Why Physicians Won't Unite to 'Rescue' Medicine

Leigh Page

Disclosures

September 04, 2014

In This Article

Doctors Are Loyal to Their "Tribes" of Specialists

One of the steepest barriers against physician unity is specialty identification. When physicians decide what groups to join, specialty interests come first, Dr. Laufer said. "Physicians are more likely to belong to a specialty society" than to the state medical society or the American Medical Association (AMA), he said.

Specialties sometimes take their turf battles to the state legislature, forcing lawmakers to choose sides, he said. For example, Dr. Laufer said Arizona cardiologists and some other specialties clashed over a bill[3] sponsored by the Arizona Radiological Society that would have put restrictions on referrals by physicians to their own imaging facilities. Dr. Laufer said the bill was defeated.

The cacophony of various specialty interests is particularly apparent in Washington, DC. A list[4] by Open Secrets, a nonprofit watchdog of healthcare organizations operating in Washington, contains more than 80 organizations representing specialties, subspecialties, clinics, and individual practices.

Even Dr. Lindes, who stressed the need for unity, said the needs of family practitioners often come first for him. "Sometimes it's better not to compromise with other specialties," he said. For example, he regrets that "family medicine has allowed itself to be lumped together with other specialties under the umbrella of primary care," he said. "This ignores what makes family medicine unique."

Reimbursement is a ticklish topic that quickly divides physicians by specialty. In a 2010 study,[5] almost 80% of doctors, including higher-paid specialists, said they supported giving primary care physicians higher reimbursements, but that support decreased by half if it meant a 4% cut in reimbursements for other doctors.

"Physicians have been divided into tribes that are specialty-derived," said Hal C. Scherz, MD, a pediatric urologist in Marietta, Georgia. Dr. Scherz founded a new national medical society called Docs4PatientCare, which started by opposing the ACA. "They are fighting against each other for a piece what they perceive as dwindling reimbursements."

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