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“Go talk to the people at Aurora, go talk to the people at Wheaton, go talk to the people at St. Catherine’s, go talk to the people at All Saints,” Mr. Ryan said while meeting with constituents last month, according to “They will say the same exact thing, which is, ‘We are getting paid less and less per service for all these people coming in.’ You see, the government is underpaying providers for the cost of care.”

Opting out of med school

With the prospect of more government regulation and smaller paychecks, top students who normally might choose medical school may look elsewhere.

“A lot of younger people who might go to medical school are saying, ‘Why should I incur $300,000 in debt when I’m not even sure I can make a living?’” Dr. Armstrong said. “You lose some of your best and brightest because they’re smart enough to see what’s going on.”

Analysts agree that the trend of using more physicians’ assistants, nurse practitioners and foreign-trained doctors is likely to accelerate.

“And that’s not necessarily a bad thing,” Mr. Garthwaite said. “But it should be consciously done. It shouldn’t be the unintended consequence of a law.”

One option gaining ground among disgruntled doctors not ready to hit the golf course is going off the insurance grid.

“There are a number of doctors looking for alternative ways to practice medicine by trying to get out of the third-party system and going to fee-for-service,” said Dr. Hal Scherz, a Georgia surgeon and president of Docs 4 Patient Care. “I hear many of these stories. I know one doctor who’s gone to strictly cash. Her prices are posted, her service is better, and her patients love it.”

Pay as you go

That is how it’s done at the Surgical Center of Oklahoma, which accepts no third-party payments from private insurers or the government. The center opened in 1997, long before Obamacare was even a blip on the horizon, but Dr. Keith Smith, a co-founder, said the signs of greater government involvement in medicine were already evident.

“We saw it coming. We assumed there was going to be more tyrannical stuff coming from the government. We just didn’t know what form it would take,” said Dr. Smith, who refers to the health care law as the “unaffordable care act.”

His practice charges far less for surgical procedures than traditional hospitals — he even posts his prices online — by avoiding third-party payers, he said.

“We are ahead of the curve, but I hope everyone does what we do,” Dr. Smith said. “The cost of care is going up as a direct reaction to Obamacare. The more expensive health care gets, the more people are going to flock to us.”

If and when she re-enters medicine, Dr. Rosenwasser said, she plans to take the pay-as-you-go approach.

“If I do open another practice, it’s going to be me, the patient and no Medicare or Medicaid, no insurance coverage,” Dr. Rosenwasser said. “I’m going to treat my patients how I know they should be treated.”