<p>So yesterday we had to take my father in law to a dentist - on holidays so we had to go to emergency dentist. We got talking and my S was with us and he also has a senior applying to colleges - you know how that conversation can go. As soon as he found out my S was going for a medical degree the dentist got all serious, looked up and said, "Pull out. Pull out immediately, pull the plug and get out while you can. That profession is being destroyed thanks to the Affordable Care Act. Go be a dentist instead. Medicine is no longer a good return on investment for your future."</p>
<p>We were a little startled by his reaction - sort of funny how serious he got. </p>
<p>What have you all come across regarding this issue?</p>
<p>@Midhelper, if going into medicine is primarily for the financial side of the profession, one can do something else instead (e.g. investment banking, actuarial science, computer software engineering, etc etc) and get a much better return. That is why I have been saying to my kids is to do what they enjoy. Remember that they will have to face their profession for the rest of their lives and it would be extremely difficult to be able to do that if they are in professions they do not enjoy, even if they are making a lot of money! I am fortunate to never have to think about the financial side of medicine and went into medicine because I felt that was what I wanted to do and have enjoyed my profession since, so much so that I just cannot imagine myself retiring. So, I hope all parents guide their kids along to fulfill their potentials and interests appropriately in a profession that their kids enjoy and do not think about the financial side of the profession. The money will come in if you are good at what you are doing, irrespective of what it may be. You can only be good at what you are doing if you enjoy doing it. As a physician who enjoys very much what I do, Affordable Care Act or not isn’t going to influence my choice of career, except to be more cognizant of the potential changes in the horizon.</p>
<p>@SuperDoctor, thank you. The ACA is a nuisance and will impact on the quality of care a physician can give to his/her patients. I am against the ACA but it does not mean I should discourage high school students from going into medicine, if medicine is their interest. If you are committed and are a good doctor, you will find ways to overcome the problems associated with ACA and when you do so, it would be so fulfilling professionally. So, at you stage in life, just be simplistic and go and pursue your dream. Do not be deter by what people say about ACA or other issues. They may change in future and politicians come and go, but once you forgo your dream, you may never have the same opportunity again.</p>
<p>Even after aggressively trying to convince my kids to choose a different career, every experience they have had has confirmed their passion for medicine. To me it sounded like the Care act would be good for people but we have not been following closely at all. We have no information about its impact on doctors. As much as my kids are not thinking about the money, as a parent I would like them to always be comfortable enough so that they can focus on the true spirit of being a doctor without worrying about their financial situation. We are not rich enough to pay for it all and medical schools are not cheap - they are going to have to take out a lot of it in loans. I want to know that they will be able to pay their loans back and still be able to buy a house, car etc.</p>
<p>@Midhelper, sometimes it is better for the kids to have to take up loans so that at least they appreciate their accomplishment more. I think my kids suffer from “Affluenza” and they just do not appreciate what they get. I understand your concern but would like to point out to you that as long as your kids are happy, irrespective of what they make as a physician, they will still be making a lot lot more (with or without the ACA) than the average household in this country.</p>
<p>I’m a huge proponent of the ACA, and I think it’s doing to do some great things for US healthcare to bring us up to the standard of many other Western countries. However, it will change the face of medicine. Physicians are no longer going to be compensated in the extreme ways that they are today, and that could be a problem to the many students who aim to go into medicine as a lucrative career. No longer will doctors be millionaires. However, I’m perfectly happy with a smaller salary.</p>
<p>@bruno14, it is not about the compensation that physicians opposing to the ACA are worreid about. I worked in the United Kingdom for 14 years and in this country for 15 years. Therefore, I have had the opportunity to compare social medicine with private medicine. Social medicine is an excellent and noble concept but, unfortunately, because of resource constrains, rationing will be done and so there will be waiting list. Furthermore, if reimbursement goes down to the level that a physician will lose money treating a patient, the physician is not going to treat the patient. It sounds good to claim that now more Americans have health insurance, what is the use if no doctors would accept the patients? At the moment, because of the reduced reimbursement for Medicare and Medicaid patients, many physicians have stopped taking these patients, because they are actually losing money treating the patients. I am an oncologist/hematologist and I do not mind providing free service to patients without insurance and have done so very often, but if the patients need chemotherapy, if the patient has either Medicare or Medicaid cover, Medicare or Medicaid actually pays me, for some of the chemotherapy, less than the cost price of the chemotherapy. Therefore, I would be losing money, even before taking paying for the overhead, etc into consideration.</p>
<p>“The ACA is a nuisance and will impact on the quality of care a physician can give to his/her patients. I am against the ACA”</p>
<p>I thought the intention was to improve the quality of care given to patients; then, wouldn’t that be good [for the public]? Though i do agree, on the other side of things, it may not always be a mutually beneficial on the doctor’s side. While doctors may be impacted negatively, hospitals, collectively as an industry are going be facing some pretty large downfalls.</p>
<p>@GreenSage, the ACA would be a great policy if there is unlimited resources. Unfortunately this is not going to be the case. Having insurance does not mean that the patient will be cared for or receive improved quality of care. If the policy is a bad one, i.e. the cheaper ones, the patient may have very limited access and the resource constrains will also impact on the care of the other patients. Already many people are finding out the “If you like your policies and your doctors, you will get to keep them. Period” as being oversimplistic to the extent that it is close to a lie.</p>
<p>From my personal experiences speaking with physicians, I’ve gathered that the ACA will bring doctors more money than before. Now, thanks to its individual mandate, cheaper insurance prices, and barring insurance companies from denying coverage due to preexisting conditions, MORE people will have insurance and will be able to afford going to the doctor. So, the nearly 47million Americans currently without insurance will have better opportunity to get coverage and bring their money to doctors’ offices.</p>
<p>At least that’s what I’ve heard. Can anyone confirm/deny this? Thanks in advance :)</p>
<p>@Blink202, simple arithmatics will tell you that this just cannot be done. “Cheaper insurance” is an over-generalization. Yes, it will be cheaper for some but for many, it will be more expensive, or it will be expenses that the individuals have never needed to pay because the individuals do not believe in insurance. So, if it is cheaper to pay the fine for not having insurance than to take up insurance for those “healthy youths”, why bother taking the insurance especially if the insurance company can no longer deny pre-existing? Why not wait until something happens and then take up the insurance? This is likely going to happen and when that happens, the insured pool will have a very large proportion of sick people who need a lot of resources to cover the medical bills. Then how do you keep the insurance premium low?</p>