The Mayo Clinic, one of Obama's favorite ACO organizations, notified its Medicare recipients last year that it was accepting no new Medicare beneficiaries. Practice consultants recommend that internists have no more than 11% Medicare patients in their practice.

Medical students, who I have taught for 14 years, are becoming more left wing. It is very rare to hear of one interested in private practice of the old, entrepreneurial type. Very few are interested in primary care and I have told those few who express such an interest to get an MBA as they will be managing "providers" with RNs and PA licenses. They all know it.

The Obama people, like those in Massachusetts, are probably thinking of making participation mandatory for licensure. They can require continuing education so why not caring for Medicaid patients ?

That is probably when we sill see medical school applications crash.

I believe this secret shopper program is designed to justify what will likely be a new rule from CMS. I suspect that all physicians who want to participate in Medicare and Medicaid programs will be required to show that they have not adjusted their patient mix based on insurance coverage. If such a rule is implemented I and many other physicians would stop participation in both Medicare and Medicaid.

The real purpose of the "spying" is the adminstration's continued effort to demonize physicians.

The IPAB is going to make payment policy that rations care that will run counter to physician recommendations for patient treatment.

I think it is fair to say that most people trust their physician much more so than they do the government. If you can't raise the level of trust in one institution then bring it down in the "competing institution".

BTW, my wife is a primary care physician who sees mostly Medicare recipients. You can limit the the percentage of your practice that is devoted to Medicare/Medicaid patients.

We have not taken new patients in some years, at least not those off the street because her practice is as full as she intends for it to be. We do take an occasional family member of an existing family usually as the result of a death of another existing patient that is somehow acquainted.

As far as being driven into a salary position in a hospital owned practice for instance, Obama and all his thugs and Czars can't live long enough put our piece of Humpty Dumpty into that puzzle

Your right about the end of private practice. My cousin and her partners recently closed their once thriving private practice. The passing of Obamacare was the last straw that killed it. Two of her partners were close to retirement age and did so. One other partner is leaving medicine and my cousin has been teaching in a medical school. She got tenure so she is a full time professor of medicine now. So she at least landed on her feet, so she is "lucky", which many doctors will not have. They will likely end up bankrupt.

@bpbatista

It certainly is and I don't know why the Obama administration is trying to "discover" this. It is a well known problem. If you call up a primary care physician and tell them you are on Medicare they will tell you that they don't take it. My neighbor who is in his 70's has to pay 100% of his PCP bills because his Doc won't accept Medicare and legally he can't make up the difference.

Here is an article on a new clinic that opened up in Anchorage specifically for Medicare patients
External Link 

It is noted that you did not mention the other dynamics discussed in the article.

The IPAB will have enormous impact on the way physicians manage the treatment of patients. We've already seen a pre cursor to this with the various correct coding initiatives that CMS has promulgated.

The response by physicians to a mandate from Obama/Sebelius will be heartbreaking. The quality of care rendered to publically funded patients will decline and in some very subtle ways.

Here's a perfect example: Medicaid patients have an appointment cancellation/no show rate that is significantly higher than that of those who pay their bills or manage to obtain coverage with their own money. Doctors respond to this with "medicaid day". All the medicaid patients are scheduled for the same day, often double or even triple booked. That way the office doesn't have slack time because so many flaky patients just didn't show up for their free care.

Look for more such survival techniques and look for them to be imposed on Medicare patients too as the need to sustain a practice destroys the civility we've hoped for.

This can be called a "stealth survey", or anything else the government wants to call it, but it's the federal government spying without a warrant on people engaged in 100% legitimate activity without any reasonable suspicion of individual wrongdoing.

I guess you can't stop all Middle Easterners at the airport, or Mexicans on the border, but you can spy on all doctors as a corrupt suspect class to which restrictions on profiling are inapplicable.

If the Clinton or Bush administrations did it, there would be calls for impeachment - - by Barack Obama.

What if the Federal Government decided to only compensate doctors at $.05 on the dollar? Some posters here are suggesting that is perfectly OK even though it is a clearly illegal mandate, even though liberal judges would endorse it. As reader Miguel A Martinez commented below, that is the definition of slavery. Ironic that a "black" President would endorse such a thing.

Government tampering and jerrymandering of free markets has led to every one of the disasters presently facing the country. This is why no government should ever be permitted to engage in price fixing activities. It is illegal in the private world, it should be illegal in the government world as well. Good luck prosecuting Gorelick, Raines, Frank, and Dodd though. It's a sweet racket if you can get in on the deal.

Get rid both medicare and medicaid.Increase social security check and call it good.