Physicians won’t stop practicing medicine, Dr. Goertz said, but they may move into another community with fewer Medicare patients or join a group that sees fewer Medicare patients.
“Altruism is great, and all of our members have a dedication to patient care, but they also have to understand what their families need,” he said.
Dr. Timothy J. Laing, a rheumatologist at the University of Michigan and chairman of the government affairs committee for the American College of Rheumatology, agreed that physicians would be forced to make tough choices if the cuts went into effect.
“I think it would make a lot of rheumatologists think very hard about access for Medicare patients,” Dr. Laing said. “What had always been taken for granted since the inception of the program – that Medicare was welcome in every office – would now begin to be questioned.”
The hope for physicians, Dr. Laing said, is that the 29.5% cut mandated by the SGR is simply so large that it would be unthinkable for members of Congress to let it go into effect.
Dr. Jonathan Leffert, an endocrinologist in Dallas and chairman of the legislative and regulatory committee for the American Association of Clinical Endocrinologists, said he thinks it is likely that Congress will do something to avert the massive SGR cut, even if it’s a temporary fix.
“Medicare patients not being able to see their physicians is pretty toxic for both Democrats and Republicans,” he said.
But anything beyond a temporary fix is likely to depend on the makeup and philosophy of the members of the joint committee. “We’re in a wait-and-see mode here,” Dr. Leffert said.
In the meantime, Dr. Leffert predicted that physicians will keep on seeing their patients as usual because the environment is simply too uncertain to do anything else.
Shawn Martin, director of government relations for the American Osteopathic Association, said the joint committee’s deliberations could give physicians a chance to open up a real debate over permanently fixing the SGR.
“We think it’s an opportunity to have a very real and meaningful conversation regarding what the SGR baseline debt really means to the long-term stability of the program,” Mr. Martin said.
There’s no guarantee that the joint committee would repeal the SGR, Mr. Martin said, but it will at least get people talking about the problem.
***This story was updated on Aug. 12, 2011.