The Affordable Care Act is decimating a venerable American institution: the one-doctor medical practice. Already hit hard by government red tape that has simultaneously cut revenues and boosted costs, Obamacare is forcing even tiny practices to install expensive, complex software systems that sharply reduce time for patients. It hasn't gone well:
- Nearly 70 percent of physicians say digitizing patient records has not been worth the cost, according to a survey by Medical Economics magazine. Though some like the law's mandated printouts, the added time spent managing the system is hurting productivity. Doctors who once aimed to see four patients an hour now struggle to see three, a 25% drop in productivity.
- One big problem is the dozens of systems don’t talk to each other, because the feds didn’t specify interoperability. So communication gains among hospitals, clinics and doctors offices aren’t happening.
- Also, doctors can be criminally liable if hackers get hold of patient data through the online systems, adding a costly risk to the practice.
Many sole practitioners say they can't afford to continue under new mandates. Surveys suggest that older physicians are retiring in high numbers. Younger ones are closing practices and taking jobs with integrated health systems.
The mandates clearly shift advantage to large doctor groups and health systems that can spread costs over more patients. Places like Kaiser Permanente, a giant company that uses technology and standardized treatment to orchestrate a team of technicians, nurses and doctors. This "factory-style medicine" is rapidly becoming the norm.