An open letter to the next president

Dear President-elect:

First, congratulations on your historic victory and new job as the 45th President of the United States. Second, I feel compelled to write to you about a pretty big section of your citizenry largely overlooked during the major party conventions as well as the heated debate season: physicians.

Related: What insurers leaving Obamacare exchange means for physicians

While the closest we got to healthcare during the campaign was the fate of the Affordable Care Act-and perhaps your own personal health-physicians (nearly one million strong at last count) are facing a number of serious issues as you prepare to take the oath and move into the White House. 

First is Obamacare itself.  I’m hopeful you can do something to make the program work more effectively and truly affordably for patients.  In addition to thousands seeking new coverage as payers flee the marketplace, many of the remaining plans are accompanied by high deductibles and copays out of reach for your average American.  Unfortunately, they don’t call you or their representatives in Congress to complain, they complain to their doctor … who has no control over the issue. 

Hot topic: Why physician burnout happs and what we can do to prevent it

And while you are addressing the ACA, perhaps take a look at those constantly narrowing provider networks.  It may be time to revisit that “If you like the doctor you have … you can keep your doctor” statement, as it is becoming less and less of a reality.

And speaking of payers, you may have heard that the “Big Five” would prefer to be the “Big Three.”  Now I don’t have to tell you about difficult negotiations. If you are a doctor seeking a decent reimbursement for your services or a drug for your patient, is turning into a costly-both in terms of time and money-endeavor.  And that’s when you actually can negotiate, a rare exception these days with payers pretty much adopting a take-it-or-leave-it attitude. If you could look into that, it would be great.

Next: "There are nearly a million reasons why these things are important"

Additionally, if it’s not too much trouble, could you take a look at another national behemoth that is troubling docs: the rising costs of drug prices? You and your opponent were pretty vocal in promising to rein in skyrocketing price tags with the help of Congress, so I’m hoping you can deliver on that promise, and fairly quickly.  Physicians - and patients - would really appreciate it and for many, it’s becoming a life-and-death issue.

Further reading: Doctors spending over $32,000 on health information technology

Another issue you may want to look at is MACRA. Don’t worry if you don’t know what that means, a lot of U.S. physicians are in the same boat.  Your friends in the Senate and House reformed Medicare’s payment programs in a way that is really going to hurt solo and small-practice physicians.  The road paved with good intentions … Am I right?

Finally, if you could also take a peek at these additional issues in your free time, I’m sure physicians would appreciate it: interoperability of electronic health records, the proliferation of direct-to-consumer drug ads, the opioid crisis, preserving autonomy for independent physicians, the clear conflict between HIPAA and the need to share patient information, something called “maintenance of certification” (Google it), and oh yes, how physicians can actually treat their patients and improve their well-being on a regular basis.

Blog: The truth about why the U.S. can't control healthcare costs

I know you have a lot on your plate and you might only have this job for four years, but there are nearly a million reasons why these things are important.  So please make them an important part of your administration. 

Keith L. Martin is content channel director for Medical Economics. As a physician, what would you like to see the next president tackle upon taking office? Tell us at [email protected].