Catholic Doctors in the Age of Obamacare
John Brehany, PhD, president of the Catholic Medical Association has an interesting article here in the National Catholic Register. Here is my response:
As a Catholic doctor who is 53 years old practicing geriatrics, I agree that Obamacare has the potential to make it exceedingly more difficult to practice medicine according to the dictates of our conscience. It will also be more difficult to be profitable and stay in business given the cuts in medicare which have already occurred over the past 10 years.
As a geriatrician, 99 percent of my income is derived from medicare payments. Over the past ten years, even before the threat of Obamacare, yearly medicare reductions now have us getting re-imbursed for only 50% of what we bill for. Malpractice rates continue to rise. In one year in my state, they doubled. Also, I am not compensated for the hours on the phone with family and loved ones that are an essential aspect of geriatric care. Fortunately, at this point, I am an “employee physician” and the hospital system that employs me is taking these cuts “on the chin.” However, it’s only a matter of time when my employer realizes they can’t maintain the luxury of paying geriatricians who don’t generate anything close to their salary because of the massive reductions in medicare payments. This is in spite of the fact that geriatricians are a most-needed specialty given the retirement of the baby-boomers and the care they will require.
The other aspect of this “perfect storm” for Catholic physicians is the pressure to cut costs at the end of life and to “end the suffering.” We are practicing in an era when the concept of redemptive suffering has no meaning to most patients and many families think the purpose of hospice and palliative care is to provide a quick and painless end to their loved one’s suffering. As a medical director in a nursing home, I am regularly asked to stop tube feeds by families and push the morphine to lethal doses. Thankfully, in my state, it is still illegal for doctors to kill people and my nursing home, though not Catholic, agrees with the basic Catholic concepts of appropriate end-of-life care and my administration rarely questions my decisions to continue or initiate artificial nutrition and hydration. However, with the advent of Obamacare, institutions will eventually be pressured for financial reasons to withdraw and limit care and we will definitely see more euthanasia being performed than it is even now, in covert and subtle ways. The public’s acceptance of physician assisted suicide and euthanasia will increase as the costs of a fully implemented Obamacare drain the already insolvent coffers of medicare.
As Catholic physicians, we are certainly in a difficult time, but I am thankful to have the wonderful guidance of the magisterium to assist me to make the right decisions in caring for my patients. If I have to quit practicing because I am told to kill my patients, that’s ok. Better to go to heaven without a pension than hell with money in the bank.
As a Catholic doctor who is 53 years old practicing geriatrics, I agree that Obamacare has the potential to make it exceedingly more difficult to practice medicine according to the dictates of our conscience. It will also be more difficult to be profitable and stay in business given the cuts in medicare which have already occurred over the past 10 years.
As a geriatrician, 99 percent of my income is derived from medicare payments. Over the past ten years, even before the threat of Obamacare, yearly medicare reductions now have us getting re-imbursed for only 50% of what we bill for. Malpractice rates continue to rise. In one year in my state, they doubled. Also, I am not compensated for the hours on the phone with family and loved ones that are an essential aspect of geriatric care. Fortunately, at this point, I am an “employee physician” and the hospital system that employs me is taking these cuts “on the chin.” However, it’s only a matter of time when my employer realizes they can’t maintain the luxury of paying geriatricians who don’t generate anything close to their salary because of the massive reductions in medicare payments. This is in spite of the fact that geriatricians are a most-needed specialty given the retirement of the baby-boomers and the care they will require.
The other aspect of this “perfect storm” for Catholic physicians is the pressure to cut costs at the end of life and to “end the suffering.” We are practicing in an era when the concept of redemptive suffering has no meaning to most patients and many families think the purpose of hospice and palliative care is to provide a quick and painless end to their loved one’s suffering. As a medical director in a nursing home, I am regularly asked to stop tube feeds by families and push the morphine to lethal doses. Thankfully, in my state, it is still illegal for doctors to kill people and my nursing home, though not Catholic, agrees with the basic Catholic concepts of appropriate end-of-life care and my administration rarely questions my decisions to continue or initiate artificial nutrition and hydration. However, with the advent of Obamacare, institutions will eventually be pressured for financial reasons to withdraw and limit care and we will definitely see more euthanasia being performed than it is even now, in covert and subtle ways. The public’s acceptance of physician assisted suicide and euthanasia will increase as the costs of a fully implemented Obamacare drain the already insolvent coffers of medicare.
As Catholic physicians, we are certainly in a difficult time, but I am thankful to have the wonderful guidance of the magisterium to assist me to make the right decisions in caring for my patients. If I have to quit practicing because I am told to kill my patients, that’s ok. Better to go to heaven without a pension than hell with money in the bank.
posted by Russ Rentler, M.D. | 8:08 PM
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