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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 02-20-2013, 03:35 PM   #151
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Originally Posted by Cephalic Trauma View Post
That's exactly how it works. They take the government number, determine how much they will pay based on that figure (i.e. 120% of medicare), and pay it. I have physicians in my family, and I get lectures from physicians every day, so I'm sure they aren't lying.
This really cements in my mind, though, that Medicare is a great plan -- for doctors.
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Old 02-20-2013, 03:37 PM   #152
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I think there are a few problems with healthcare. Obviously, I'm not in the industry and (in the vein of this thread) don't have my thumb on its pulse, but 30 million more people coming into a system means the jobs of those in the healthcare industry are very stable, they're in large demand. The better you are, the more wanted you will be. And that's why I believe, as I stated in my first post in this thread, that there's never been a better time to be in the profession.

Medicare (and Medicaid) made the healthcare industry rich. Anytime you have the full backing of the United States to support your paycheck because you are doing operations and checkups and testing, you're going to see a stable monetary benefit (not to mention, an increase in the amount of operations, checkups, and testing -- that age-old incentive issue).

Even supposing Medicare payments to doctors are cut, even drastically, my belief is that the healthcare system will be a well-compensated profession.
You shouldn't use your thumb to take a pulse.
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Old 02-20-2013, 03:39 PM   #153
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What kind of Soviet-style system do you have built up in your mind for our healthcare system? You honestly don't have to see patients unless you want to. Also, these 10 extra patients are privately insured (not Medicare patients).
I have to make a living. I will leave medical school with 200 grand in debt.

It comes down to one thing that you are ignoring. Everything revolves around medicare. Medicare sets the standard, and private companies set prices based on the standard.

There are multiple private insurance companies, and different companies will pay different rates for different procedures.
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Old 02-20-2013, 03:41 PM   #154
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Originally Posted by La literatura View Post
This really cements in my mind, though, that Medicare is a great plan -- for doctors.
Your earlier statement about there never being a better time to be in healthcare seems out of touch in the context of what I hear from people actually in the field.
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Old 02-20-2013, 03:44 PM   #155
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This doesn't make sense. Think about it: why are there differences between costs for similar operations, then? Under your theory, there should be a uniform cost in the healthcare system.

The reality is that hospitals and insurance companies negotiate on payment plans. I'm sure Medicare plays a role in it, but it's one of many roles.
Because different companies will pay different rates for similar procedures in order to make a profit.
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Old 02-20-2013, 03:45 PM   #156
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Your earlier statement about there never being a better time to be in healthcare seems out of touch in the context of what I hear from people actually in the field.
We had a lecture about this from the CEO of a major hospital associated with our school.
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Old 02-20-2013, 03:47 PM   #157
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Your earlier statement about there never being a better time to be in healthcare seems out of touch in the context of what I hear from people actually in the field.
I think there's a lot of uncertainty in the field right now. After all, the regulations covering ACA haven't been completed yet. Everyday, who knows how many pages are printed detailing regulations.

I get that it's probably unnerving, especially for doctors who have been around for 25-35 years.

But I don't see the AMA running around acting crazy like a freshmen Republican Representative.
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Old 02-20-2013, 03:49 PM   #158
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Originally Posted by Cephalic Trauma View Post
I have to make a living. I will leave medical school with 200 grand in debt.

It comes down to one thing that you are ignoring. Everything revolves around medicare. Medicare sets the standard, and private companies set prices based on the standard.

There are multiple private insurance companies, and different companies will pay different rates for different procedures.
And there are multiple hospitals, and different hospitals/doctors will get different rates.

Which goes to show you that it's not as simple as "What's 120% of Medicare? Okay. Done."
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Old 02-20-2013, 03:50 PM   #159
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We had a lecture about this from the CEO of a major hospital associated with our school.
And he told you to drop out of school and get a degree in accounting.
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Old 02-20-2013, 03:56 PM   #160
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And there are multiple hospitals, and different hospitals/doctors will get different rates.

Which goes to show you that it's not as simple as "What's 120% of Medicare? Okay. Done."
The hospitals a patient has access to are limited by the provider. You can't stray out of your PPO, or you will pay higher rates.
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Old 02-20-2013, 03:57 PM   #161
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And he told you to drop out of school and get a degree in accounting.
I hope you aren't relying on one.
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Old 02-20-2013, 03:58 PM   #162
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You shouldn't use your thumb to take a pulse.
.... truth....
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Old 02-20-2013, 04:00 PM   #163
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I hope you aren't relying on one.
Well, have you thought about quitting? Have other kids in your class dropped out because of ACA?
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Old 02-20-2013, 04:10 PM   #164
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Originally Posted by La literatura View Post
I think there's a lot of uncertainty in the field right now. After all, the regulations covering ACA haven't been completed yet. Everyday, who knows how many pages are printed detailing regulations.

I get that it's probably unnerving, especially for doctors who have been around for 25-35 years.

But I don't see the AMA running around acting crazy like a freshmen Republican Representative.
I'll pass your reassurances on to my acquaintances. I'm sure it will make them feel better to know that one of Obama's faithful is confident that their worries are unfounded.
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Old 02-20-2013, 04:11 PM   #165
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Well, have you thought about quitting? Have other kids in your class dropped out because of ACA?
No. I love the science of medicine. I can't see myself practicing anything else.

I assume my classmates feel the same way.
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