This morning I sit quietly in my hotel room, contemplating the day ahead at the 2013 Heart Rhythm Society Scientific Sessions in Denver. Emotions clash.
On one hand, it will be great to see old friends an colleagues, to be spoon-fed information, and to relax. On the other hand, I find myself in an electrophysiologic angst: how I can spend the time upbeat knowing that the relative value of the work that heart rhythm specialists do was cut at least 30% on 1 January 2013, thanks to new billing codes that bundled multiple codes into one?
Can I afford to be here?
I do not say this lightly. Our first quarter’s pay this year compared to last year was recently disclosed and the results were striking. Guys like me who have devoted years to our training, stood at bedsides for countless hours, and endured training that finally ended at age 36 (counting a brief two-year hiatus for a general medical officer stint as an ER physician for the US Navy), got a whopping 30% cut from CMS for the much of the procedure work we do, stealthy cloaked in codes.
It is real. It has happened. And its effects are being felt by many, real time, even now, at #HRS2013.
I realize in these economic times that many professions are feeling similar pressures. I am not here to lament nor ask for pity, but rather to describe. In many ways, I am lucky: lucky to have good friends, a fascinating skill, and wonderful colleagues and support staff to work with. But I wonder, how all of this will change things.
Certainly, we tabled our plans to hire another EP. No wonder EP fellows are finding it tough to get a job. Hospitals are not hiring. Wards are being consolidated. Pennies are being pinched, and so are staff. Patients are waiting more to see guys like me. Attendance at continuing education conferences is falling. While the effect on physician care "quality" are probably uncertain at best, but it is becoming quite obvious that "innovation" in my field of medicine as we’ve known it is stagnating or moving overseas.
It is all change – I get that – part of the Great Experiment of our nation’s health care reformation project that is moving fast and furious to places unknown. But change is difficult. It shakes things up. Anxiety and restlessness at times like these can consume a psyche or, in ideal circumstances, lead to something new, something liberating, something better.
So off I go to the 2013 Heart Rhythm Scientific Sessions, hoping to keep my chin up, my ear to the ground, and my eyes open.
You never know what you might learn.