Medicare Cuts Postponed!


Opposing Medicare Cuts, Ohio AFL-CIO

November 17th was “White Coat Wednesday“, as declared by the American Medical Association (AMA).

“White Coat Wednesday” was the day chosen by the AMA for physicians to contact their state representatives to ask them to stop the proposed 23% cuts in medicare payments.  Unless something was done, these cuts were slated to start December 1.

Thousands of calls were made, and the Senate tonight unanimously passed a bipartisan bill postponing the cut in Medicare reimbursement from December 1 to January 1.  Before the house adjourned, a bill was proposed that would extend the effective date of Medicare cuts until the beginning of 2012.

That is good news for now, but we obviously need more fundamental improvements to fix a broken system and boost declining physcian morale.

Today I have been reading, In Their Own Words: 12,000 Physicians Reveal Their Thoughts on Medical Practice, in which physicians express their frustration and disappointment regrading the current state of medicine.   This gem of a book, written by Phillip Miller of physician search firm Merritt Hawkins, and Lou Goodman and Tim Norbeck of The Physicians Foundation, came out of a large survey of physicians across the country. The survey gave doctors a chance to answer the question of how they feel about being physicians: What would they say if asked to speak directly to patients about medical practice in America today?  The chapter, “Doctor For A Day”, does an excellent job of giving the non-physician a realistic understanding of what it is like to be a doctor in todays’ world.  The authors let the physicians speak for themselves, providing ample statistics.  Many directly relate to Medicare cuts, as well as hundreds of direct quotes from physicians sharing their 2 cents.

A sampling of statistics:

82% of the physicians said that their practices would not be sustainable if Medicare reimbursement is cut.

38% of the physicians would stop seeing Medicare patients altogether or reduce the number of Medicare patients they see.

36% of physicians said that Medicare reimbursement is less than the cost of providing care.

78% believed there is a shortage of primary care physicians in the United States.

60% said they would not recommend medicine as a career to a young person.

A selection of direct quotes: (over 4, 000 physicians wrote comments on the survey)

“I believe most primary care physicians are at the breaking point.  There needs to be a grass roots effort to make everyone aware of this.”

“I put everything I have into treating my patients, but it’s too much work with too little in return.  I am about to lose my family for nothing.  My children have suffered because of time without their dad.”

“Can you imagine what would happen if your plumber handed you a bill for $60 and you replied, ‘I think I’ll just pay you $32?’ In no other profession are services paid for in such an arbitrary fashion. ”

“The current model is not working.  Primary care doctors are tired of the continuous pay cuts, reimbursement games, and endless paperwork.  As we spend less and less time with our patients because we have to fill out prior authorization forms for every third prescription we write, we become more distanced from the heart of it.  There will be a serious healthcare crisis in this country when we walk away. ”

And a simple plea,


There was no lack of candid expression from the physicians who shared their thoughts in this survey.  However, it is often only through these types of surveys that doctor’s voices are heard.  Doctors are not usually the ones sounding the horn about their struggles.  Why the relative silence in the midst of significant challenges?  A number of reasons come to mind:

  • Doctors are too busy to do much else besides see patients and do paper work.
  • Doctors in general do not like to complain, even to each other.  It is seen as a sign of weakness.
  • Accustomed to working independently, doctors don’t tend to form their own action groups or unite.
  • Doctors expressing job dissatisfaction do not generally evoke sympathy from the public. There is a widespread perception that doctors are overpaid and have it easy compared to the rest of the working world.

Yes, it is true that being a physician has definite advantages, and many people are having a very hard time economically. However, the reality remains that if things do not change, there will continue to be a shortage of primary care physicians, with increasing numbers of physicians across the board leaving medicine prematurely. The sentiment among physicians I have spoken with is that the situation is going to get worse before it gets better.

Hopefully, that will not be the case.  But regardless, this is a good time to give consideration to one’s practice and see how the picture looks for the long haul, if improvements are slow in coming. What would make the biggest difference for you?  If you could change one thing, what would it be?

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You helped me find the courage to seek out leadership positions and become a medical director as well as a physician advisor. I am grateful we crossed paths and am a different person because of it. You have inspired me to "believe" in spite of my inner skeptic. I consider you one of my most important mentors and am proud to also call you a friend. This says a lot given the apprehension I felt when I took a chance with our first coaching session. Even though I have already made a successful transition, I still value your ongoing mentorship and can enthusiastically attest that the value of your services is tremendous!

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I met Heather at the SEAK conference. She and I revisited this question.  Did I want to quit being medicine completely? She helped me to identify my needs, wants, and my vision for my FUTURE, not just in medicine, but in life!!!

She was able to listen to my "ramblings" about becoming a stand-up comic, lounge singer and voice-over actor and translate them into action steps.  I chose to become a composite of all of these. Now I am a more confident, healthier, happier person. I credit this in its entirety to the tutelage I have received and continue to receive from Heather.  She cares. She listens. She was there for ME.  She will be there for YOU!

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Heather helped me understand that I am more than just a doctor and that my experiences in clinical medicine are valuable in so many arenas.  As a result I realized that there are other ways to use my background, still be able to help people and continue to challenge myself and grow.  To that end I discovered coaching - specifically health coaching.  I am on my journey becoming a health coach and truly loving it!

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What started out as an initial thirty-minute consultation call turned into an amazing four-year journey that transformed my life, personally, spiritually and professionally. 

Heather helped me to discover my doing so, I discovered I still had a calling for medicine but it now came from a place of truth... wife and I are opening our first concierge medicine clinic in a community we love. I’m actually excited to have the opportunity to practice medicine the way I believe it’s meant to be, with a focus on the doctor-patient relationship and an emphasis on faith. I know if I had not reached out to Dr. Fork, my life would not be where it is at today.

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She is incredibly knowledgeable about the range of careers available to physicians and provided me with advice and connections which I would not have found on my own.  From the start she encouraged me to step out of my comfort zone and try different things.  I was laid off unexpectedly in early 2017, and Heather gave me the confidence to create a new livelihood by following my heart and making decisions based on trust, not fear.  Now I am enjoying working part-time in a clinical setting in addition to teaching and writing.

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After months of struggling to find a non-clinical career that matched my values and passion, I stumbled upon Heather's website which truly changed my life."

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Working with Heather ultimately helped me leave my job in corporate healthcare and find a path that was much more fulfilling."

My career was going reasonably well but I couldn’t shake this nagging feeling I could do better; or at least find a better long-term career fit.  

I was able to find a surgery job that better aligned with my goals and professional interests.  Additionally, Heather helped me start a consulting business which has allowed me to pursue a true passion: helping medical students, residents, and attendings surgeons navigate the challenges of high-stakes standardized exams.    

If you are reading this as a “Type A” surgeon who doesn’t think coaching is for you, I would encourage you to give Heather a shot.  I’m very glad I did!

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Through our work, I learned to trust myself to make good decisions for my own future – something I hadn’t realized I was struggling with because as an emergency physician, I make life-changing decisions with patients every day. 

By feeding my creativity and interests in other realms of my professional life, I’ve found renewed compassion for my patients and myself, making every shift an opportunity to actually care for people. Thank you Heather. I really couldn’t have made these changes without your help!

- Liz McMurtry, DO

Emergency Medicine Physician

The simple truth is - Heather Fork totally helped me change my life."

I never would have had the courage to make the changes I’ve made without her unwavering support, wealth of knowledge and commitment. 

When I first started working with Heather, I was downtrodden...I’d been practicing medicine for 20+ years and yet had never quite found my place.  During the first year I worked with Heather, I left the practice I’d been working at, and recreated an entirely new professional purpose.

I’m now an executive and leadership coach, a university professor, and a Brené Brown Daring Way facilitator, and I have never looked back.  I love what I am doing more than at any other time in my professional life and I credit Heather with seeing in me what I was never able to see in myself, until now.

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I remember when she said ‘do your resume before our next meeting’, I was about to push back but she gently nudged me along and I’m glad I did exactly what she wanted me to do. We also did interview prep via Zoom and I was offered a great job in UM. She has continued to follow up even after I was offered this job, helping me with pointers about negotiating. I will totally recommend the Doctors Crossing and Heather to anyone feeling stuck like me and looking for a great coach! Thank you Heather!

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