Doctors concerned about effects of healthcare reform
A survey of almost 3,000 physicians indicates 65 percent are worried that healthcare reform would result in less pay for them and lower the quality of care for their patients.
The 2011 National Physicians Survey polled 2,958 physicians of varying specialties and practice types in all states. Thomson Reuters and HCPLexus conducted the survey in September 2010 and updated it in December 2010 and January.
Thomson Reuters-HCPlexus executives say the NPS is the most comprehensive survey of physicians surrounding their thoughts on the future of healthcare, including ideas on the healthcare reform law, EMRs and Accountable Care Organizations.
According to the NPS, doctors fear that the quality of care will deteriorate under the Patient Protection and Affordable Care Act and that their reimbursements will go down as well.
When asked about the quality of healthcare over the next five years, 65 percent believe it will deteriorate, with only 18 percent predicting it would improve. Consumer perception is more optimistic, with close to 30 percent of consumers believing care will improve under the PPACA.
When asked who would treat the 32 million Americans receiving healthcare under the PPACA, 55 percent suggested a nurse practitioner or physician assistant would administer care.
"It is likely that with increased demand for general surgeons, rising overhead costs and decreasing reimbursement, there will be many of us simply retiring or finding other opportunities rather than accept the risks of surgical practice and below minimum wage benefits," said a surgeon from Arizona.
When asked about the impact of reform on patients, 58 percent said it would be negative, while 27 percent said it would be positive. They also indicated that primary care providers and nurse practitioners would treat most patients.
"I believe that specialists feel that the PCPs will allocate the majority of their time to the patients with commercial insurance or sources that have higher reimbursements and leave the lower level payers for their PAs and nurse practitioners to manage the majority of the time. These patients also have a history of being less likely to take an active role in their own care and have more 'self inflicted problems,' i.e. smoking, obesity, etc.," responded an Illinois-based orthopedic surgeon.
"It is clear that many physicians feel strongly that the proposed future state is counter to what they believe is the best way to serve patients," said Raymond Fabius, MD, chief medical officer at Thomson Reuters. "As practicing physicians are genuinely concerned for the health of their patients and their ability to serve them, any sustainable efforts to reform healthcare delivery would benefit from their inclusion and support."
Key findings from the survey:
- During the next five years, 18 percent say the quality of healthcare in this country will improve, 17 percent say it will stay the same and 65 perecent say it will deteriorate.
- 9 percent of the doctors surveyed say The Affordable Care Act will result in physician reimbursement becoming more fair, while 17 percent say it will neither be fair nor unfair and 74 percent believe it will be less fair.
- 27 percent of physicians believe the impact of the Affordable Care Act for patients will be positive, 15 percent say it will be neutral and 57 percent say it will be negative.
- 8 percent of physicians believe the impact of the Affordable Care Act on them will be positive, while 14 percent say it will be neutra and 78 percent say it will be negative.
"The National Physicians Survey tells us that physicians have not been enlisted in the healthcare reform process," said David L. Shrier, CEO of HCPlexus. "The message they've taken from healthcare reform appears to be 'do more with less.' Doctors are telling us they feel disenfranchised and overburdened. In order for healthcare reform to succeed, physicians need to be engaged in dialog and need to be communicated the benefits of the PPACA as part of a continuous messaging campaign."
