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Doctors vs. Obamacare: Can your physician simply ‘opt-out’?

Tuesday, January 17, 2012

plan b

Unbeknownst to most people in or out of the healthcare arena, however, are the legal options available to physicians to either never enroll in Medicare or to voluntarily withdraw their participation in the government’s plan. The legal nuances of the doctor-Medicare relationship may shed light on options available to physicians to skirt inclusion in Obamacare if the law’s enforcers decide to use a heavy hand in mandating their participation.

Quoting a memorandum by the California Medical Association’s Solo/Small Group Practice Forum delegation on January 9, 2012, physicians became aware of a “bulletin circulated by the American Medical Association [referencing] an email authored by an unidentified Center for Medicare and Medicaid (CMS) employee who stated that a non-enrolled physician who treats Medicare beneficiaries must either involuntarily enroll in Medicare or else provide medical care free of charge. Apparently some embrace conscription of physicians and believe that the federal government can require physicians to work for free.”

The real challenge for physicians today is that they lack true representation by the American Medical Association (AMA). Since the AMA’s membership represents only about 15% of practicing community doctors in America, and since the AMA lost 12,000 member doctors in 2010 alone (and are expected to have lost at least that amount in the year 2011), the AMA has a real credibility problem with the nation’s physicians.

Furthermore, since the AMA publically signed on as a supporter of the Patient Protection and Affordable Care Act (PPACA) with only the implicit blessing of their limited membership, and many local and state AMA-affiliated medical societies remained eerily quiet during and after the contentious health care reform debates, the vast majority of doctors feel the organization betrayed them. America’s doctors need true representation to the public and to their elected representatives. Without proper representation, doctors are looking for ways to simply opt-out of all government health care plans.

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  • Raymond

    Mr.Barack Obama….

    Please show us your REAL birth certificate.

    • jim letourneau

      so Bush ying about a OUI as a teenager and his family is a out and out living a lie and has been proven by the cop who gave him the OUI, and doing everything to cover the lie, is okay, White and rich, your so smart.

    • Tsippora Berke

      your “master piece” of a comment is totally ineligible. What on earth are you talking about? pulling the race card again?
      do you really think that will solve this nation’s problems?

    • daves

      Is this article about Medicare or Obamacare?

      For a Physician to opt out of Obamacare they would pretty much have to stop treating patients since Obamacare is just a requirement to have private insurance.

    • Pineapple

      O’Bamacare exempts over 1200 groups, most of which are unions. It also exempts Congress and the President.
      Most of Nasty Pelosi’s constituents are also exempt.
      How does this not violate the fourteenth amendment which requires equal protection under the law?

    • Stagemgr

      Boy! Has someone pulled the wool over your eyes again. You might try reading some of the enormously long Obamacare plan. If it were just to have healthcare it wouldn’t be so long and involvd that no one can read it all. That way it hides a lot. It is the government’s way of taking over your health care and giving you no say in what, where or when you get health care. You and your friends are the ones that put this idiot in the White House. You should be embarrassed for being to stupid and ashamed of selling out America!!@

    • June9245

      You have removed any doubt, pertaining to the fact you are a total idiot, thanks!

    • Republican and loving it

      Idiot. Obama has spent more money in the 3 years in office than Bush did in 8 years. A vote for him will be a vote for disaster! Vote Republican.

    • rocky

      What the hell is an OUI and what does that have to do with the artical. You sound like an illiterate liberal with nothing intelligent to add to the discussion. You sound like fire maker and you just love throwing gas on the fire.

    • OneCitizenOfTheRepublic

      My General Practicioner (GP/family doctor) is the best in the world. We love him. He is awsome…and he will take NO MEDICARE / MEDICAID / ADVANTAGE…period. Says it saves him megabucks already…AND he refuses to post his patients medical records to the federal government.

      Sorry, my doctor is already overbooked…do you wonder why?

    • IGotAComment

      I’m happy for you. I also have a great personal health care provider.

      What concerns me in what is going to happen to my health insurance? Is it going to be ObamaCare with possible reduced reimbursement for the family practice. I’m working so I have an income and can pay more if insurance pays less.

      What happens to the people on Medicare? The recent extension of the payroll tax extension is taking money that was supposed to go to Medicare and Medicaid. It is putting something like $140 billion back in the taxpayers’ pocket but it is bankrupting Medicare. Why did they do this? It is something like $20 a week extra. $20 is nothing to me … but if the elderly don’t have health care, what are we going to do.

      Obama won’t answer me. Maybe he’ll tell you what is going to happen to the elderly. I don’t really think that Obama’s single example he gave on TV when he pushed for its passing of what a man did with that extra money was great. The man was going to go out with his family and have pizza. Let’s see: Pizza vs health care for the elderly. Something is wrong with the values in the White House … IMHO.

    • jim letourneau

      Bush, unfunded tax cuts, unfunded war, 700,000 jobs lost 2000- 20008 worst oil spill in history, all w/Geo. Bush & Dick Channey fact check, (Acoustic Switch Bush remodel Mineral Mnagement Service, that called it Channey rules. fact check it’s all there, health ins for Americans

    • justnora

      Is English NOT your first language? Are you maybe drunk…..or just a moron?

    • Dalek

      Keep in mind Jim that the Democrats had control of the Congress during some of that time. I didn’t see them doing anything to fix the problems either. Bush did warn them several times about the housing crisis. Your friend Barney said everything was peachy. He lied or he is stupid. Take your pick.

    • daves

      The payroll tax cut affects Social Security taxes withheld, not Medicare.

      It is paid for so SS benefits will not be affected.

    • daves

      Oh – and your insurance will only change if the insurance company changes it. If that happens you will always be able to buy insurance from a different company.

    • Pineapple

      He will probably be audited by the IRS every year.

    • lisa

      I’m a physician and have stopped taking as of Medicare last week (but will still see my current Medicare patients).Drastic cuts in reimbursement has gotten me to the point that my 3 employees have no benefits and they work part time and I haven’t had a vacation since 2007. Medicare will be cut 27% this year. I also posted a sign in my waiting room that I would not be accepting Obamacare and have opted not to get $44,000 from them for my computer system as they would have access to my patients records. Try getting a heart bypass under Obama-scare when they see you smoke!

    • Proud Patriot

      We don’t need it anymore. A Constitutional expert has stated that “natural born citizens” means a child born of 2 citizens, which he is not.
      Also check out the 1875 Supreme court ruling on that.

  • SMW

    Obama has lied so much..he doesn’t know the truth!

  • Anne

    I hope for Doctors sake they can opt out! I wouldn’t want to be in a professional where the government mandated who my customers must be! CHOICE…..that’s what freedom is all about. If the government wants to HIRE their own Doctors, then I guess those Doctors would have to abide by the rules of their employer. However, the government DOES NOT OWN private Doctors, and hopefully, never will!

    • jim letourneau

      you need to fact check, where is your practise,

    • Steven

      jim letourneau: Fact check WHAT? The comment starts with I HOPE. A stated DESIRE is not subject to fact checking.
      You ask where Anne’s practice is. She NEVER claimed to be a doctor.

    • Retired Marine MSgt in Marana, Az

      Don’t try to confuse poor Jim with facts. Stupidity is not cureable.

    • Raymond

      I love it.

    • Dalek

      Sometimes a 2×4 helps tho. ROFL

    • Bob

      Jim, you’re the one that needs to fact check as well as spell check. The doctors must abide if they take a payment to government payments at what they give. To opt out means they won’t accept medicare patients however are required to “work” on them in an emergency. Payment keeps shrinking. You can spread the BS talking points of the left, but they still are lies and inaccurate and lacking fact, something the left seems to be good at.

    • Flipper

      It is too bad that Jim can’t write a simple sentence that people can understand.

    • Anne S

      You need to learn how to spell correctly. It is practice, not practise. A doctor practices medicine.

    • Stagemgr

      I wish you would learn to spell and use real English. It is very hard to follow your thought when you don’t make sense.

    • Bob

      Many Doctors are opting out of accepting any insurance and specialists lead the way with this. Medicare payments keep getting smaller and many doctors can’t survive on the reduced rates. One study of a orthropaedic surgeon by (I believe)Harvard showed that in order for a group to survive it was necessary for them to get $145.00 per patient to walk in the door. This pays for rent, nurses, insurance, equipment, time and the like. Medicare wants to offer $25.00 which the doctors can’t afford. Doctors can unionize due to federal laws so how can they say no other than not accepting any insurance? In many instances union bosses and lawyers make several times what many doctors make, yet where is their regulations?

    • Bob

      Can’t unionize…….

    • fordman

      So this is what Obama is up to. He wants every business in America to unionize to raise the price of everything. A doctors practice is private so why can the government get involved in it? Obama has his hands in everything in this country and it’s time it stops.

    • TheThinMan

      The doctors can opt out – it’s called pay as you go – you bring the cash, check or money order and you get healthcare treatment – YOU get to worry about collecting from ObamaCare/medicare/medicaid. They’ll supply you with the codes, maybe, but they’ll take their money up front, as they say. The AMA, like AARP, have become political anecdotes, on the take or coerced by the politicians/administration. Of course, with AARP, who used to represent retired persons, has simply become an insurance collection agency. I always laugh when i see their commercials/ads and some woman says, it’s backed by AARP so they trust it. I wouldn’t trust AARP to wash my dog, much less pay them to provide health care – they are simply interested in my money – like politicians.

    • Valerie

      ARRP never did represent the elderly, it just fleeced them.

    • Riverdweller

      AARP lost a LOT of members when they backed obamacare. Every other mailing from them is just propaganda from them to buy insurance of one kind or another.

    • jjkrjw

      Enrollment of pre-med students is way down. There will be a horrendous shortage of doctors but our dictator will simply import doctors from Pakistan. Check your yellow pages and see how many Mohammeds are already in your city. Indian doctors will be imported, too, but the cultural differences will not be as noticeable as with the muslims ones.

    • Bea

      I refuse to go to those type of doctors.

    • IGotAComment

      Remember my words: ANY PORT IN A STORM.

      When you are hurting, you’ll see anyone who has a chance at helping you.

      I’ve seen first hand what the communist did.

      They have two levels of medicine: the upper for the rich and politicians and a lower level for the masses. I leave it to you to figure which level you are in.

    • daves

      Anne – do you know what Obamacare is? A requirement to buy private insurance. Do you hope that your doctor doesn’t have to treat patients who have private insurance?

      What would your doctor’s office be, a cash only business? They can do that if they want but they will probably lose a lot of customers.

  • Steve

    Luke 10:18And he said unto them, I beheld Satan as lightning fall from heaven.
    In ancient Hebrew the word for lightning is barack, the word for heaven or the
    heights is bama and to connect the words either an “a” or an “o” is used.

    2 Thessalonians 2:3 (King James Version)
    3Let no man deceive you by any means: for that day shall not come, except there
    come a falling away first, and that man of sin be revealed, the son of perdition;

    Political Correctness a term first seen in Mao’s Little Red Book, a communist engendered abomination that is instituting censorship little by little.

    “If the freedom of speech is taken away then dumb and silent we may be led, like sheep to the slaughter.”- George Washington

    Carl Marx, once wrote that, the goal of the Communists was to quote,. “enter into men’s minds and cast God down from his throne.”

    Matthew 12:31Wherefore I say unto you, All manner of sin and blasphemy shall be forgiven unto men: but the blasphemy against the Holy Ghost shall not be forgiven unto men.


    In ancient Babylon their economy was based on usury.
    “If you lend money to one of my people among you who is needy, do not be like a moneylender; charge him no interest. Exodus 22:25
    Hath given forth upon usury, and hath taken increase: shall he then live? he shall not live: he hath done all these abominations; he shall surely die; his blood shall be upon him. Ezekiel 18:13
    Usury is unlawful; expressly prohibited by GOD!
     Article 1 Section 8 of the U.S. Constitution clearly states that only the Congress can print and coin money! 

    The Federal Reserve Act of 1913 was slipped thru congress during the Christmas break with the majority of it’s members absent. 

    The Federal Reserve is self serving and privately owned in violation to the Constitution, charging interest on illegally printed money. Money printed from nothing!
    In America On June 4, 1963, a virtually unknown Presidential decree, Executive Order 11110, was signed with the authority to basically strip the Federal Reserve Bank of its power to loan money to the United States Federal Government at interest. With the stroke of a pen, President Kennedy declared that the privately owned Federal Reserve Bank would soon be out of business. Five months later A UNITED STATES PRESIDENT, PRESIDENT JOHN F. KENNEDY was MURDERED BY COMMUNIST!
    “If you lend money to one of my people among you who is needy, do not be like a moneylender; charge him no interest. Exodus 22:25
    Hath given forth upon usury, and hath taken increase: shall he then live? he shall not live: he hath done all these abominations; he shall surely die; his blood shall be upon him. Ezekiel 18:13
    Usury is unlawful; expressly prohibited by GOD!
    In ancient Babylon their priest sacrificed babies to their gods baal, and molech.  
    In America the communist under their socialist programs have sacrificed over 50 million American babies to their god satan!
    Leviticus 20:2-5
    2Again, thou shalt say to the children of Israel , Whosoever he be of the children of Israel , or of the strangers that sojourn in Israel , that giveth any of his seed unto Molech; he shall surely be put to death: the people of the land shall stone him with stones.
    3And I will set my face against that man, and will cut him off from among his people; because he hath given of his seed unto Molech, to defile my sanctuary, and to profane my holy name.
    4And if the people of the land do any ways hide their eyes from the man, when he giveth of his seed unto Molech, and kill him not:
    5Then I will set my face against that man, and against his family, and will cut him off, and all that go a whoring after him, to commit whoredom with Molech, from among their people.
    Luke 22:35-36 Then Jesus asked them, “When I sent you without purse, bag or sandals, did you lack anything?” “Nothing,” they answered. 36 He said to them, “But now if you have a purse, take it, and also a bag; and if you don’t have a sword, sell your cloak and buy one.
    Jeremiah 50:16Cut off the sower from Babylon, and him that handleth the SICKLE in the time of harvest: for fear of the oppressing sword they shall turn every one to his people, and they shall flee every one to his own land.
    Jeremiah 50:23How is the HAMMER OF THE WHOLE EARTH CUT ASUNDER AND BROKEN! how is Babylon become a desolation among the nations!
    Jeremiah 50:14 “ Put yourselves in array against Babylon all around, All you who bend the bow; Shoot at her, spare no arrows, For she has sinned against the LORD.

    All nations compassed me about: but in the name of the LORD will I destroy them. Psalm 118:10


    “The thing that separates the American Christian from every other person on earth is the fact that he would rather die on his feet, than live on his knees!”. George Washington



    • TheThinMan

      “P” on you and your Bible thumping that has nothing to do with the conversation.

  • willyt

    Many doctors do not accept Medicare assignment because of the steep cuts they get to their fees. Those docs with steep overheads do work for free when they accept Medicare assignment. People should consider keeping their private or retired insurance if their policy is worth a hoot because they can then opt out of Medicare Part B and save over a hundred dollars a month for that cost.

    Unfortunately many such policies were dropped by companies to save money and by municipalities for the same reason. Just the same, docs have been bearing the cost cutting by the government and you get the best and fastest service with private insurance like BC-BS.

    In NObama’s Cum-Bay-Yah autocratic vision, he will sit atop Reagan’s shining city on the hill and shoot out the lights with his BB gun until he controls death panels and metes out health care according to “social fairness”.

    You over 70? Say goodbye old buddy ’cause you ain’t on the list of likely survivors.

    • TheThinMan

      That’s fine, where can I sign up for euthanasia treatment?

    • jjkrjw

      Think this is why obama is setting up FEMA camps all over the country?

    • IGotAComment

      Try a couple of $100+ per day.

      No doctor cares about a $100 per month.

    • Cathy

      It’s not a simple matter of dropping Medicare. The government says if you drop Medicare, they will cut off your Social Security. There is a lawsuit working its way through the courts now on this subject. Dick Armey, retired Congressman and several others wanted to drop Medicare as they said they could get better insurance. The government told them they would stop their Social Security, so they have taken it to court. This story appeared in The Wall Street Journal well over a year ago, and the lawsuit is still ongoing.

      Initially Medicare would not let you pay for a procedure that they did not cover as they did not want those that could afford it to get more than poorer people. I asked my doctor about it, and he said he could be prosecuted for recommending a procedure not covered. This, too, went to court and was overturned.

      So, if Obamacare becomes a reality, everyone can look forward to this type of tyranny, not just the senior citizens as the government will completely control the health care in this country.

    • Pineapple

      I received a heart stent at the age of 61. At my current age of seventy two, a heart stent would not be approved by O’Bamacare.
      I would simply be left to die.

      If I were a member of Congress, or the President, I would qualify for a hear stent, regardless of my age.

  • m. sharpe

    Where were these opt out doctors in 2009? This complaint is almost as bad as Pastors complainning about low funds coming into the churches. Socialized medicine is to put the private guys out of business. Taxes Vs. tithes; Sam got His first, the churches kept silent,now they must live with the left-over.

  • Raymond

    President Obama decided to do one of his public addresses against the backdrop of an American farm, but the ceremony couldn’t get started because of all the flies buzzing around his head. Obama demanded to know why the flies wouldn’t leave, so the farmer explained to him, “Well, those are called circle flies. They always circle around the back end of horses.” Obama angrily replied, “Hey, are you saying that I’m a horse’s behind?” The farmer answered, “No Sir, Mister President. I would never call someone a horse’s behind. It’s hard to fool them flies though.”

    • jim letourneau

      Bush Acoustic Switch if you have someone that can read Raymond read that Bush Channey remodel the Mineral Management Service, direct cause of worst oil spill in history, fact check Raymond if you can, the reply just above me, has a cure for everyting. might even beable to fix stupid Raymond

    • Ltjg

      I must ask, What have you ever done to contribute to society?

    • Dalek

      I think someone lost their village idiot. ROFL

  • Linda

    Or as my Medicare eligible husband’s doctor noted – My nurse and I will provide care for free. Our patients may leave a donation on their way out. . . . Prayerfully the amount will pay our way and we will be able to continue to help people.

  • Eddo

    I agree with thinman about aarp. I used small letters because they are no longer relavent. They are a corrupt organization who is in the insurance business for the money. Guess what org. was a heavy supporter of Obamacare? Yep, aarp. And guess who the obamacare directs people to for insurance. Yep, aarp. Cozy.

    • jjkrjw

      AARP has been a leftist group for years, pretending to look out for older people but mainly looking out for themselves. Now they’re in favor of cutting Social Security benefits.

    • Valerie

      This is not surprising. When the threat of Obamacare began, I started posting on the AARP website under my mother’s name. I posted many comments warning seniors about the dangers of Obamacare and the corrupt interest AARP had in making it law. Particularly why AARP’s new CEO, Barry Rand, was so eager in having it pass. Here’s one of those posts:

      “Those of you who’ve expressed your displeasure at AARP’s support of Obamacare because you know it will deny you access to your own doctor, destroy the private health care system, put health care decisions in hands of Federal bureaucrats, ration care – generally denying expensive care to older Americans, and force those old enough to be AARP members into periodic “end of life” counseling need only to look into the background of Addison Barry Rand, the new CEO of AARP to understand what is going on.

      Mr. Rand’s life goals have nothing to do with the proper representation of older people in society. He is, and has been since he left his private high school, a black activist – a self described “agent for social change”. A repeated beneficiary of Affirmative Action policies, he has taken pride in being the first black this, and the first black that throughout his career. His suggestion for his own epitaph is, “He stayed in the fight all the way. He kept pushing for social change. He made his contribution in his way, and he did it throughout the whole visit here.” In Chicago, where Barack Obama comes from, the first sentence in the epitaph would have been, “He was down for the struggle”. The two sentences have the same meaning, but black activists in Chicago aren’t as reluctant as Mr. Rand to use the jargon of the ‘hood”.

      Now in his middle 60’s, Mr. Rand sees America in the hands of a President who, like him, presents himself as an agent for social change, who expresses the goal of remaking America, and who maintains only a thin veil over his own racism. Anyone who believes that Mr. Rand would take any action in behalf of AARP which was not in total agreement with Barack Obama’s goals is extremely naive. You can complain all you want and offer as many good reasons as you like why the AARP position on the government take-over of health care does a disservice to its membership, it will be to no avail. Mr. Rand doesn’t care what you think, and he doesn’t care what happens to you. He has goals of his own. He’s going to see to it that he is remembered as being down for the struggle.”

      And, of course, making some “bucks” while he’s at it, doesn’t hurt either.

  • IGotAComment

    Medical care providers who DO NOT take Medicare, Medicaid or other lower paying insurances are simply maximizing their dollars per hour earnings. Why should they spend half an hour with grandma when her insurance (Medicare) pays 40 cents of every dollar charged when s/he can see a patient with insurance and get 90+ cents of the dollar charged and bill you for the rest. By law, a doctor is not allowed to charge a Medicare patient the extra non-paid portion back to the patient.

    So the next time you hear of a doctor who won’t take Medicare/Medicaid, you know s/he is simply maximizing the health care facility’s income … pure and simple. But then they aren’t doing anything that the plumber, city employee, Congress person or You or I do. We all maximize our dollars per hour spent at work. Don’t we???

    • Blackfoot AZ

      IGotAComment – I don’t know what insurance you have, but every time I go to the Doctor I receive a statement, from my insurance company, that shows what the Doctor’s charges are and what my insurance company paid. This is due to a negotiated price the Doctor has agreed to, and it is no where near 90 cents on the dollar! I’m not saying obamacare is a good thing, but Doctors don’t have to accept any ones insurance. Accepting someones insurance is the Doctor’s choice. The only difference with Medicare is they can’t negotiate the price that Medicare will pay.

  • robert j. wolfe

    I Can Solve All Health Problems and…The Federal Government Alone With The Pharmaceutical Companies Do Not Want You To Know And Will Not Tell You About It…

    I Will Tell You. Test Me. Look For Yourself.

    Cancer Cure, 100% and Cures For Almost Every Ailment You Can Have, Get, Catch…Heart Disease Included…

    Answer #1..Youtube: Dr. Royal Rife Videos And Watch With Your Eye’s, Cancer Die’s…

    Answer #2..Youtube DCA..A 100% Cure For Every Cancer Tested…But, Federal Government Does Not Want You To Have Them.

    You Will Need Doctor’s For Broken Bones, Cut’s Etc…

  • Chuckleduck

    Eat right, exercise and cut down on DR. calls. We will all have to change..

  • Jmillerdoc

    As a medical doctor I can tell you that every single one of my colleagues have decided they will not participate in Obamacare…some will retire, others will just say no. Personally, I do not accept any government plans or any insurance for that matter. I work my main job as a hospital employee under salary and my free market job is a clinic that accepts cash only….I give a receipt and the patient can filet with their insurance if they wish…if they don’t like it they are freeto find another doctor. Many of us are going the cash only route in the clinic. I cut 6% from the top by not having to pay a collections firm. I charge between $75 and $150 a visit and small procedures are extra and negotiated prior to performing them. I am turning away new patients, so there’s plenty of willing cash paying customers out there and I believe they will always be someone willing to pay a fair price for a fair service… hell with the governments plan…if they try to force me, I will go to UAE or somewhere else where I can knock down half a million a year and just retire after four or five years….if Obamacare stays on the books I feel sorry for the average person out there on a paycheck to paycheck lifestyle…they won’t have a doctor, period. Too many of us will quit and there just isn’t enough to see everyone…do the math, do a title research and see….this will destroy healthcare for the average person. Only the rich will get exceptional coverage, everyone else will get in line and wait….I guess Obummer gambled that is doctors were stupid…he was wrong again….

  • Play2k

    Good Point.. Doctors are reduced to “union members” without any say!

  • J J

    Waivers, waivers, waivers!! If the doctors are now capable of opting out, unions don’t have to participate, states have options, Congressmen still have their own policies, who is left to pick up the tap on this monstrosity? The poor, the unemployed, the illegals??? I just don’t understand the point of the stupid legislation!!! Why don’t we just get rid of it and start over and really think things thru this time?

  • joelas

    When the people really get clear about what Obamacare is not going to pay for, and the poor care and high cost, I beleive they will find themselves better off to not partake of any government system. Pay the fine. Get a high deductible major medical insurance what ever they can afford, set away savings, and take preventive action with exercise and healthy diet. Search the intenet for healthy alternative options and avoid the lifestyle, drug and surgeon caused illnesses, Your results on the average will be much better. You will make some errors choosing natural substances that are not effective or in insufficient quantity, but they don’t harm you. In contrast you pay a lot for doctors to abuse you. You must learn to treat yourself to beat the system.

  • David

    The Doctors that no longer belong to the AMA and the ones that never did, need to start their own group that will represent them and their patients.Don’t idly stand by and let this Liberal bunch at the AMA tell the world that they represent all of America’s Doctors while they sell you and your profession down the Government Health care Drain!!!