The ICD-10 doctor exodus: Fact or fiction?

Anecdotal evidence suggests the coding shift might chase physicians into retirement.

By Susan Morse for Healthcare Finance News

If the rumors are true, ICD-10 is not going to solve the physician shortage. Too bad the hard evidence to suggest doctors near retirement age are calling it quits by Sept. 30 to avoid the switch to ICD-10 on Oct. 1 is hard to find.

One recruiter anecdotally said he knows of three physicians in a practice in Louisiana who are retiring early rather than face what they perceive as the cost of implementation and payment disruption from ICD-10.

But the American Medical Association said it has no such information, even as it points to the cost and additional staffing needed to implement what it calls “a massive administrative and financial undertaking” to prepare for the coding change.

ICD-10 will result in a five-fold increase in the number of diagnosis codes, from the current 13,000 to 68,000, the AMA said.

Cheris Craig, chief administrative officer for the Urology of Greater Atlanta, said that despite trying to make the transition from ICD-9 to ICD-10 as easy as possible for physicians, she knows of at least one doctor who has decided not to deal with it.

“One physician is planning on it so much he’s retiring the day before,” Craig said.

Not all doctors are against it.

“It wasn’t hard, it wasn’t expensive, and it wasn’t time-consuming,” Dr. Edward Burke of Beyer Medical Group told a Subcommittee on Health in February.

During that same hearing, heart surgeon and subcommittee member Rep. Larry Buschon, R-IN, said physicians have reason to worry about being reimbursed for procedures under the new codes.

“In the operating room … you’re not going to be looking through a code book,” Buschon said. “They’re going to deny the payment.”

The physician shortage is expected to grow, with the demand exceeding supply by 46,000 to 90,000 doctors by 2024, according to the Association of American Medical Colleges.

Jason Farr, vice president of recruiting for The Medicus Group, said he’s already dealing with the shortage.

He recently spoke to a hospital administrator in Louisiana who, when Farr asked him about what to expect for 2015, was told, “‘We may be looking at additional things on top of (the shortage),’” Farr said based on info he’s heard second hand.

The administrator told him three physicians were retiring early because they were concerned with the cost and payment disruption caused by ICD-10, Farr said.

“We’re already thinking of retiring in a few years,” Farr said the administrator heard from the doctors. “Instead, we’re going to close up shop early.”

The physicians were about five to eight years from retirement, all senior partners who had a great practice, Farr said.

Those physicians figured the cost of additional staffing to convert to ICD-10 would be $14,000 to $68,000. Add in training, software upgrades and payment disruption over unpaid reimbursements, and the cost would increase to about $100,000, Farr said the doctors estimated.

Farr is now searching for three replacements. About half of his searches are due to retirements, he said.

“We’re already a physician market that is transitioning from private practice to hospital-employed,” Farr said. “Private practices have to absorb this (ICD-10 cost) directly. They feel that. Hospital-employed physicians have not near the same headaches because they’re employed by the hospital.”

Farr said that in his job, he always asks the reason for the recruitment. He’s expecting to hear about more searches due to ICD-10.

“Some physicians are on the fence about it, this just pushes them over,” Farr said. “This is the last drop in an already full cup.”