No matter the fate of Obamacare, doctors stand ready to help patients

For physicians, this sort of uncertainty is business as usual.

I've heard from a lot of physicians lately who are, let’s say, less than enamored with our new president’s first actions since occupying the White House and the uncertainty ahead.


Related: The complicated puzzle of moving past Obamacare


It’s a kind of “medical limbo,” awaiting the first domino to fall: will it be the repeal of Obamacare … and the coming of whatever replaces it? Will it be new leadership at HHS or CMS revisiting Medicare reimbursement reform? Will it be major changes to Medicaid? Will it be something else entirely that will shift the way physicians treat their patients – for better or worse?

Keith L. Martin

For physicians, this sort of uncertainty is business as usual.  You never know when an innocuous-looking envelope will appear from a payer with some “important news regarding your contract” (i.e. “we’re paying you less starting today for the same thing you did yesterday”) or a Medicare memo announcing a major change in the program that you then have to decipher.

It’s part of the business of running a private practice. (And part of the reason more and more physicians are finding direct pay more attractive. See our cover story on page 14 for more information.)

And patients, fully aware of and confused by what’s going on in D.C., turn to the one source that knows everything about the future of medicine and the inner workings of insurance companies: physicians.

But this uncertainty comes with opportunity, one that physicians seem prepared to embrace.


Further reading: Replacing Obamacare not an easy path for new administration


Seven years ago, the same uncertainty accompanied passage of the Affordable Care Act. Physicians were cautiously optimistic about the new law, balancing fear of a mass patient influx due to greater insurance opportunities with excitement about possible better pay, especially in primary care.

Next: Physical and emotional beacon for patients


The first few years post-ACA enactment were consumed with physicians and practice staff learning – and then explaining as best they could – all the ins and outs of marketplace plans, high deductibles, and sometimes even how coverage works for the newly insured. It was time consuming (and often frustrating), but in the end, it strengthened the physician-patient relationship knowing there was some help on the road to better health.

And that’s where physicians find themselves again: As both the physical and emotional beacon for patients. Afraid of losing Obamacare coverage in the near future or in the middle of a lingering medical crisis, patients are turning to their physicians for guidance. And physicians are providing it.

And even if “I don’t know” is the reply to a complex patient question, it’s better than the on-hold music of a payer hotline or trying to locate a non-frequently asked question on a website.

The skill sets that make physicians successful in private practice are the ones needed to assist patients with both the medical and financial side of their well-being.

So no matter what the future brings, no matter the next executive order signed “Donald J. Trump,” no matter the next act of Congress or how the payer industry responds to all of the above, physicians remain steady despite the uncertain road ahead. 


In case you missed it: Trump attempts market stablization of Obamacare


It’s what patients expect and what makes for an excellent physician.  



Keith L. Martin is editorial director of Medical Economics. What are patients asking you about healthcare changes? Tell us at

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