Where doctors stand in the healthcare reform debate

Only 15% of physicians want full ACA repeal, but 73% want changes to law

HAGERSTOWN, Md. - Many Americans have dug in on their opinions for where the country's healthcare system should go - but where do doctors stand in this debate?

Being on the front lines of medicine, doctors like Ralph Salvagno have a unique place in viewing how shifts in healthcare policy play out.

"We can have our own political beliefs about what party may offer the best solution, but we don't have to decide one way or the other...which is a good thing," said Dr. Salvagno, who is the incoming chief of staff at Meritus Medical Center. "Unfortunately, that means we have to accept whatever comes our way."

There's no doubt that policy changes in Washington will affect doctor's offices nationwide. But whether the Affordable Care Act (ACA) is changed, or scrapped completely, remains to be seen. 

Only 15 percent of primary care physicians (PCP's) said they would like to see the ACA repealed in its entirety, in a recent survey published in the New England Journal of Medicine. No doctors who identify as Democrats wanted it repealed, while 32.4 percent of Republicans did.

"If it's repealed, there will be some significant changes that we'll have to deal with," Dr. Salvagno added. "What's going to happen to those people who got the expanded coverage?"

About 20 million people have gained health insurance through the ACA, while many states have expanded their Medicaid programs. Dr. Rohit Gulati, vice president and chief medical officer of WVU Medicine in the Eastern Panhandle, said that despite claims from those who oppose the law, doctors are not suffering financial burdens from it - for the most part.

"More patients are able to access healthcare, whether it's private practice or healthcare systems," Dr. Gulati said. "So the private practitioners have benefited from people having insurance."

However, more than 73 percent of physicians surveyed said they would like to see changes to the law. They favored policies that increase consumer choices, provide tax credits to Medicaid-eligible citizens to purchase private health insurance and increase the use of health savings accounts.

In that survey, physicians responded most negatively to policies that would shift more costs to consumers through high-deductible health plans.

"Things have moved to be patient-centric, rather than being physician-centric," Dr. Gulati explained. "It's all about the patient, how we treat the patient, what's good for the patient and what the outcomes are."

"We're still doctors, we're still taking care of our patients, we're still doing the things that we really set out to do," Dr. Salvagno added. "All these other things are just tools. We've just got to figure out how to best use those tools."

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