Over the past week at my house, I've watched Lucy pull that football away from Charlie Brown approximately 89,241 times. During the six months I've been writing FiercePracticeManagement and prior six years writing about physician practices, the infamous SGR and the doc fix, I've seen that football get yanked out from under physicians who care for Medicare patients in the same insidious loop.

As we enter the Thanksgiving holiday, you can be reasonably optimistic that the 23 percent cut scheduled for Dec. 1, will be delayed until the end of the year, after which, if you decide to stay in the game, you'll have to risk the humiliation of trying to kick that proverbial football once again.

These circumstances can make it tough to count your blessings as a physician. But I don't allow my 2- and 3-year-old to mimic 'ole Chuck's lament that, "I'll fall flat on my back and kill myself," and I don't think it's a productive attitude for physicians either.
Yes, it's a comfy seat I say this from. While I try to fill FPM with as much information to help practices succeed as I can dig up, sometimes I do indulge in the option to present the problems without the answers.

As I pointed out last week, however, we always have options. They may not be pretty, but they exist. According to research from the Medical Group Management Association, if the SGR does not get fixed:

• 67.2 percent of medical practices are likely to limit the number of new Medicare patients unless Congress halts the cuts to Medicare reimbursement.
• 49.5 percent say they will stop seeing new Medicare patients.
• 27.5 will cease treating all Medicare patients.

And those ready to endure the threats to their reimbursement will consider sacrifices in other areas:

• 76.6 percent likely will delay the purchase of new clinical equipment and/or facilities.
• 60.5 percent likely will reduce administrative support staff.
• 54 percent probably will cut clinical staff.
• 45.3 percent probably will delay the purchase of EHRs.

A recent survey from the American Academy of Family Physicians yielded similar results, with about 62 percent of the 576 family physicians surveyed saying they may be forced to stop accepting new Medicare patients, and 73 percent indicating they would have to limit the number of Medicare appointments because of the looming pay cut. More than 40 percent, meanwhile, said they would have to defer purchase of information technology, and about 38 percent said they would have to reduce staff.

Whatever options you decide are the best overall for you as a healthcare provider and as a human being who needs to make a living, remember this: Your patients, no matter what kind of insurance they carry, will need and be thankful for the medical care you make your life's work to provide. - Deb