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    How physicians can deal with policy uncertainty

    Physicians have always had to be keenly aware of changes in healthcare, from technological innovations to new approaches to patient care. But these days, palliative care internist Amy Davis, DO, is also keeping one eye on healthcare policy developments emanating from Washington, D.C.


    Blog: The largest cause of medical errors is Congress


    From the final rule for Medicare payment reform late last year to the election of Donald Trump as president, a lot has happened in a relatively short timeframe. These changes have created an air of uncertainty for Davis and other physicians nationwide, as they await the fate of the Affordable Care Act, wonder what a physician—U.S. Rep. Tom Price, MD—will do as head of the U.S. Department of Health and Human Services, and whether other programs and mandates that have shaped healthcare over the last eight years will change or disappear.

    “It’s getting harder, not just to be a physician trying to figure out what to do, but also as a small business owner,” says Davis. “I need to keep the lights on and I need to pay my staff.”

    In her solo practice located in suburban Bryn Mawr, Pennsylvania, 146 miles north of the nation’s capital, Davis has added counselor to her role of physician, for her patients as well as her staff. Both groups are worried about their own medical coverage and financial well-being.

    Davis recalls a recent encounter with a Medicare patient in need of physical therapy. The patient feared that his yearly allocation of services—something so certain in the past—would change under a Trump administration.

    “I said to the patient, ‘You are set for the year, don’t worry,’ and he said in return, ‘Trump is changing things in the middle of the game and waiting for people to challenge him legally. What if things change in the middle of the game for me?’” says Davis. “I had no reply. The rules don’t seem to apply to [Trump].”

    Davis’ approach jibes with advice from Bob Doherty, senior vice president for governmental affairs and public policy for the American College of Physicians (ACP). Doherty told Medical Economics that physicians can’t completely reassure their patients about what’s to come.

    “Doctors like to be reassuring and say: ‘Don’t worry about it.’ Clearly, that’s not the case,” Doherty says. “I think the best thing [physicians] can do is hear [patients] out and let them know that you have their back.” 


    Related: Q&A with ACP's Bob Doherty on the future of healthcare


    Similar anxiety exists among Davis’ employees, worried about their health coverage and paychecks. To keep morale high, she brings in the occasional treat and constantly reassures them that they are in good hands. “I’ve told them that you will get paid before anyone else, including me,” she says. “A happy staff makes me happy.”


    No strangers to change

    Davis, like thousands of other physicians juggling their clinical and business duties, is no stranger to change. She acknowledges that it comes with the territory, and is maintaining an even temperament these days despite the unknown ahead.

    Next: “Physicians in general don’t tolerate uncertainty very well"


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