One of the enduring staples of American life over the past century has been the family doctor who hangs his or her shingle in the town square and opens a medical practice.  But the Texas Medical Association warns that the so called 'solo practice,' already an endangered feature of the American landscape, may be unknown in the state in the coming few years, because Obamacare has driven a final stake through its heart.


  TMA President Dr. Stephen Brotherton says the Affordable Care Act places more financial strains on solo practitioners that may make it impossible for them to survive.


  "Demands for electronic medical records are very expensive," he told 1200 WOAI's Berit Mason.  "The ability to practice the art of medicine without dealing with all this technology is being taken away."


  Solo practitioners have been a dying breed for more than a decade, as the costs of processing insurance, Medicare and Medicaid claims now takes up more and more of a doctor's time and attention.  It is estimated that simply processing the proper insurance firms, with everything works smoothly, costs $58 per patient, and frequently the doctor has to spend long hours on the phone with insurance officials or government bureaucrats.  Many solo practitioners say they spend fully one third of their work day in such 'non medical' tasks.


  This has prompted solo practitioners to band together into clinics or medical groups.


  Dr. Brotherton says the biggest victims are people who live in rural areas, where there often aren't enough physicians to form a medical group.


  "More rural areas where it is not easy to band together means doctors are leaving those small towns," he said.  "That, of course, makes living in those towns less safe, because you always have to drive somewhere to get treatment."


  He says almost no newly minted physicians are choosing solo practice these days, because the administrative costs are just too high.  Many people forget that physicians are small businesses.  They have to pay for employees, pay the light and electric bill and the rent for their office, and this already stretched budget has been broken by the new demands of Obamacare.


  Dr. Brotherton says this loss of a one to one bond with the family doctor is making America less healthy.


  "Continuity of care is safe for people who have a primary care doctor who they use and they can call for help have a tendency to live longer, be healthier, and engage in fewer risky behavior," he said.