MichelleMalkin.com photoshop winner Rachael from Kentucky

Several related items for you to contemplate this morning…

First, my Fox News appearance last week in which I noted how doctors and would-be doctors are fleeing the practice of medicine over Obamacare:

Second, via Matthew Balan at Newsbusters, this vulgar gang of MSNBC liberals denigrating me over my critique of Obamacare — not by answering any of my policy points, but by making crude jokes about my appearance and body parts…

JIM WARD: Did she need a colonoscopy to pull that out of her ass? (Lavoie and Miller laugh) Is there insurance for that? CHRIS LAVOIE: Someone on your Facebook page just said, dear Michelle Malkin, your colon is not a fact checker, no many how many of your ignorant statements you pull out of your ass. (Lavoie and Ward laugh) …Miller played the Malkin soundbite twice in the first hour of her program, first during a segment with Democratic Party strategist Karl Frisch, and again minutes later as she talked to Current TV correspondent Jacki Schechner, who once was the communications director for the pro-ObamaCare coalition Health Care for America Now. Ward’s colonoscopy line came during the Frisch segment. During the clip, the conservative writer talked about a “brain drain” from the health care sector as a result of ObamaCare. After Miller played it the second time, Ward chimed in with a barb at Malkin’s intelligence: “Boy, she would know about brain drain.” Schechner herself launched an insult at the Fox News commentator: “Michelle Malkin is a senior fellow at fantasy think tank.” She soon added, “I have no idea where she [Malkin] gets this stuff, other than just making it up out of her own mind.” About ten minutes later, a caller from Memphis, Tennessee named Gloria stooped to attacking Malkin’s appearance

Third, the latest Los Angeles Times headline from California about…the doctor shortage and its implications for Obamacare…

As the state moves to expand healthcare coverage to millions of Californians under President Obama’s healthcare law, it faces a major obstacle: There aren’t enough doctors to treat a crush of newly insured patients. Some lawmakers want to fill the gap by redefining who can provide healthcare. They are working on proposals that would allow physician assistants to treat more patients and nurse practitioners to set up independent practices. Pharmacists and optometrists could act as primary care providers, diagnosing and managing some chronic illnesses, such as diabetes and high-blood pressure.

Fourth, this Healthcare Daily update on the continued loss of doctor-owned practices because of Obamacare:

It is predicted that fewer than 40 percent of physicians will own a practice at the end of 2013, with nearly 90 percent of them citing business expenses a a top concern, according to a survey by Accenture. According to the consulting firm, 36 percent of physicians will own a practice by the end of the 2013, down from 57 percent in 2000: ORDER IT NOW An accompanying survey of 204 physicians found that 87 percent cited business expenses as a top concern influencing their decisions to seek employment. Sixty-one percent named managed care, and 53 percent identified requirements for electronic health record systems. In addition, 53 percent mentioned problems managing staff, and 39 percent cited the large number of patients needed to break even.

Fifth, the latest in a long line of Obamacare medical device tax-induced cutbacks and layoffs:

Minnesota’s medical device makers say a new tax to help pay for the federal health care law could cause cutbacks, and even layoffs. The state is home to more than 700 medical device companies, and between 250,000 to 300,000 workers. The nine employees left at Signus, a Chanhassen-based spinal implant company, took a 40 percent pay cut, and the owner isn’t getting paid at all. He blames the new medical device tax. “I look around and I don’t know how to explain it to everybody,” said Tom Hoghaug of Signus Medical. “Sorry, I have to lay you off because I have to pay tax to the federal government.” …Minnesota Congressman Erik Paulsen is trying to repeal the tax — an effort that has bipartisan support from Minnesota Democrats and Republicans. “There have already been thousands of layoffs across the country,” Paulsen said. “That means fewer jobs. It means less innovation.”

And another new piece from the Washington Times spotlighting doctors closing their doors because of, you guessed it, Obamacare…

After 25 years of practicing medicine, Dr. Tamzin Rosenwasser packed in her dermatology practice in 2011, barely a year after the passage of President Obama’s health care initiative. The timing wasn’t coincidental. “I have interrupted practicing medicine because of Obamacare,” said Dr. Rosenwasser. “I’d read the bill. I was conversant with what had already happened with Medicaid, and I didn’t want to go down that road with Obamacare.” The Affordable Care Act isn’t scheduled to be fully implemented until next year, but some doctors already are viewing it as dead on arrival. The medical rumor mill is abuzz with stories about physicians girding for Mr. Obama’s signature domestic policy achievement by limiting their exposure to Medicare and Medicaid, selling their practices, converting to fee-for-service approaches, or even retiring from medicine altogether. “Every single day, people are talking about retiring early, getting out of clinical medicine, or going into hospital administration, where you don’t have to think about patient care anymore,” said Dr. Richard Armstrong, a Michigan surgeon and chief operating officer of Docs 4 Patient Care, which opposes the Affordable Care Act.

Reality outside the Beltway/MSNBC bubble bites.