Need to eliminate stress? Drop out of Medicare

Doc burnout

Doctors stressed out by government meddling in healthcare should consider opting out of Medicare, according to a physician-penned commentary in the fall issue of the Journal of American Physicians and Surgeons.

Although the opinion piece by neurologist and editor-in-chief Lawrence R. Huntoon, M.D., Ph.D., appears to be at least partly tongue in cheek, likening Medicare to an “abuser” that doctors should leave to protect their brains from the ravages of stress, it also talks about the “punishing penalties” of MACRA, the Medicare Access and CHIP Reauthorization Act of 2015.

Professional organizations including the American Medical Association, the American Academy of Family Physicians and the Medical Group Management Association have asked the Centers for Medicare & Medicaid Services to delay MACRA’s physician performance measurements by six months to a year. The rules are too complicated for the change to be made as planned on Jan. 1, 2017, they argue.

RELATED: MACRA: CMS will give docs 4 options for 2017

Huntoon writes that the law’s Merit-Based Incentive Payment System (MIPS) is trying to “beat solo physicians into submission” with progressive cuts in fees for noncompliance. He says CMS predicts that 87 percent of solo practitioners and 70 percent of doctors in groups of two to nine physicians will be punished financially. He further argues that in addition to trying to eliminate independent fee-for-service medicine, a goal of MACRA is to eliminate solo and small-group practices so the government can control a smaller number of entities.

“The cure for (stress-related) brain atrophy and all of the symptoms that accompany chronic stress is to remove the causative stress from one’s environment,” he wrote. “Medicare physicians have the opportunity to do that by opting out of Medicare. … Given the punishing penalties of MACRA, more physicians are beginning to recognize that the only way to win is to not play the government’s game.”