I'm a physician in private practice (with a group) and my salary will drop due to the ACA, especially with regards to certain procedures and what insurance will pay. But that doesn't really bother me.

I'm perfectly ok with that because I feel that the ACA is the right thing to do for the country. It's not perfect (tell me which piece of legislation ever is), but my opinion is that it's going in the right direction.

The issue I have with restrictions in pay is that the government doesn't always make the best decision in deciding what the proper ratio of health care workers should be in a critical care setting.

Replacing 1 doctor with 3 nurses (because they cost the same) and then granting nurses more autonomy to make up for the lack of doctors on staff is something that is terrible for healthcare in general. Nurses, as a generalization, do not have the experience, training, or medical background to always make the best patient management decisions.

So many times a patient doesn't realize that its not a doctor that is taking care of them and are never educated about the real differences in care between a doctor and a nurse. We can thank the overactive nurses lobby for that.

If you want to reduce costs, cut our salaries, but don't try to replace a doctor with a nurse. That's just not fair to the patient.