"I think it was about '87 when Medicare started cutting us or certainly not giving but a token increase," he says. "That was the year I made the most and it has been downhill since. You cannot make a living seeing patients. We are regulated and cannot raise any prices."
"How can you make it when you cannot charge more but our costs go up every year?" he adds. "Remember, we are a small business, but we are totally at the whim of the government. The government jerks you around every few months and I mean every few months. They always talk big cuts so when they do smaller ones, it looks like we got a great deal."
Interestingly, there are 20 physician members of the 112th Congress, including three senators, 16 representatives, and a delegate. None of them are considered leaders of the doc fix debate, and their presence seems to have no impact on this physician issue—or others.
The AMA itself has spent much of the past two years lobbying to abolish the SGR, with so far little to show for it. Gilberg points to two House members, Rep. Allyson Schwartz, D-PA, and Rep. Phil Roe, R-TN, who are working for change. Schwartz and Roe issued a statement saying they continue to garner bipartisan support to repeal the SGR.
Generally, physician lobbying groups have failed to make true inroads to get doctors' voices heard in Washington D.C.
At best, the politicians talk about fixing the SGR but don't do anything except apply an annual band-aid. And the clock to 2012 is ticking.