Several local doctors with small, private practices have mixed feelings about the Affordable Health Care Act, but most agree it will cause many family doctors to consolidate or leave the field.
“Practices like mine won’t survive,” said Dr. Dave Webster, who has operated the Webster Family Practice Clinic in Killeen since 1999.
Clinics not prepared for the Affordable Health Care Act — and even some that are — will find themselves consolidating, merging or being bought out, said Chris Strickland, the office coordinator for Lampasas and Copperas Cove Family Medicine Clinics.
While ensuring staff at the Lampasas and Cove clinics are well trained on the Affordable Health Care Act, often referred to as “Obamacare,” and not going anywhere, most smaller practices are going to feel a financial burden to keep up with regulations required by the federal government.
The Affordable Health Care Act requires stricter guidelines on documenting and reporting how doctors do their jobs, Dr. Karen Harrison said.
She runs Harrison and Harrison Internal Medicine in Copperas Cove with her husband, Dr. Raymond Harrison. They have been preparing for Obamacare, which opened for enrollment Oct. 1. Coverage starts Jan. 1.
“You are going to have to report these numbers — and you are going to take some time away from patient care — so you will have time to do that, or hire someone to do that for you,” Harrison said. “The mergers will kind of help, because you have a system then to help accomplish whatever we are asked to do.”
Some clinics won’t be able to take patients with the government insurance because they will not be able to offset lost revenue as people start to find the loopholes in the Affordable Health Care Act, Strickland said.
“(Small clinics) don’t have the negotiation power to get good prices from that plan,” he said.
Power of merging
Merging practices to facilitate those changes are underway.
“It has been happening for some time,” said J.D. Sheffield, who runs the Coryell Memorial Medical Clinic. “When they started to talk about the (Affordable Health Care Act), that definitely sped up the mergers and joinings.”
Another issue that may encourage doctors to consolidate is fees.
“Part of it is having a government-certified system,” Karen Harrison said. “There is going to be pay for performance, where fees (charged to the doctors) are going to be based on how good a doctor you are.”
Harrison said the performance-based system could cause some problems with doctors, but said doctors who put patients first won’t have a problem.
The mergers caused by handling the administrative back end of those regulations could have the opposite effect, though.
Webster said he makes money by providing quality care to his patients and often gets new patients through referrals from people pleased with his service.
Business models should be based on doing what is best for the patient, he said. But working for a larger organization often means a different focus.
“If policies are more concerned with saving money and cutting costs, that doesn’t help the patient,” Webster said. “You will always have a doctor torn between what he has to do to keep his job and what is right for the patient.”
Having to deal with the changes to health insurance could cause some doctors to leave the field rather than join other, larger practices better equipped to handle the new law.
“Older physicians like myself are going to retire,” Webster said, adding he has heard that 25 percent to 50 percent of doctors will retire or drop out of the medical field. Losing that many doctors will lessen access to health care, as it will create longer waiting lines to see physicians.
The Affordable Health Care Act, in that respect, will actually make it harder to see a doctor and receive care, Webster said.
While changes are coming, none of the doctors expressed immediate concerns about leaving the field or their practices.
Harrison said her clinic plans to cope with the health care law changes in ways that are best for the patients and the practice.
“We’ll eventually figure out what is best for our practice and what is best for patients and what is going to allow us to take the best care of our patients,” she said. “This was my hometown, and when I completed my residency, I wanted to come here.”