I have been wondering this for years. The longer I’ve been in the trenches, I learned that the productivity standards always get steeper, and the goal posts will always move further out of reach. For those not in the medical field, you many not be aware that most, if not all, of medical practices require providers (that includes doctors, physician assistants, nurses, physical therapists (PT), etc.) to see a specific number of patients a day or to bill a specific amount of units per day in order to justify a paycheck. Brace yourselves, this is my latest opinion piece!
But, with many recent changes to federal funding of the Affordable Care Act, Medicaid, and Medicare, there are further increasing pressures to an already strained system. Reimbursement has continued to lower from Medicare in the PT field for years now. But, with cutting back on federal funding of insurance plans, we will see more Americans with more expensive healthcare coverage that may ultimately get dropped out of sheer budgetary necessity. Or, we will see providers getting paid less for services, and, therefore, we will see many providers discontinue care from certain healthcare plans (like Medicaid). There is also a call from Medicare to reduce spending with the use of pre-authorizations that may either limit access to necessary services, or just wear out the beneficiary from even trying in the first place. And, some rural healthcare hospitals and practices that previously relied on Medicare and Medicaid reimbursement, may find themselves shuttering their doors because they cannot keep their lights on.
We are also seeing federal student loan borrowing become more restrictive, with limits placed on exactly how much money can be borrowed from the federal government. Some may wonder – what is the big deal? People can just get private loans. However, private loans do not come with the perks federal loans have such as lower repayment options and the ability to forebear loans for a period of time when financial hardship is encountered. Public Service Loan Forgiveness (PSLF) keeps seeing further restrictions to access, including limits on the amount of money you make and restrictive qualifications on student loan repayment plans. And, they will no longer allow married couples to file their taxes “Married Filing Separately” to still qualify for the repayment plans that the PSLF program requires you to have. So, what we may see happen is less people from middle or lower class families going to school for high dollar degrees like medical doctor or physical therapy. And, if a young person decides to get married, they will not qualify for PSLF due to the combined income of the married couple disqualifying them from the necessary repayment plans for the program. We will, most certainly, see a downward trend of medical students across the board in America, as well as a downward trend of medical providers willing to work in public service.
In addition, the income for a profession like PT or Pharmacist makes it difficult to support that the means justify the end. We may see more youth opting for cheaper or less involved medical professions such as Medical Assistants, technical positions, or basically any profession you can receive through a technical school or just a few years of college.
And, if productivity standards continue to rise and reimbursement continues to plummet, we are going to see higher rates of burnout in the medical profession. I think we may see more retirements happen sooner than planned, we may see more medical professions leave the profession altogether, and less youth willing to invest in that career path. A shortage is likely on the horizon, with less access to care for all of us.
Here is to hoping this changes! I would love to do a follow up that states the course of this writing has changed!
Heal today, transform tomorrow. Unlock your potential to heal, learn and grow. – Dr Barb Wally, LLC
Note: These blog articles are not in exchange for a one on one Physical Therapy visit. Please contact me if you are interested in receiving a Physical Therapy visit!
*This content is original and copyright Dr Barb Wally, LLC*
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