In a previous post, we looked at the challenge physicians will face under the ACA in spending enough time to do effective differential diagnoses with patients and that this activity will more and more be picked up by Physician’s Assistants and Nurse Practitioners. I personally enjoy watching reruns of the popular cable drama “House”. I like the nostalgia of watching a doctor (and his entourage of four other docs) spend literally days with a patient who has a difficult diagnosis, and at the same time order every test they can collectively think of. Nostalgic because it seems as alien to me in today’s medical world as any historical movie I have ever seen. In the New World of US healthcare, such expenditures of time and money will be forbidden in all but the concierge medical practices that are springing up (albeit at significantly increased cost to the patient).

In addition to the sheer volume of medical information that must be absorbed by today’s physician, he or she must also contend with the rules and regulations imposed on them by the ACA, EHR (Meaningful Use-1 and -2) and the (now delayed) implementation of ICD-10. And, if you are a Primary Care or Family physician, you will soon see an influx of new patients from the ACA exchanges presenting a real challenge of how to handle all of these needs in a day of only 24 hours.