Following Dr. Vince Bufalino’s post on the effects of the Proposed 2010 Physician Fee Schedule on quality and access, several members have written in to describe their reaction to the proposed rule. I wanted to highlight just a few because of their eloquence and passion.

From Thomas Cahill, Jr., M.D., F.A.C.C.:

Hooray for Dr. Bufalino.
I feel that not just cardiologists but that physicians as a whole are giving away the farm. We are the most important providers of health care in this world. There is no way we should stay unorganized and let a group of politicians take over health care. Certainly, there is waste in any system. But when I was on call two nights ago, no patient I was asked to see questioned my arrival at 10 p.m. to evaluate their chest pain or felt that this was an issue of inappropriate healthcare; this only applies to other people, not these patients or their loved ones. Who else was there in the ER that night? Besides the dedicated ER staff, a cardiologist from our friendly in-town competitor; not a trace of a single congressman clamoring for health care reform. We work hard, respect and love and care for our patients; we do not get inappropriate tax cuts or post-retirement benefits including pension and health care that Congress appropriates for its own members.

There is no way we should shrink and pretend that we do not earn what we make honestly, which is what we do when our leaders announce in public forum that we back Obama's health care plan. As a society the ACC should be publicly making a very clear statement like Mayo Clinic did that we do not back the president's plan to put an eventual (or hasty if he really gets his way) end to the private practice of medicine, a noble profession. Stand tall, you are not the enemy of our nation. You are the leaders and must work even harder to get the patients to put grassroots pressure on Congress to prevent the decline of Medicine.

As far as the CMS cuts, this may be just a vanguard of the slicing and dicing by the political left of the payment to any health care provider who is not screaming, fighting, kicking until someone backs off. It is time we take off the white gloves and get our knuckles skinned in the battle for the health care dollar. If we do not, the tougher more organized competitors will be glad to take away another 10 -15%. And Congress will be glad to tax you out of 50 - 60% of your income.

From Jaime Gerber, M.D., F.A.C.C.:

The impact of the cuts in reimbursement that CMS proposes will devastate private practice cardiology across the country. In our area, access to care for Medicaid Tite 19 patients is already difficult. This will be the first casualty of cuts as we will no longer be able to service these patients. Following will be a restriction in the number of Medicare patients that we are able to enroll. Already our primary care colleagues have largely closed their practices to new Medicare patients.

Layoffs will then follow. These cuts will cause a huge job reduction adding to the worst recession since the 1930's. Nurses, techs, secretaries and assistants will lose their jobs as the private practice groups struggle to maintain financial viability. Plans to buy new EMR's and upgrade technology will be shelved and capital spending frozen. As in any business, operating costs will be cut to meet revenue. And like most businesses, people are the most costly budget items.

The net effect of planned physician cuts will be to worsen the recession, further shift costs to the hospital emergency rooms and to reduce quality of care and access to care for all.

From Gloria Hui, M.D., F.A.C.C. (her comment is in response to my first call for comments):

I believe the public should be educated on the difficulty of practicing medicine as it stands now, even before the proposed Medicare cuts. In April 2008, we moved our practice from Building 1 to Building 4 within the same medical center complex. We filed the address change with Medicare immediately. However, it took Trail Blazer, the Texas carrier for Medicare, nearly 6 months, before we were reimbursed for services rendered for our patients. Reimbursement sent to our old address was not allowed to be forwarded. Trail Blazer never returned mail, e-mail, nor phone calls. We exhausted our line of credit from the bank. Approximately 80% of our patients are Medicare. Our practice nearly collapsed. The more patients we saw, the deeper we were in debt. Not until having this experience did I realize why some of our colleagues would restrict the number of Medicare patients they see. I can fully empathize with them now. We need to collectively stop this type of physician abuse.

The responses are varied but the message is the same: These cuts CANNOT go through. Quality cardiovascular is at stake.

Keep the comments coming! Leave your thoughts below on the proposed cuts.

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