Pinnacle Health Group conducted an email campaign by surveying physicians about their thoughts on the healthcare reform bill. The survey started in May and was continually sent to respondents until September 2010. We queried 5,000 actively practicing doctors, residents and fellows across the country, which yielded a 22% response rate.
Almost two-thirds of doctors who answered the survey worked for a for-profit facility, while 35% worked in non-profit healthcare groups. The demographic of physicians who answered the survey are predominantly single specialty and hospital-employed physicians. (35.7% and 27.5%, respectively).
Physicians cite “compensation” as the most relevant issue that will affect physicians (91.6%) as well as the “financial implications of the reform on their practice” such as reimbursements and overhead expenses (81.9%). One physician remarked, “With the exception of the last two years, inflation usually occurs at a rate of 3% each year, yet Medicare reimbursements keep shrinking over the last 10 years. How is this system sustainable? If the workers’ salaries and administrative costs keep increasing, doctors will soon go out of business or have an unacceptable standard of living, given all the responsibility and stress of being a physician, and leave the profession, especially since the government is trying to lower the Medicare age even further.”
Another related, “The bill and other aspects of medical reform are only increasing practice overhead such as making EMRs essentially mandatory. They are also increasing the administrative work that is not compensated such as mandatory reporting of outcomes.”
The quality of care delivered to patients is also a big concern for 77% of surveyed physicians. “I think the reform will leave us with an overall preventive care and care for minor ailments available to all, but anything beyond that will become ‘rationed,’” opined one doctor. “Currently, the US has a significant number of chronic care and advanced care needs patients. The new healthcare bill does not provide adequately for the monetary or physician resources necessary to meet the needs of those patients. In addition, the profession of medicine is likely to become one of ‘technicians’ who learn the mechanics of providing medical care but not the deeper skills needed.”
Another remarked, “If access is independent of responsibility, it will result in greater consumption and greater overall costs. This, along with increased time and expense to comply with regulatory oversight, will increase provider fatigue and degrade the quality of actual care delivered. I am at or near capacity now and cannot foresee how to do more with less.”
Another physician commented, “The quality of medicine will likely decrease as it will possibly become financially untenable to sustain a practice with the impending reimbursement reductions and increasing overhead costs. Physician extenders will most likely shoulder some of the burden and the private practice of medicine as we know it will become obsolete and replaced with clinics with enormous wait times and less qualified practitioners.”
Half of all surveyed physicians also consider malpractice / tort reform as a critical factor for effectively practicing medicine. For an ER physician, “Tort reforms can help us decrease defensive medicine strategies. No tort reform means no separation of legitimate and frivolous lawsuits, which can further the cost of medicine. While congress cites malpractice insurance is only few percent of overall healthcare expenditure, it is the excessive use of healthcare resources due to defensive medicine that drives healthcare and doesn’t get included in the equation. Rational use of healthcare resources can only come with tort reform.”
Another physician commented, “Declining reimbursements without tort reform to contain physician expenses is untenable. Most single-payer models that other countries have that are so touted by politicians also include an assumption of medico-legal risks by the government rather than the individual practitioner. By not including these measures in the bill, it unfairly places the burden of medical costs on the physicians.”
Physicians are also optimistic about the bill. A Radiologist related, “At our locale, ER is way overboard with unnecessary procedures like CYA, defensive medicine, CT and other high tech imaging. If there were more in line we could shave the health care bill by about a third. What is it about more insured patients and less interference from the insurance industry in the care we provide that is objectionable?”
A private practice doctor remarked, “In general, more coverage for more people will improve my practice, because I take care of many underinsured patients. The changes should balance out that discrepancy between practices. I think the healthcare reform bill is a step in the right direction. It is going to take some time, particularly with re-establishing a different hierarchy of care. There needs to be more emphasis on primary care medicine and incentives to encourage people to go into primary care practice.” Another physician commented, “Expanding coverage from 85% to 95% isn’t going to ruin medicine. In fact, it will assist my patients with life-threatening illnesses and avoid pauperization. All other industrialized societies have provided this coverage as has the insurance given to veterans and the US Congress. Underinsured Americans can eventually benefit.”
Don’t forget to access our other surveys for physicians and clients! We are dedicated to bringing clients and physicians with in-depth information on today’s physician recruiting industry! The Annual Survey on Why Physicians Leave can be accessed here!