When Obamacare is implemented, many doctors will have to find a new ways to do business.
They will have to find ways of cutting costs and eliminating unnecessary tests and procedures, and they will be rewarded for keeping people healthy and out of the hospitals.
"There will be more work but what I tell my staff here you have to work smarter," said Dr. Jeffrey Rosen, a primary care physician.
Rosen said he is looking down the road to Obamacare, which goes into effect Jan.1, 2014.
"We have gone completely electronic, that in itself is a process, right now its additional work but long term should shorten the work and improve the care,” he said.
But still, Obamacare is commonly misunderstood.
Dr. Steven Ullman, University of Miami professor of Health Sector Management, the Affordable Care Act is extremely complex.
“I do not think you can be in favor of it. I don't think you can be opposed to it,” Ullman said. “There are so many elements to it."
New doctors, who are just getting started, are also concerned. Although they might get incentives to locate in underserved areas or student loan forgiveness, they too might get confused about what it entails.
"The doctor coming out today is facing a system that is much more business focused. The realization is that it is business," Ullman said.
And for longtime doctors, there is a possibility of more paper work and more patients.
“Do I have additional staff I did not have a year ago? Yes, I did that because I drank the Kool-Aid,” Rosen said. “I think this is going to work."
He will need that staff because under Obamacare, hundreds of thousands of Americans will have mandated health insurance. For the first time in history, these Americans will have to seek out primary health providers.
“It is going to be difficult for people to find a primary care provider,” Ullman said. “We are going to expanding access but expanding access does not mean expanding provision of care."
Only 20 percent of American doctors are general practitioners. Of that group, many are unsure of what is coming down the road.
Dr. Oliver Dipietro operates a one-doctor clinic in Bay Harbor and sees an increase of patients in the future. But to prepare for the new business, he has hired a nurse practitioner.
"But really none of us know what to expect,” Dipietro said. "Physician extenders will be an important part of primary care."
With the Affordable Care Act implementations, insurance companies and government will be more involved than ever.
“We are concerned about the reimbursement structure,” Dipietro said. “What the model is going be because you know this is a business too."
“There was a time when doctor and patient could decide what needed to be done. No one would question it,” Dipietro said.
But not anymore. According to the doctors, Obamacare will stiffen the already tight approval process.
"The payer might say that test was unnecessary,” Dipietro said. “That we are not going to pay for it.”
So it is a new world for the doctors, the specialists, the medical experts and patients.
"I wish someone would tell us about it,” Dipietro said. “We are going to be in the trenches January first and no one has approached us as of yet."
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