Blog | Monday, November 22, 2010

QD: News Every Day--Physicians fleeing from health reform's expected effects


Physicians are moving out of practice ownership and into employment models because of health care reform, reports a survey. But, health care reform is likely looking at some further changes of its own to make it more politically palatable.

The report was commissioned by The Physicians Foundation, a non-profit grant-making organization comprised of medical society and physician leaders, and was conducted by the physician recruiting firm Merritt Hawkins.

The survey was mailed to 40,000 physicians generated at random from the American Medical Association's Physician Master File database. Surveys were mailed to 10 medical specialties, including internal medicine and hospitalists, but weighted toward primary care physicians. An electronic version of the survey was e-mailed to 60,000 physicians in Merritt Hawkins' database, of which 56% are in primary care. The response rate was 2,379 completed surveys (2.4%). The overall margin of error for the entire survey is +/-1.93%, although the error rate fluctuates across questions.

Among the findings:
--26% of doctors thought they'd continue to practice as they do currently. The other 74% said they'd change how or whether they'd continue to practice.
--40% of physicians said they would drop out of patient care in the next one to three years, either by retiring, seeking a non-clinical job within health care, or leaving health care entirely.
--60% said health reform will compel them to close or significantly restrict their practices to certain categories of patients (93% restricting Medicaid patients, and 87% restricting Medicare patients).

Physicians were generally dour on health care reform's expected impact, according to the survey.
--Half expected health reform to increase patient volumes, but 69% said they no longer have the time or resources to handle more patients.
--59% said health reform will cause them to spend less time with patients.
--10% said reform will improve the quality of patient care they are able to provide, while 56% said reform will diminish it.

Finally, 89% believe the traditional model of independent private practice is either "on shaky ground" or "is a dinosaur soon to go extinct."

But independent of that report, there are hints of consensus building on Capitol Hill when it comes to health care reform.

The first bipartisan proposal to alter health care reform was proposed last week, according to The Hill. It's a waiver that would allow states to opt out of the individual mandate to buy health insurance. In exchange for waivers three years earlier than allowed under the current law, states would have to set up a health insurance system that meets federal levels for population covered, as well as affordability and comprehensiveness. One health policy professor described it as, "a clever way to force an adult conversation."

Also, an 18-member, bipartisan presidential panel is expected to vote on deficit-reduction measures, including higher taxes on health care and higher Medicare premiums. A majority vote from that panel would send their ideas to the full Congress for discussion, and the ideas reflect that, "Strange bedfellows are a 'testament to the moderate nature' of the ideas under discussion," reports The Washington Post.