Barring last minute action by Congress, physicians were set to receive a 21-percent reduction in Medicare payments as of March 1.

Yes, you've heard this story before, every year for the past nine years, in fact. You only have to change the percentage of threatened cut; the actual story never changes—cuts are threatened, forces are marshaled, letters are dashed off, Congress eventually sticks its head in the sand, approves a temporary fix and life goes back to normal.

Complicating this latest round in the perennial sustainable growth rate dance is the fact this year's fix was part of a much larger and more newsworthy Senate jobs bill. Already operating on an expiring two-month extension from the January 1 deadline, Senate Majority Leader Harry Reid took the courageous step of proposing a (wait for it) … one-month extension of the proposed freeze on Medicare cuts. Enter retiring nutjob—pardon me, I meant Senator—Jim Bunning, who conducted his own version of a filibuster, drew a line in the sand saying he'd had enough of this deficit spending stuff. And so it goes. No extension of unemployment benefits, 2,000 federal employees furloughed, and a 21-percent cut in physician payment, because the gentleman from Kentucky developed a conscience.

Meanwhile, ASCRS, the AAO, the AMA, and every other self-respecting acronym in medicine is urging its members to contact Congress and providing them with instructions and background on the implications of changing their Medicare participation status.
You'll have only a few more days to do this, by the way. March 18 is the deadline.

As usual, by that date, the issue will likely have faded from the headlines, with the customary temporary fix imposed and no one really any the worse for wear. If that happens, none of your Medicare patients will be any wiser about what an SGR is and how the government treats the physicians it pays to provide their medical care. Maybe it's time to enlist them in the battle to put an end to the SGR.

In truth, none of the options available to physicians in terms of participation, non-participation or private contracting is very appealing. But in a time when we are seeing patients take more of a role and having a greater say in their own medical care, it would be well worth the expense to put some dollars against a public education campaign to teach these patients/voters/constituents how the payment system works—or doesn't.