Obamacare deals blow to one-doctor medicine

In a slow-motion version of the problems that crippled online insurance “exchanges” for months, doctors who see patients under Medicare and Medi-Cal programs have been forced by the phase-in of a 2009 federal "stimulus" law to install expensive, complex software systems that sharply reduce time for patients.

For many doctors, it’s the final straw. Surveys suggest that older physicians are retiring in high numbers. Younger ones are closing practices and taking jobs with integrated health systems.

Early this month, I spent a few hours with my friends Dr. Doug Moir, a heart specialist in Escondido, and his wife, Margaret, who runs the business side of their one-doc practice (which also includes a nurse and assistant).

Both Moirs are pillars of the Escondido community. Just thinking about their volunteer schedule wears me out.

Over a 40-year career, Doug has helped thousands of people, both inside and outside his practice. At a robust 72, he’d love to keep going, but he increasingly questions how long he can afford it.

“This year we’re looking at putting money into the business to keep it going,” he said. more.........

My doctor is one of these guys. He told me he is thinking of joining a group practice. He has been a single doctor office since the day he started. I hate those clinical doctor offices. I hope he can hang in there.