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Old 02-01-2013, 10:15 PM  
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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, 05:47 PM   #76
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Originally Posted by La literatura View Post
Yeah, these right-wing scare tactics were tried two years ago when the ACA was attempting to get passed. Maybe you should start referencing death panels for grandma.
You realize ACA already implemented them, right?
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Old 02-04-2013, 05:50 PM   #77
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No, rather than art history, women's studies, and history, more people graduate with degrees in nursing.
So this is your grand ideology you thought I wouldn't understand?

More demand doesn't mean reduced total cost in health care. It might mean a procedure will cost less than today but if you increase the number of procedures you're losing ground. More demand means more cost insurance for providers and the government, thus the rest of us.
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Old 02-04-2013, 06:34 PM   #78
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Umm... what? America is absolutely short-staffed on doctors, and the attractiveness of getting into the medical profession is going to drop significantly as long as school is a gazillion dollars to afford and overall medical income is dropping like a rock. Doctors will have to work more hours to take care of more people and get reimbursed less. That's what happens when you create a medical system that incentivizes people to go to a doctor because their tummy hurts vs. when you have an actual emergency. They are going to have spend a GINORMOUS amount of cost to just comply with the insane government bureaucratic bullshit. They are going to continue to pay an ungodly amount of malpractice insurance. They are going to have to invest a shitload of their hard-earned money on new electronic records capability. And all the while, they are going to have to provide lesser quality care and be exposed to a lot more liability, because the government is telling them how to treat their patients.

Health care reform is absolutely needed. That means insurance reform. Pricing reform. Better electronic systems. And yes, something has to be done to demand non-insureds or illegal immigrants pick up health insurance. I don't like how they did it, but it has to be done. But reform could have been achieved without the ridiculous micromanagement of doctors. And it scares the shit out of me, because we decided that in order to reform health care, we are going to make our medical field a hell of a lot worse. I want my doctor taking care of me, not some government bureaucrat.
Your doctor still takes care of you. There's not a government bureaucrat unless you're talking about medicare or mediacaid. If you have insurance, your doctor gets to work with the insurance bureaucrat, which only in the insurance world is better than a government bureaucrat.
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Old 02-04-2013, 06:38 PM   #79
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You realize ACA already implemented them, right?
Were you hauled into the government bureaucrat court to decide if you could get some meds?
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Old 02-04-2013, 06:40 PM   #80
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Originally Posted by mlyonsd View Post
So this is your grand ideology you thought I wouldn't understand?

More demand doesn't mean reduced total cost in health care. It might mean a procedure will cost less than today but if you increase the number of procedures you're losing ground. More demand means more cost insurance for providers and the government, thus the rest of us.
I'm not sure what you're talking about with your first statement. I take it I said something to you a while ago about something.
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Old 02-04-2013, 06:41 PM   #81
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Originally Posted by La literatura View Post
Were you hauled into the government bureaucrat court to decide if you could get some meds?
I'm not sure what that means.
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Old 02-04-2013, 06:44 PM   #82
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I'm not sure what that means.
The death panels you think have been implemented by ACA. Can you explain that?
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Old 02-04-2013, 06:44 PM   #83
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I'm not sure what you're talking about with your first statement. I take it I said something to you a while ago about something.
We were discussing why adding 30 million people into the healthcare system would/would not raise the costs to the consumer/taxpayer.
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Old 02-04-2013, 06:47 PM   #84
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The death panels you think have been implemented by ACA. Can you explain that?
When I say death panels I mean government bureaucratic's deciding who does and does not receive health care. Do you agree or disagree with that definition of 'death panels'?
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Old 02-04-2013, 06:58 PM   #85
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When I say death panels I mean government bureaucratic's deciding who does and does not receive health care. Do you agree or disagree with that definition of 'death panels'?
Death panels, as the former Republican vice-presidential nominee wrote, was where: "[Elderly] or [people with mental diseases] will have to stand in front of Obama’s 'death panel' so his bureaucrats can decide, based on a subjective judgment of their 'level of productivity in society,' whether they are worthy of health care."

It's not just rationing. Rationing has always existed in the health care system. Is there government rationing today? With medicare and medicaid, sure. Has there been increased rationing since ACA?
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Old 02-04-2013, 07:13 PM   #86
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Originally Posted by La literatura View Post
Death panels, as the former Republican vice-presidential nominee wrote, was where: "[Elderly] or [people with mental diseases] will have to stand in front of Obama’s 'death panel' so his bureaucrats can decide, based on a subjective judgment of their 'level of productivity in society,' whether they are worthy of health care."

It's not just rationing. Rationing has always existed in the health care system. Is there government rationing today? With medicare and medicaid, sure. Has there been increased rationing since ACA?
As long as it doesn't meet Sarah Palin's definition of a death panel it isn't a death panel? If you get to sit down during the process, no death panel, right?
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Old 02-04-2013, 07:16 PM   #87
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Originally Posted by La literatura View Post
Death panels, as the former Republican vice-presidential nominee wrote, was where: "[Elderly] or [people with mental diseases] will have to stand in front of Obama’s 'death panel' so his bureaucrats can decide, based on a subjective judgment of their 'level of productivity in society,' whether they are worthy of health care."

It's not just rationing. Rationing has always existed in the health care system. Is there government rationing today? With medicare and medicaid, sure. Has there been increased rationing since ACA?
I consider my definition of death panels more accurate in present terms although I do believe Palin's definition could happen once health care is turned over to politicians.

And the answer to your second question is yes, without a doubt. Hospitals can now be penalized for readmitting Medicare patients. All because of a provision of the ACA. To me that is rationing.
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Old 02-04-2013, 07:24 PM   #88
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As long as it doesn't meet Sarah Palin's definition of a death panel it isn't a death panel? If you get to sit down during the process, no death panel, right?
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.
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Old 02-04-2013, 07:30 PM   #89
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I consider my definition of death panels more accurate in present terms although I do believe Palin's definition could happen once health care is turned over to politicians.

And the answer to your second question is yes, without a doubt. Hospitals can now be penalized for readmitting Medicare patients. All because of a provision of the ACA. To me that is rationing.
And others consider it sensible cost-control measures that are necessary for government-funded health care.
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Old 02-04-2013, 07:34 PM   #90
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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.
The MSM is proud you're paying attention to them.
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