Since 2009, we have heard politicians tell us how Obamacare would improve access to health care and lower premiums.  Very few, if any, of these individuals were experts in the medical field.  They were not doctors or hospital administrators.  They were elected and appointed officials, many lawyers, and many whose entire professional experience has been concentrated in government.  That Americans felt it was a good idea to turn the transformation of our health care system over to people with limited to no experience in the actual practice of medicine is astonishing.

Four years into Obamacare implementation, we are finally beginning to hear from the people actually involved in providing or receiving health care.  We are hearing from Obamacare exchange participants who are unable to access medical care due to a lack of network approved physicians and hospitals.  We have heard from pediatric hospitals concerned that they are being left out of exchange networks.  And we are starting to hear from doctors who are finding the mandates and the costs too cumbersome to effectively treat their patients.

In his Wall Street Journal editorial, “A Doctor’s Declaration of Independence,” Daniel F. Craviotto Jr. talks about this very issue,

“In my 23 years as a practicing physician, I’ve learned that the only thing that matters is the doctor-patient relationship. How we interact and treat our patients is the practice of medicine. (Emphasis intended.) I acknowledge that there is a problem with the rising cost of health care, but there is also a problem when the individual physician in the trenches does not have a voice in the debate and is being told what to do and how to do it…So when do we say damn the mandates and requirements from bureaucrats who are not in the healing profession? When do we stand up and say we are not going to take it any more?”

One such mandate which Craviotto refers to in his piece is the requirement for electronic health records (EHR).  The ACA demands that all individual and group practices have an electronic medical records system in place by 2015 which incorporates “meaningful use” criteria as dictated by the Centers for Medicare and Medicaid Services (i.e. doctors are told what type of data they need to maintain).  Such systems are costly, not only in terms of technology, but also in terms of staff training, maintenance, and the interference with patient time as doctors spend precious moments during office visits tapping required data into a screen that may have nothing to do with a patient’s condition.  Dr. Craviotto contends he spends two hours a day typing into his medical records system – time not well spent for a man who has allocated tens of thousands of dollars and countless hours in training to become a surgical specialist.

As the Obamacare mandates increase the costs and frustrations of practicing medicine, doctors are finding the rewards decreasing.  Craviotto indicates that Medicare and Medicaid reimbursements have not kept up with inflation, and in fact, have declined significantly.  As an example, Craviotto points to an inflation adjusted decrease of 68% in the reimbursement for a total knee replacement over the period 1992-2010.

Craviotto notes that no other profession would stand for the amount of outside interference that doctors are subject to – certainly not lawyers or labor unions – and he asks who will be left to stand up for the profession of medicine once the senior doctors practicing today have retired.

As long as the federal government continues to be the driver of health care policy, Americans need to consider the consequences and remember – President Obama,  Nancy Pelosi, Harry Reid, and former HHS Secretary Kathleen Sebelius do not know how to perform surgery or diagnose an illness.  We need to examine the effects Washington’s health care policies are having on the professionals who actually provide medical care and ask ourselves if we are creating an environment in the health care profession that will continue to attract the best and brightest to the field of medicine.

Dr. Craviotto’s editorial can be found HERE.