It’s 2016. Where am I?

2015 was a mixed year for neurologists and doctors in general. The Sustainable Growth Rate was repealed in a rare moment of bipartisan cooperation. Whether this will stem the tide of doctors leaving Medicare remains to be seen. In my area, it seems like another internist changes to concierge practice every week.

Even with these changes, I can’t say the reimbursement rates have returned to previous levels. Neurologists, in a primarily thinking field, often take the brunt of cuts on the few procedures we have. Like other fields, we try to cram more things into limited time and hope it all somehow works out.

2016 brings an election year, and again doctors will be in the unenviable position of ping-pong balls whacked between both sides to score political points. It would be nice to have political parties willing to work out what’s best for the health of Americans as a whole rather than trying to fire up the extreme ends of the political spectrum.

2015 was the year a new International Classification of Diseases system was foisted on us for reasons I still don’t understand. With it came a whole new wave of codes and modifiers to learn. This in turn takes a lot of time, for which we aren’t paid. Time is something I, and most docs, don’t have a lot of. I’d like to focus on caring for patients, and nothing more, but the powers that be appear to have a dim view of such silliness. This brings me back to watching internists gradually shift to cash-pay models and wondering how big the demand would be for a general neurologist in that world. The only one I know who actually did it shut down in a few months.

What’s on my wish list in 2016? Obviously, the health and welfare of myself and those around me comes first. For my patients, it’s some breakthroughs for the terrible diseases we still have no real treatments for. For my practice, it’s staying strong enough to remain independent. Some better reimbursement and non–snake oil sources of revenue are always nice. I’m hoping that in 1 year I’ll be able to write something more optimistic.

Wishing you all a great 2016!

Dr. Block has a solo neurology practice in Scottsdale, Ariz.

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