Talented Physicians Forced Out by Healthcare Changes

I was seeing a patient recently, and he told me that the nephrologist to whom I referred him is leaving. Now this physician is probably in his 50s, is healthy, and has college-bound kids, so I knew he could be retiring. I said, “No, no. You must have misunderstood. Maybe he’s just not taking new patients.”

A few days later, I heard from someone at the hospital, that Dr. A is indeed leaving. How can that be? Was he sicker than I thought? Did he win the Mega Millions? I figured he must have scored a good gig somewhere, and I (half) jokingly said whatever it is, I want in.

I ran into him a day or two later and just gave him “the look.” He laughed and said, “It’s true.” I asked him why and how? He said that because of the way the healthcare system is now, he just can’t afford to keep his practice open. He is a solo practitioner in an internal medicine subspecialty. He said reimbursements are down and expenses are up. He said that primary-care physicians are being discouraged from referring patients to specialists. He does have college-bound kids and can’t afford to not have funds. So he has found himself a corporate job; five weeks vacation, paid benefits, normal office hours. I was right. He did find a good gig.

He loves medicine. He loves his patients. He said he will miss practice. He is keeping his hospital privileges, just in case. He will still come to meetings and such, and he will keep abreast of all things medical. He is going to see how things go and someday, he may return.

It saddens me that the healthcare system is such that it is forcing out excellent physicians. Specialists in “intellectual” fields do not get paid nearly as much as those in “technical” fields. You get paid handsomely for procedures. You get next to nothing for a 30-minute conversation about prognosis and risk and benefit of treatment. You get absolutely nothing if this conversation happens over the phone. Even if you do it from home on a Friday night.

I have been lucky thus far, to be in a specialty that is in need of growth. I do worry about the future of the practice and the future of medicine in general. We can only hope that things get better.

Find out more about Melissa Young and our other Practice Notes bloggers.