How has the Affordable Care Act affected your practice?


Some of the urologists interviewed had not noticed any effect from the ACA, although another said he has seen fewer younger patients.

“I tell our physicians never to look at the insurance but just treat the patients’ needs. Saying that, we are seeing more medical assistance patients (Medicaid) and patients who signed up for the lowest cost-the Bronze plans.

Since the ACA went into effect, even taking out our practice expansion, we’ve had a patient growth of about 15%. That includes new patients and an increase in our ambulatory surgical centers as well. Our medical assistance patients make up about 3.5% of our practice and that’s been consistent over the years.

More Marylanders definitely have insurance, and we haven’t seen a problem with people losing their insurance. People deserve care and more patients are getting care-and doctors should get paid for it.”

Sanford J. Siegel, MD

Owings Mills, MD


“I’m in a university hospital in an area that has no safety (public) hospital, so we naturally see a larger proportion of Medicaid patients. Utah hasn’t taken the expanded Medicaid, although whether it will or not is still under discussion.

I really haven’t seen much of any impact, positive or negative, of the ACA. We don’t have the expanded Medicaid so that isn’t bringing anyone in, and Utah has an extensive Children’s Health Insurance Program, so children have been able to get care all along. But I haven’t seen a decrease in patients because they have lost their insurance either.

It may be that as time passes, more people will lose their existing insurance plans or realize their deductibles are higher, but so far it has not seemed to have had any impact on our practice.”

Blake D. Hamilton, MD

Salt Lake City


“I know many people lost coverage and had to buy a more expensive policy that covers care they don’t need, like obstetrics. They also have much higher deductibles, so they are avoiding coming in.

I’m also seeing fewer younger people, primarily because they lost insurance or their deductible is through the roof now. I think a lot of them actually just ignored the law and aren’t insured at all.

We don’t see a lot of Medicaid patients in Greenwich, and those who are on Medicaid would generally go to the clinic for noninsured or underinsured patients, so I haven’t seen any increase among those patients either.

The real problem in my opinion is that nobody seems to understand the ACA insurance. I’ve had patients who don’t understand that they have to meet their $8,000 deductible before their co-pay coverage kicks in, even if they go to the doctors on the insurance company’s panel.”

William C. Brown, MD

Old Greenwich, CT

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