How One Boston Doctor Really Feels About Obamacare

The Affordable Care Act affects patients and doctors. Here is one physician's take.

Doctor photo via Shutterstock

On June 28th, the eve of my first primary care clinic, a large controversy had been clarified. The Supreme Court of the United States (SCOTUS) upheld the main components of the Affordable Care Act (ACA). In the hospital, the moments following the announcement were tense and confusing. As whispers of the ruling floated down the hospital hallway, we exchanged high-fives and hearty handshakes. The law would stand.

The ACA has been thoroughly dissected since its passing, and the implications have been hotly debated. Public opinion remains divided on the law, and there has been a similar spectrum of opinions within the medical community. Although many of the nation’s largest medical societies formally backed the law, debates among constituents have been heated and divisive. A poll of physicians revealed split attitudes regarding the law, and another survey of young physicians, which is the group most profoundly impacted by the ACA, revealed that many feared it would negatively impact medicine. These proverbial fires have been further fueled by suggestions that the law pits primary care against specialty medicine.

I am deeply concerned about what it means for my profession. A recent editorial in the Journal of the American Medical Association reviewed survey data and reported that in comparison to their older counterparts, young physicians and medical students are generally supportive of the ACA. These findings, however, are offset by reports that the majority of students do not understand major components of the law and the effectiveness of its provisions. The data suggests that some physicians are still ambivalent and confused about the reform.

Fortunately, in Boston, we’ve already had years of unique healthcare reform that has allowed us to observe early results from redesigned and expanded access to healthcare. We have the privilege of treating patients in our hospitals and clinics who were denied care under older systems. We already have the opportunity to help our institutions with innovative patient safety and quality improvement projects. Such efforts will play an important role in clarifying the ACA’s strengths and weaknesses and will continue to guide future reform.

For those of us in (and considering careers in) primary care, the SCOTUS ruling affirmed that our work has an important place in future reform. For the biomedical community and healthcare industry, the ruling sustained the crucial discussion of how to continue improving our field. That issue transcends partisan views. And for existing and future patients, it represented a commitment to align action behind the belief that pursuing better health for all is right, noble, and most importantly, approachable.