Doctors Abandoning Private Practice in Droves to Work at Hospitals

"Do hospitals actually have family physicians and GP’s? I thought hospitals only had specialists? How does this work?"

Here in Washington, one such entity is "Multicare". Multicare is a non-profit entity that owns and runs hospitals, clinics, and, for a better word, "multi-specialty" facilities where individual physicians practice. And yes, they have both family physicians and GP's as well as pretty much any specialty you might need.

The Catholic organization in the same area runs pretty much the same way. And frankly, it works VERY well, and did so long before Obama got into the act. Hopefully, his changes won't screw things up too terribly.

I think it is good to keep your options. I, too, have kept my credentials. Yes, I have considered locum tenens. I have considered going up to a small town in Wyoming and/or Alaska,….give the doc a rest and vacation and go see the country. They sometimes put you up in the doctors home while he is away. No surgery, mostly general practice type stuff. Luckily my financial circumstances are in good shape and I do not need to, but just for patient contact, meet some new people, see a different part of the country. I don't know…..it seems the older I get the lazier I get. I have a farm with about 150 Angus cows and enjoy fooling with them. Nature seems less stressful in my circumstances. Got 5 lakes on my place. Fish, ducks, deer. I used to like to deer hunt, but I'v gotten soft-hearted and don't want to kill another thing. Just enjoy their beauty.

My daughter is fine. She was out of the hospital in 23 hours after laparoscopic appendectomy.

What concerns me is that an unsuspecting public has been sold a bill of goods. There will be no going back. In one fell swoop obama took over every doctor and hospital and insurance policy. The public has no clue what is about to befall them. We and the hospitals are partly to blame. The public gets an inventory or what they are charged for…..$5 for an aspirin or tylenol…..$9 for a box of kleenex…….The public knows nothing of cost-shifting or logistical requirements or how many people (salaries) take that kleenex box to get to their room. They see it as being outrageous. Perhaps it is. Hell, (and this happened many times) if someone is down and out, and I want to do a free surgery on someone, HCFA says I can't unless I charge the government (medicare) the same rate I offered the indigent. I have to make the same "good-faith" effort to collect the bill. So there you are. I would have been happy to take a chicken or let someone clean a fence line for my services…..not all the time….but on those down-and-putters. So,also, the public knows nothing of cost-shifting from performing medicaid procedures (does not allow doc to break even) to a private insurance policy. It was finally rejected by the insurance companies and government and this was Obama's opening, and he took it.

Now, as inequitable as seemed to be, the ACA will be truly a debauch.

Sorry for the delay in responding.

Agree with all your points, particularly on the ACA, and the lack of understanding by the public as to its implications. To me it appears to be designed to usher in a single payer system, most likely built on the British model. Complete with and equivalent of the Liverpool Care Plan, if I read Zeke Emanuel’s blueprint correctly. That graph included in their 2009 Lancet paper (on age dependent probability of qualifying for health care expenditures) shows their truly vile intent, IMO. Throws 2500 years of medical ethics out the window.

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