Bauman: Nervous but glad

Editor's Note: We asked our editorial board members to share their opinions of the Supreme Court ruling on the Affordable Care Act. Here's what Mary Ann Bauman, MD, said.

I am nervous of the unknown and worried about the inevitable bureaucracy, but I am glad we are doing something to address our healthcare issues. So, I am pleased with the decision.

We have been working on meaningful use and the patient portal. We are recruiting for new primary care physicians, but the number of available doctors remains the rate-limiting step. This shortage is accentuated because internal medicine residents are, almost exclusively, choosing hospitalist roles, which are readily available.

We have discussed using midlevel providers but are not yet recruiting in that arena. Many of our physicians have full practices, and we have been concentrating much effort on our pay-for-performance contracts, recognizing that if we can incent our doctors to focus on keeping those patients healthy and out of the hospital, we will be well prepared when the numbers and or types of patients expand.

The challenge will be to make sure that, if and when single payment programs are implemented, primary care gets its fair share, as there will be multiple players (hospitals, specialists, hospitalists, rehab, home health, etc.) vying for those dollars.

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