It was a chance encounter.

After all it’s not every day you see an internist who still frequents a hospital.  We’ve known each other for years and he’s been watching the changes in health care, too.

“Boy, they’re really not happy Over There.  Seems they’ve contracted with Big Boy insurance as part of their new ACO model.  Everyone’s going to get their piece before the doctors: Over There hospital, their four million administrators,  lawyers, grounds crews, parking staff….  Then, after everyone else is paid, the doctors might get a few scraps if there’s some left over.  No guarantees.  All risk, no certainty of reward.  There was no way I could still go there.  I joined them, but had to leave when I saw how unworkable that was.”

“Isn’t this our new way forward?” I asked.

“I guess so.  Scary.  But I’ve got just a few more years.  Just have to get the kids through college.”

There are those who will call this doctor’s statement a veiled threat.  Perhaps it is.  Maybe economic times will make it difficult for many physicians to leave the security of their workplace in the upcoming years, but we should not take this doctor’s comments lightly.  There is an aire of uncertainty, and with it, anxiety.  Doctors, like every person working today, are under growing financial pressure.  But unlike every person today, they are saddled with unique physical, emotional, and legal threats, and it is no wonder many will leave the field for other endeavors if it’s not worth it to stay.

Thirty percent of all of today’s doctors are over 55.  Most of these doctors just want to get their kids through college.

What happens then is anybody’s guess, but one thing’s for sure: these resourceful individuals aren’t likely to  be left holding the financial health care bag.

And with them will depart important leaders for our younger generation of doctors in medicine.

Westby G. Fisher, MD, (aka Dr. Wes) is a board certified internist, cardiologist and cardiac electrophysiologist practicing at NorthShore University HealthSystem in Evanston, IL. He is also a Clinical Associate Professor of Medicine at the University of Chicago’s Pritzker School of Medicine. He blogs at Dr.Wes, where this post originally appeared.

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