The Aging Surgeon.

Everyone ages-some more gracefully than others. The changes associated with aging are well known but not often discussed. Age-related changes in surgeons may eventually lead to a need for the surgeon to stop operating or even retire. It may be difficult for the surgeon to recognize these changes, but there may be some telltale signs. If the surgeon is not able to interpret that it is time to retire, others may need to step in. Physician assessment of surgeons may be requested or required by employers or hospital credentialing committees. Although not widespread, such practices are becoming more popular. There are modern means of assessment, which include written screening examinations and actual personal professional assessment by a qualified physician evaluator. If retirement or career change is necessary, it must be carefully planned and executed for the surgeon to bow out gracefully.

Is a Physician "Provider Tax" the Solution to Michigan's Medicaid Woes?

BACKGROUND: Michigan is facing a Medicaid budget shortfall. Evidence suggests that the underlying factors causing reliance on Medicaid and cost of treatment to increase are getting worse. A tax on Michigan physicians has been proposed by legislators to meet the budget demands of Michigan's Medicaid program. QUESTIONS/PURPOSES: This paper looks at the legal basis of such a tax, studies the successes and failures of other states that have implemented similar taxes, and attempts to assess the effect this tax would have on Michigan doctors and patients. CONCLUSION: With current Medicaid rules, such a tax would increase federal matching funds and potentially reimbursement rates. However, the cost of a tax on physicians would not be born equally, and there are no guarantees that the revenue would provide a funding solution.