More Physician Burnout Predicted from MACRA "Doc Fix," According to the Journal of American Physicians and Surgeons (AAPS)

TUCSON, Ariz., Sept. 8, 2016 /PRNewswire-USNewswire/ -- Physician burnout is a serious problem, and much of it is attributed to the stress of working in the government system, writes neurologist Lawrence Huntoon, M.D., Ph.D., in the fall issue of the Journal of American Physicians and Surgeons. Physicians have been living under the threat of threatened large Medicare fee cuts dictated by the sustained growth rate (SGR) formula, and now face nearly certain fee cuts, along with vastly expanded administrative work, because of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA)—sometimes called the "Doc Fix."

One of the goals of the Patient Protection and Affordable Care Act (ACA or "ObamaCare") and MACRA is to eliminate independent fee-for-service medicine, and solo and small-group practices, Dr. Huntoon states. "It is far easier for government to control a relatively small number of entities (Accountable Care Organizations/Alternative Payment Models) compared to a relatively large number of independent physicians."

MACRA creates the Merit-Based Incentive Payment System (MIPS) with progressive cuts in fees for non-compliance up to 9% by 2022, Dr. Huntoon explains. "Compliance with MIPS for solo physicians was designed to be extremely difficult.… CMS predicts that 87% of solo physicians and 70% of physicians in small groups of two to nine physicians will face financial punishment." Many will be driven into large groups or become hospital employees.

Chronic stress has deleterious effects on body and brain. Dr. Huntoon outlines the results of a recent functional MRI study that identifies the effect of stress on neural networks. These structural changes may help to explain symptoms such as difficulty sleeping, weight gain, anxiety, memory difficulties, increased difficulty making decisions, irritability, and depression.

The cure for brain atrophy and the symptoms that accompany chronic stress is to remove the stressor from the environment if possible. "A recent survey revealed that 40 percent of physicians in solo and small-group practices are considering the healthy brain choice of leaving their abuser, Medicare," Dr. Huntoon writes.

The Journal of American Physicians and Surgeons is published by the Association of American Physicians and Surgeons (AAPS), a national organization representing physicians in all specialties since 1943.

SOURCE Association of American Physicians and Surgeons (AAPS)

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