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Old 02-01-2013, 11:15 PM  
Taco John Taco John is offline
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Survey: Pysicians reducing their hours/access

Comprehensive Survey of 13,575 U.S. Physicians Points Toward Substantial Challenges

Research Commissioned by The Physicians Foundation Also Examines Physician Morale and Perspectives on Current / Future State of U.S. Healthcare System

Boston, MA, September 24, 2012— American patients are likely to experience significant and increasing challenges in accessing care if current physician practice patterns trends continue, according to a comprehensive new survey of practicing physicians. One of the largest physician surveys ever undertaken in the U.S., the research was commissioned by The Physicians Foundation, a nonprofit organization that seeks to advance the work of practicing physicians and help facilitate the delivery of healthcare to patients.

Physicians are working fewer hours, seeing fewer patients and limiting access to their practices in light of significant changes to the medical practice environment, according to the research, titled “A Survey of America’s Physicians: Practice Patterns and Perspectives.” The research estimates that if these patterns continue, 44,250 full-time-equivalent (FTE) physicians will be lost from the workforce in the next four years. The survey also found that over the next one to three years, more than 50 percent of physicians will cut back on patients seen, work part-time, switch to concierge medicine, retire, or take other steps likely to reduce patient access. In addition, should 100,000 physicians transition from practice-owner to employed status over the next four years (such as working in a hospital setting), the survey indicates that this will lead to 91 million fewer patient encounters.

“It is clear that the introduction of nearly 30 million new patients into the U.S. healthcare system through healthcare reform, added to the already growing physician shortage, will have profound implications for patient access to medical care,” said Walker Ray, M.D., vice president of The Physicians Foundation and chair of its Research Committee. “The rate of private practice physicians leaving the medical field, as well as changes in practice patterns that reduce the number of hours spent seeing and treating patients, is alarming. When these lost hours are added up, we get a much fuller and more ominous picture of the kind of access crisis that patients may soon face.”

More than half of physicians (52 percent) have limited the access of Medicare patients to their practices or are planning to do so, while one out of four physicians (26 percent) have already closed their practices altogether to Medicaid patients, the survey shows. Physicians cited rising operating costs, time constraints and diminishing reimbursement as the primary reasons why they are unable to accept additional Medicare and Medicaid patients.

The survey, fielded online from late March to early June 2012 by Merritt Hawkins for The Physicians Foundation, is based on responses from 13,575 physicians across the U.S. The overall margin of error (MOE) for the entire survey is (μ ± 0.998 percent), which indicates a “low to very low” sampling error for a survey designed to draw opinions and beliefs from a large population. Generally, an overall MOE at 99 percent confidence is considered highly trustworthy at +/- 2 percent or less, and all questions within the survey met this criterion.


Physician Morale

An overwhelming 80 percent of physicians cited “patient relationships” as the No. 1 most satisfying part of their job. Yet the survey also found an overwhelming majority of physicians, 77 percent, are pessimistic about the future of medicine. Eighty-two percent believe they have little ability to change the healthcare system.

Multiple factors were cited as driving widespread feelings of discontent among the nation’s physicians. “Liability / defensive medicine pressures” (related to potential malpractice lawsuits) was cited first, followed by “Medicare / Medicaid / government regulations,” “reimbursement issues” and “uncertainty / changes of health reform.” These issues and others cited throughout the study tend to distract or interfere with the time physicians spend with their patients, according to survey respondents.

“The level of pessimism among America’s physicians is very troubling,” said Lou Goodman, Ph.D., president of The Physicians Foundation and CEO of the Texas Medical Association. “More than 84 percent of physicians feel that the medical profession is in decline and nearly 58 percent are reluctant to recommend medicine as a career to their children. That means we need to make significant changes to ensure that we preserve the patient-physician relationship and continue to have the brightest minds going into medicine.”

Healthcare Cost Drivers

When asked about the factors driving increases in healthcare costs, “defensive medicine” was cited as the No. 1 cause for 69 percent of physicians, followed by an “aging population” (65 percent). On average, older patients visit physicians three times as often compared to younger patients. Other factors ranked included “cost of pharmaceuticals,” “advances in technology / treatment” and “social conditions.”

Additional survey findings of note include:

• Close to 92 percent of physicians are unsure where the health system will be or how they will fit into it three to five years from now
• More than 62 percent of physicians said Accountable Care Organizations (ACOs) are either unlikely to increase healthcare quality and decrease costs, or that any quality / cost gains will not be worth the effort
• Physicians are divided on the efficacy of the “medical homes” concept, and many (37.9 percent) remain uncertain about their structure and purpose
• While close to 70 percent of physicians have implemented electronic medical records (EMR), 47.4 percent have significant concerns that EMR poses a risk to patient privacy

“The 13,000 plus physicians who participated in this landmark survey, which included nearly 8,000 open-ended responses, strongly demonstrates the overwhelming desire of America’s physicians to share their perspectives and concerns about the current state of medicine,” said Tim Norbeck, CEO of The Physicians Foundation. “The accuracy, rigor and sheer scope of this survey should make it an invaluable piece of research to policy makers, healthcare providers, media and other stakeholders that truly want to understand the challenges that face America’s healthcare system.”

http://www.physiciansfoundation.org/...al-challenges/
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Old 02-04-2013, 08:35 PM   #91
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Originally Posted by mlyonsd View Post
The MSM is proud you're paying attention to them.
You don't remember the death panel controversy? Surely that wasn't a minor glib on the political radar.
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Old 02-04-2013, 08:48 PM   #92
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Originally Posted by La literatura View Post
And others consider it sensible cost-control measures that are necessary for government-funded health care.
You realize you're describing decreased benefits. AKA death panel.

Maybe once you're receiving Medicare it should only pay for antibiotics. That would solve a lot of those pesky old people problems.
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Old 02-04-2013, 09:01 PM   #93
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Originally Posted by La literatura View Post
You don't remember the death panel controversy? Surely that wasn't a minor glib on the political radar.
blip
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Old 02-04-2013, 09:03 PM   #94
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Originally Posted by mlyonsd View Post
You realize you're describing decreased benefits. AKA death panel.

Maybe once you're receiving Medicare it should only pay for antibiotics. That would solve a lot of those pesky old people problems.
Yes, but the opposing argument is that there was too much lingering on, and hospitals would just bill medicare when it wasn't needed. Certainly there needs to be an appropriate balance.
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Old 02-04-2013, 09:04 PM   #95
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Originally Posted by Taco John View Post
blip
Just a blip? Hmm. I thought it could be a glib. Is glib a word? I should look it up I guess.
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Old 02-04-2013, 10:17 PM   #96
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Originally Posted by La literatura View Post
That was the general idea. You basically had to plead your case to some government stooge who would then decide if you were worthy of care. Old people, mentally retarded people, conservatives, evangelicals need not apply. This was the New World Order, ushered in by an African Adolf Hitler.

That was the key Republican scare tactic of summer 2009 with all those townhall debates.
It sounds to me like you've turned it into a strawman so you don't have to deal with the reality.
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Old 02-04-2013, 10:18 PM   #97
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Yes, but the opposing argument is that there was too much lingering on, and hospitals would just bill medicare when it wasn't needed. Certainly there needs to be an appropriate balance.
Why should a government overlord (if you don't like calling it a death panel) decide these things?
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Old 02-04-2013, 10:27 PM   #98
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It sounds to me like you've turned it into a strawman so you don't have to deal with the reality.
Yeah, the Republicans did create a strawman with the death panel rhetoric. Worked pretty well for them.
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Old 02-04-2013, 10:32 PM   #99
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Why should a government overlord (if you don't like calling it a death panel) decide these things?
By "these things," do you mean deciding which cost-cutting measures for Medicare? Or do you mean something else?
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Old 02-05-2013, 07:44 AM   #100
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By "these things," do you mean deciding which cost-cutting measures for Medicare? Or do you mean something else?
Whether we call it death panels or cost control, we're still all talking about government bureaucrats deciding which medical services real people will have covered. Your euphemism doesn't change that.
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Old 02-05-2013, 07:45 AM   #101
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Yeah, the Republicans did create a strawman with the death panel rhetoric. Worked pretty well for them.
Is that why you're doing it?
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Old 02-05-2013, 07:58 AM   #102
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Whether we call it death panels or cost control, we're still all talking about government bureaucrats deciding which medical services real people will have covered. Your euphemism doesn't change that.
Who should decide how to cut costs on Medicare? Anyone? No cutting costs? Full buffet?
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Old 02-05-2013, 08:00 AM   #103
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Who should decide how to cut costs on Medicare? Anyone? No cutting costs? Full buffet?
We're not talking about just Medicare alone. We're talking about the entire scope of Obamacare.
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Old 02-05-2013, 08:02 AM   #104
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Is that why you're doing it?
Critics (mylonsd) now want to say that the ACA has started to implement death panels, using a term that Republican fear-mongers used in 2009 to attempt to derail the bill. (The proposal, as you may recall, involved end-of-life counseling). What am I doing that you find so objectionable?
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Old 02-05-2013, 08:04 AM   #105
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We're not talking about just Medicare alone. We're talking about the entire scope of Obamacare.
Mylonsd and I were talking about medicare cost-cutting measures, but I'm open to expanding the discussion. Is it your argument that government bureaucrats are mandating that insurance companies cut certain benefits?
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