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Old 02-01-2013, 10:15 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, 01:55 PM   #46
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Originally Posted by Taco John View Post
I've never made it out to be simple. I think that's the point. It's not.

The rest of your post is difficult to address, because of how much you've misinterpreted on you way to trying to make a point.
Are you kidding? You even stated: "In this case the math is simple:" and then proceeded with a simplistic formula showcasing your spin on the medical industry.
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Old 02-04-2013, 01:57 PM   #47
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Originally Posted by La literatura View Post
Are you kidding? You even stated: "In this case the math is simple:" and then proceeded with a simplistic formula showcasing your spin on the medical industry.
In that case, the math is very simple. But to project that and say "Having a good, affordable health care system isn't as deceptively simple as you make it out to be. "

There's more to the health care system than just physicians. They're a key piece though. Nothing a physician does is cheap as it is - and virtually EVERYTHING they do is important.
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Old 02-04-2013, 01:57 PM   #48
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Are you joking? Do you even know any doctors?
Apparently not. Are there some that don't see as many patients and are compensated well? Yes, but that is a very small minority. The norm is 50 hours or more.

Not to mention the 80 hour time limit they had to put on resident (first 3-7 years after med school, for those who don't know) work schedules because they were too tired. Does he know anything about that? Probably not.
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Old 02-04-2013, 01:59 PM   #49
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Originally Posted by La literatura View Post
What does your understanding of economics tell you about what happens when the demand for something rises?
Prices go up?
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Old 02-04-2013, 02:00 PM   #50
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Originally Posted by Cephalic Trauma View Post
Higher demand, less compensation. Do the math.

Dots connected.
? That's completely unhelpful.
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Old 02-04-2013, 02:01 PM   #51
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Originally Posted by Cephalic Trauma View Post
Apparently not. Are there some that don't see as many patients and are compensated well? Yes, but that is a very small minority. The norm is 50 hours or more.

Not to mention the 80 hour time limit they had to put on resident (first 3-7 years after med school, for those who don't know) work schedules because they were too tired. Does he know anything about that? Probably not.
lighten up Lucy...it was a joke
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Old 02-04-2013, 02:04 PM   #52
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Prices go up?
Possibly. Here's what I'm thinking: Supply rushes in to meet the demand. Yeah, if there's no supply, then prices will go up. If there's no way we can take care of 300 million people, but only 270 million, then there will be a fight. But the United States doesn't have a short supply of human capital and medical brilliance.
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Old 02-04-2013, 02:06 PM   #53
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? That's completely unhelpful.
How so?

You are increasing accessibility to physicians (increasing patient load, more work), while decreasing how much they are compensated. How is that so hard to understand?

I'm dumbing it down as best I can, but until you grasp that simple concept, I don't know much else I can say.
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Old 02-04-2013, 02:06 PM   #54
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Originally Posted by La literatura View Post
Possibly. Here's what I'm thinking: Supply rushes in to meet the demand. Yeah, if there's no supply, then prices will go up. If there's no way we can take care of 300 million people, but only 270 million, then there will be a fight. But the United States doesn't have a short supply of human capital and medical brilliance.
If we didn't already have a short supply (relative to the demand created by our third party payment system), we wouldn't have the high prices we already have. Where is this extra supply going to rush in from?
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Old 02-04-2013, 02:07 PM   #55
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lighten up Lucy...it was a joke
Fine.

You go play in the yard while the adults discuss business.
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Old 02-04-2013, 02:08 PM   #56
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Fine.

You go play in the yard while the adults discuss business.
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Old 02-04-2013, 02:09 PM   #57
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Originally Posted by Cephalic Trauma View Post
How so?

You are increasing accessibility to physicians (increasing patient load, more work), while decreasing how much they are compensated. How is that so hard to understand?

I'm dumbing it down as best I can, but until you grasp that simple concept, I don't know much else I can say.
Particularly the part about doctors getting paid less. Where is that? Also, the part about increasing accessibility to physicians is odd. The health insurance industry is still the barrier. More people are getting access to physicians through health insurance, but I don't think it's the case that insurance companies are lowering the bar for access to a physician.
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Old 02-04-2013, 02:11 PM   #58
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If we didn't already have a short supply (relative to the demand created by our third party payment system), we wouldn't have the high prices we already have. Where is this extra supply going to rush in from?
I suspect Osteopathic schools and an increased graduate rate of nurses, particularly nurse practitioners.
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Old 02-04-2013, 02:14 PM   #59
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Particularly the part about doctors getting paid less. Where is that? Also, the part about increasing accessibility to physicians is odd. The health insurance industry is still the barrier. More people are getting access to physicians through health insurance, but I don't think it's the case that insurance companies are lowering the bar for access to a physician.
What do insurance companies base their compensation on? Medicare. Company A will pay 300% of medicare, Company B 200%, etc etc. Cut medicare in half, cut compensation for physicians by even more (overhead, cost of procedures stays the same).

How is the accessibility part odd? That is the basis of the ACA. Individuals who didn't have health insurance before have it now.
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Old 02-04-2013, 02:15 PM   #60
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You have not made a single valid point since joining the thread.
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