor's patient mix to a slightly less wealthy mix, lowering per-patient revenue. There's also the issue that with insurance, there will be higher demand for primary care physicians (although possibly lower for acute care if preventative care is received where it wasn't before).

But I guess I don't see what the big issue for doctors is. And the article really doesn't shed any light on this, either. For primary care doctors, it seems like it would increase the number of potential patients, which is good if you aren't already at capacity at your practice. And the new patients are still going to be a revenue source, if not the most lucrative.

Finally, a few worthwhile responses.

It's funny how media news sources highlight things like the mandate as the worst part of Obamacare, where the real issues lie with the new regulations to be implemented against doctors.

My father's hospital, for one, is delighted that the government will pay for the 40% of total patients who do not pay for their own healthcare. Yet, this pay will be docketed from other, more upscale hospitals in states that have tremendously successful healthcare statistics, leading to an overall downgrade of healthcare quality in the country.

There's also the point of the new regulations. I work with doctors on a daily basis for my job. They are not delighted by the new role government has in healthcare. With Obamacare, doctors now must submit hundreds and hundreds of personal medical statistics to the government every year, tracking things such as post-surgery infection rate and recovery times. If a certain percentage of the doctors' patients have issues, then they will see their pay reduced -- except, hello, doctors cannot possibly control all aspects of a patient's health after their procedure or time in care. It's utterly ridiculous.

It... is insane claiment. 83%? Realy? How many doctors where interviewed? Were they selected to be interviewed for their conclustive views by any chance? How made up was the study?

Lies, dame lies and statistics.

I was going to use that line!

Funny that Google has no hits on this from news organizations....

And yet there still is not a news report on this "study". So why are people being even this kind to the OP?

This thread is the number one Google hit on the subject. And the other hits are other forum, mostly right leaning, or rightwing blogs. No news service appears to have picked up the story.

Just doing my part.

 

[Cheezy the Wiz]

So the question is, Dreadnought: do you believe that 83% of US doctors are considering quitting because of Obamacare? Or do you believe that 83% of the doctors who returned the survey are considering quitting?

 

[kochman]

So the question is, Dreadnought: do you believe that 83% of US doctors are considering quitting because of Obamacare? Or do you believe that 83% of the doctors who returned the survey are considering quitting?

This is obviously the case... the pissed off docs, that won't quit unless they are financially set, returned it, saying they were pissed... motivated by, being pissed... in the American sense of the term (and potentially the British sense as well).

 

[Dreadnought]

So the question is, Dreadnought: do you believe that 83% of US doctors are considering quitting because of Obamacare? Or do you believe that 83% of the doctors who returned the survey are considering quitting?

I believe that a sizeable majority, whether 83% or otherwise, oppose the new regulations set by Obamacare.

 

[Cheezy the Wiz]

This is obviously the case... the pissed off docs, that won't quit unless they are financially set, returned it, saying they were pissed... motivated by, being pissed... in the American sense of the term (and potentially the British sense as well).

I believe that a sizeable majority, whether 83% or otherwise, oppose the new regulations set by Obamacare.

Even though that's not what the data you supplied supports?

 

[Dreadnought]

Even though that's not what the data you supplied supports?

I would assume, if someone claims they are considering quitting over Obamacare, they oppose it.

 

[Cheezy the Wiz]

I would assume, if someone claims they are considering quitting over Obamacare, they oppose it.

My point being, that your data says that 83% of the 4.7% who bothered to respond said they would quit because of the ACA. That's actually 3% of the 16,000 doctors surveyed, not 83%. Thus, your data does not reflect that even a sizable majority of doctors oppose ACA, or even an amount worth regretting being lost.

In addition, by your logic, if the doctors who all wanted to quit were the ones who bothered to respond, the other doctors surveyed who did not bother to respond could equally be assumed to not want to quit because of the ACA, and thus do not oppose it.

And finally, I should think you would feel safer with the doctors doing it for the money leaving the industry.

 

[Dreadnought]

My point being, that your data says that 83% of the 4.7% who bothered to respond said they would quit because of the ACA. That's actually 3% of the 16,000 doctors surveyed, not 83%. Thus, your data does not reflect that even a sizable majority of doctors oppose ACA, or even an amount worth regretting being lost.

In addition, by your logic, if the doctors who all wanted to quit were the ones who bothered to respond, the other doctors surveyed who did not bother to respond could equally be assumed to not want to quit because of the ACA, and thus do not oppose it.

And finally, I should think you would feel safer with the doctors doing it for the money leaving the industry.

4.7%, while not high, is certainly not a terrible turnout for a survey. That being said, we cannot assume that those who did not respond are in favor of Obamacare, just as we cannot say that those that did not respond are against it. Wouldn't you, if you supported Obamacare, want to respond to the survey?

With the questions the survey gave, I'd say those that didn't respond are most likely apathetic at best, or hesitant (though not willing to quit their profession) at worst.

 

[Dirichlet]

Complaining about the sample size being too small is silly. If it was a truly random sample from the population at sample the 95% confidence interval for ratio of doctors considering quitting would be between 80% and 86%, which would not change the message at all.

The real problem here is selection bias - first, they only choose doctors of which they had fax numbers. This explains the high amount of single practioners. But the major thing is that someone who wants to rant is just much more motivated to answer the questions.

Also note that "consider quitting" is not a well-posed question, because it does not say whether the consideration was serious or just an irritated moment.

So, please shred the study for what it actually did wrong, instead of going the "OMG, sample size" route.

 

[Cheezy the Wiz]

4.7%, while not high, is certainly not a terrible turnout for a survey. That being said, we cannot assume that those who did not respond are in favor of Obamacare, just as we cannot say that those that did not respond are against it. Wouldn't you, if you supported Obamacare, want to respond to the survey?

With the questions the survey gave, I'd say those that didn't respond are most likely apathetic at best, or hesitant (though not willing to quit their profession) at worst.

Yeah, because your worldview hinges on that being true. But the data doesn't say that.

 

[Dreadnought]

Complaining about the sample size being too small is silly. If it was a truly random sample from the population at sample the 95% confidence interval for ratio of doctors considering quitting would be between 80% and 86%, which would not change the message at all.

The real problem here is selection bias - first, they only choose doctors of which they had fax numbers. This explains the high amount of single practioners. But the major thing is that someone who wants to rant is just much more motivated to answer the questions.

Also note that "consider quitting" is not a well-posed question, because it does not say whether the consideration was serious or just an irritated moment.

So, please shred the study for what it actually did wrong, instead of going the "OMG, sample size" route.

I too crunched the numbers and got a interval of approximately 77% -> 88%.

Yeah, because your worldview hinges on that being true. But the data doesn't say that.

I'm speaking from a rational perspective. We'll never know why the doctors didn't respond to the survey. Maybe a bunch of the offices simply threw it out as spam. We'll never know.

 

[Leoreth]

It's funny how media news sources highlight things like the mandate as the worst part of Obamacare, where the real issues lie with the new regulations to be implemented against doctors.

My father's hospital, for one, is delighted that the government will pay for the 40% of total patients who do not pay for their own healthcare. Yet, this pay will be docketed from other, more upscale hospitals in states that have tremendously successful healthcare statistics, leading to an overall downgrade of healthcare quality in the country.

There's also the point of the new regulations. I work with doctors on a daily basis for my job. They are not delighted by the new role government has in healthcare. With Obamacare, doctors now must submit hundreds and hundreds of personal medical statistics to the government every year, tracking things such as post-surgery infection rate and recovery times. If a certain percentage of the doctors' patients have issues, then they will see their pay reduced -- except, hello, doctors cannot possibly control all aspects of a patient's health after their procedure or time in care. It's utterly ridiculous.

This sounds like a worthwhile topic to discuss. Why didn't you make that the OP instead?

I don't see the need to divert attention from this apparently valid concern by making everyone talk about an obviously biased, statistically dubious survey instead.

 

[Turquoiside]

Thanks for the post!

If you wanted us to humor you and your obviously flawed survey, you should have tried posting in the right forum.

 

[Dreadnought]

If you wanted us to humor you and your obviously flawed survey, you should have tried posting in the right forum.

If you wanted me to humor you with a dignified response, you should have posted something more worthwhile.

 

[Turquoiside]

I couldn't care less if you hadn't even bothered to read it.

 

[Traitorfish]

What are your reactions?

Hang no fewer than one hundred known doctors, rich men, bloodsuckers.

 

[Dreadnought]

Hang no fewer than one hundred known doctors, rich men, bloodsuckers.

Use them as an example for the others!

 

[del62]

Most Doctors in Britain opposed the national health service before it was implemented, most then worked for the national health service, I doubt many are opposed to it now.

So I would not expect many to quit.

 

[JollyRoger]

I would assume, if someone claims they are considering quitting over Obamacare, they oppose it.

What do you assume if they don't answer a survey?

 

[emzie]

4.7%, while not high, is certainly not a terrible turnout for a survey. That being said, we cannot assume that those who did not respond are in favor of Obamacare, just as we cannot say that those that did not respond are against it. Wouldn't you, if you supported Obamacare, want to respond to the survey?

With the questions the survey gave, I'd say those that didn't respond are most likely apathetic at best, or hesitant (though not willing to quit their profession) at worst.

A 4.7% response rate is horrendous / hilarious if you don't do anything to normalize the data. The survey you cited didn't even do so much as weigh respondents based on demographics. I'd give it less weight than a CFC poll.