MACRA Fallout and Physician Burnout – MACRA Monday

This post is part of the MACRA Monday series of blog posts where we dive into the details of the MACRA Quality Payment Program.

I’ve been traveling the past week and still haven’t had time to fully process the MACRA final rule. In fact, it might take me a few weeks to really get things together around what’s in the final rule. It’s better that I take my time and make sure I provide you accurate information than to post early and perpetuate bad information. So, I appreciate your patience.

In the mean time, we’ll still continue on with MACRA Monday talking about some of the impact of the MACRA rule and interesting comments on what’s happening with MACRA. Today I wanted to highlight the vitriol I’ve seen online by many physicians towards MACRA. It’s been pretty ugly.

If I’m being fair to MACRA, most of the hatred has to do with the wave of government regulations and the changes happening across all of healthcare and not just MACRA. In many cases, it just seems that MACRA is the straw that broke the proverbial camel’s back. However, I’ve seen first-hand from more physicians than I can count, a real anger towards MACRA.

I do temper these experiences with the fact that so many physicians barely even know that MACRA exits. That’s not true for the ones complaining on social media, but it definitely feels like even many of those doctors barely realize what is in MACRA (with a few notable exceptions). Instead of specific complaints, they are mostly general complaints about government regulation.

Sadly, I think it kind of reminds me of my experience talking with my 12-year-old son. He’s at the stage of life where no matter what I say as a father he wants to say the opposite. I can literally say something nice to him like “You’re smart” and without even thinking about what I said he’ll knee jerk react “No, I’m not.” It makes no sense and is absolutely frustrating as a parent.

My guess is this is how the people at CMS feel when they hear doctors talking about MACRA. If MACRA was just free government money with no work, my gut is that many doctors would say it’s awful without even looking at the details. Doctors are so burnt out on government regulation that they denounce it without as much as a second thought.

Given some of the past track record, doctors have good reason to react the way they do. Can you point to very many places where meaningful use made a doctor’s life better? There are quite a few general EHR benefits, but very few specific meaningful use benefits. In fact, you can make a strong case that meaningful use added a lot of overhead and almost no value to patients or doctors. Given that, should we be surprised that doctors are afraid of more government regulation?

I’m not surprised, but with that said I also don’t think that MACRA will be the disaster that many make it out to be. In fact, I think it’s an extension of business as usual. This is particularly true in the first year of MACRA where almost no one will get penalized thanks to the MACRA Pick Your Pace options. We’ll see if that creates a pileup in future years.

I’m torn since I think we’re entering one of the most exciting times to be in healthcare. The technologies that are hitting healthcare are quite extraordinary. What we’ll be able to do with the data we’re collecting and will be able to collect in healthcare is going to surprise us all. However, on the other hand regulations are creating a burden on providers that is causing what could be irreparable harm.

Reminds me of that famous line, “It was the best of times, it was the worst of times.”

Be sure to check out all of our MACRA Monday blog posts where we dive into the details of the MACRA Quality Payment Program.

About the author

John Lynn

John Lynn

John Lynn is the Founder of the HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.

1 Comment

  • MACRA has set back real reform in Health IT another 5-7 years. CMS should worry that the usual MD is a real rule follower, very diligent in work tasks, and on the smarter end of the spectrum. So when we are revolting, they should REALLY listen. Not a slow glide of the plank for a year, either. We have VERY difficult jobs, we juggle many things, every patient and their problems and experiences are different. We like that, but they are draining our purpose in life. And when you drain the purpose in what we do, that can lead to catastrophe. Hence the fight. If over half of us are unwilling to play the rules, the system will falter, not improve, gain no value only worse costs. I spent the weekend trying to actually get my QRUR, which is my feedback report from 2015. And its all wrong. I pay for a registry to get it right. So I will receive no bonus, yet again from CMS for 2017. Unless I want to spend even more time trying to battle for a measly increase in pay. So why should I bust my A#$ trying to send data when it gets lost in translation. The reporting is so poor, so late, so confusing, so burdensome to actually get ( I had to fax my passport, and 2 bank statements to identify myself to CMS), just to get my feedback. They post if I received a $2.78 lunch from a pharmaceutical rep, but I have to spend hours trying to get feedback on my data. We have a HUGE mess on our hands. CMS touts simpler, but they do NOT get it, and its damaging us forever. Once we are out, we are out. We are not coming back, no matter how ‘pick your poison’ it gets. There is a palpable anger out here. And CMS needs to hear it, because they are NOT listening.

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