"I love what I do and I could easily practice until my 70s, but I am just fed up with all the government overregulation. They have every intention of slashing more revenue, and with the amount of money spent on liability insurance, at some point it just won't be worth practicing. I may be a consultant, and educate myself in healthcare policy."
Certainly there are other physicians who, like Scherz, are "fed up." Many who don't quit certainly may grumble to their colleagues and to themselves if the law is upheld, or even if parts of it are.
But it's not a time to create "silos" of physician opinion on this matter. As healthcare has shown in recent years, physician teamwork for improved patient care is especially crucial, but it may be even more difficult if the Supreme Court goes against the wishes of many doctors. Indeed, physicians' ability to cooperate may be tested further.
Doctors, like others healthcare professionals, need to look beyond the court action, because there are events and a movement of care that will not remain static, no matter what is written by the court. "A river is flowing toward more efficiency and accountability," says Lucy Savitz, director of research and education of Intermountain's Institute for Health Care Delivery and Research, based in Salt Lake City, Utah. The group is working with hospitals and physicians to engage in a "culture of continuous improvement."
Stream agrees. Whatever the Supreme Court decision, the health reform law hardly touches many watershed issues such as improvements in medical malpractice laws. Or it completely ignores them, such as the SGR (Sustainable Growth Formula), "which continues to rear its ugly head," Stream says. These overarching issues must be evaluated and considered by physicians, as well as lawmakers, he adds.
"Regardless of the politics and view of the (Affordable Care) act, we recognize there are limitations of our healthcare system," he adds. "We pay too much for too little quality and safety, and we need to do better. There's no doubt about that. There are initiatives for improvement that predate the act, and they are going to move ahead regardless of the Supreme Court action."
For improved healthcare, there can be no languishing in middle ground, Stream says.