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COSM14: Healthcare Reform Expected to Impact Physician Demand, Hiring

by Thomas R. Collins •

Take-Home Points

  • As healthcare reform is rolled out, the demand for services will probably play out differently in different regions.
  • Demand is already starting to slow, and that will likely slow hiring. But in large, integrated systems, there might be some expansion.
  • Quality will likely lead to higher costs as people live longer, and savings to the government will inevitably come through lower physician reimbursements.
  • Physicians need to embrace change and take part in answering all of the complex questions posed by the reform landscape.

The hiring of physicians and other healthcare providers could slow, but maybe not everywhere. Healthcare costs might go down some, depending on certain factors. Patients might be empowered to make their own medical financial decisions, but they might not be equipped to make wise ones.

Veteran physicians with extensive executive experience tried to tackle big questions surrounding healthcare reform during the panel discussion “Healthcare Delivery/Affordable Care Act—What Do We Know and What Can We Do?” In the process, they offered keen insights but also generated more questions.

The Affordable Care Act uses a variety of mechanisms to address several themes, which were laid out by panel moderator Ellis Arjmand, MD, MMM, PhD, professor of pediatric otolaryngology-head and neck surgery at the University of Cincinnati College of Medicine.

The legislation aims to promote access, control costs, improve quality, promote preventive care, improve nursing care through workforce provisions, raise revenue, and enforce requirements that insurance companies spend most of their premium revenue on the delivery of care.

The need for reform is apparent, Dr. Arjmand said. “I think that it’s important to remember that much of what we have, much of what we enjoy, has over time been publicly funded,” he said. “And we’ve built a system that is unavailable to many of the people in this country.”

The panelists were Jonas Johnson, MD, president of the Triological Society and Dr. Eugene M. Meyers Chair of Otolaryngology at the University of Pittsburgh School of Medicine; Marion Couch, MD, PhD, MBA, chair of otolaryngology-head and neck surgery at Indiana University School of Medicine in Indianapolis; and Michael M.E. Johns, MD, interim chief executive officer and interim executive vice president for medical affairs for the University of Michigan Health System in Ann Arbor.

Here are some key questions Dr. Arjmand posed to the panel:

1. What are your overall expectations for demand of healthcare as reform is rolled out?

Dr. Johnson said that it’s reasonable to expect that, if more people are insured, there will be “more work to do,” because those previously uninsured will now get preventive services they wouldn’t have gotten before. At the same time, waste will presumably be cut out of the system, so “the net effect could be even.” He added that everyone will be compared on cost and quality and cautioned that cost is a much easier thing to compare, so physicians should be prepared for that.