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February - March 2014 • Kentucky
Concerns
About the
Future of
Medicine:
Latest Survey
Reveals Physician
Fears
By Fiona Young-Brown
The latest annual survey of medical professionals by a major consulting and financial
planning service has revealed a number of
concerns about the future of the medical
industry. Perhaps surprisingly to some, not all
of the concerns are related to the Affordable
Care Act.
The 2013 Deloitte Survey of U.S Physicians
is based upon replies from more than 600
primary care physicians and medical specialists around the nation. Topics covered
included the ACA, medical liability reform,
new technologies in managing a practice, and
job satisfaction. Some of the key findings are
highlighted below:
While it might be expected to find an unfavorable response to the ACA, the number of
physicians expressing a negative opinion of the
proposed reforms had declined since 2012.
There was a slight increase in the number
with a favorable view of the changes, and an
increase in those who were unsure. The majority did agree that something needed to be done
to improve access to healthcare and to rein in
ballooning costs; the ACA was seen as a good
starting point. However, many expressed concerns that Healthcare Enrollment Exchanges
would not be ready to cope with the demand
once they opened to new insurance sign ups,
a concern that, with the benefit of hindsight,
seems well-founded.
The need for medical liability reforms was
shown to be a major concern to physicians, but
only one in ten believed that any sort of reform
is likely to occur within the next three years.
Many physicians and surgical specialists feared
that their clinical autonomy was being steadily
eroded, and that they often were expected
to make a trade off between a better income
(more likely at a larger medical facility) and
greater professional autonomy (valued more
in a solo practice). This is linked to medical
liability as financial and insurance concerns
increasingly dictate treatment options.
The bureaucratic requirements that accompany treating Medicaid and Medicare patients
is becoming increasingly overwhelming, with
nine out of ten doctors saying they did not
believe Medicaid reimbursements would rise
to match actual primary care costs. One possible outcome would be dropping these patients.
Seven out of ten physicians said that they feel
satisfied with their job, with primary care physicians being less likely than their specialist colleagues to feel job satisfaction. Among those
expressing satisfaction, the primary reason
was their relationships with patients. At the
same time, those who expressed dissatisfaction
frequently cited a lack of time to interact with
their patients as a key factor. Other reasons
for job frustration are the long hours and the
burden of satisfying Medicaid/Medicare regulations.
There is a growing interest in adopting new
technologies to assist with patient interactions, including online and mobile consulting
technologies. However, patient safety and
confidentiality were stressed as deciding factors in the adoption of new technologies.
Confidentiality is especially important given
that 80 percent of respondents see interdisciplinary teams and coordinated care as the
future of healthcare.
Eighty one percent of surgical specialists
shared a fear that the profession no longer
attracts the brightest and the best. Satisfaction,
income levels, lack of autonomy, and growing
bureaucracy were all cited as potential reasons.
It seems that most physicians surveyed agreed
that major changes are needed within the
medical profession, but knowing what those
changes need tto be and implementing them
may not be that easy.
The full findings of this survey may be downloaded from http://www.deloitte.com/assets/DcomUnitedStates/Local%20Assets/Documents/
us_chs_2013Survey