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Five Issues To Impact Docs in 2012

As the New Year approaches and the future of health reform hangs in the balance, The Physicians Foundation – a nonprofit organization that seeks to advance the work of practicing physicians and improve the quality of healthcare for all Americans – has identified five key areas that will impact the practice of medicine in the year ahead. The Physicians Watch List for 2012 is based on research the Foundation released earlier this year, including the 2010 Health Reform Research Study and 2011 Roadmap for Physicians to Healthcare Reform Paper.

  1. Changing nature of medical practices. Many physicians are choosing hospital and group settings versus private practice due to the perceived security employed settings offer. Only one quarter of physicians surveyed said they plan to continue practicing as they are; half said they would adopt a style of practice different from the traditional full-time independent private practice model. In 2012, physicians will need to carefully assess their individual circumstances and determine the practice configuration that best meets their needs and those of their patients.
  2.  Decreased return on increased burden. The added regulations and administrative responsibilities based on the Patient Protection and Affordable Care Act (PPACA) have caused physicians to focus less on the patient and more on administrating their practices. Sixty-three percent of physicians surveyed said that non-clinical paperwork has caused them to spend less time with their patients and 94 percent said time they devote to non-clinical paperwork in the last three years has increased. In 2012, physicians will need to vigilantly monitor their administrative burdens and take steps to minimize any further impact on their relationship with patients.
  3. Acute shortages of primary care physicians. A growing shortage of physicians threatens the medical profession’s ability to serve patients across key specialties and geographies. Physicians will need to redefine their roles and rethink delivery models in order to meet rising demand. The majority of physicians (60 percent) said health reform will compel them to close or significantly limit their practices to certain categories of patients. Of these, 93 percent said they will close or significantly limit their practices to Medicaid patients and 87 percent said they would close or significantly restrict their practices to Medicare patients. In 2012, physicians will need to evaluate how they can optimize their time to accommodate the current and future needs of their patients.
  4. Critical need for physician leadership tools / skills. In the healthcare environment of tomorrow, many physicians will assume greater business and people management responsibilities within practice groups and hospital settings.  In 2012, physicians will need to acquire new types of non-medical leadership skills to be effective in these expanded roles, while still maintaining their trusted relationships with patients.
  5. Impact on patients. The need to provide higher quality in an environment characterized by increased reporting, problematic reimbursement and high potential liability, will place extraordinary stress on physicians, particularly those in private practice. Only one physician in ten believes that health reform will enhance the quality of care they are able to provide to their patients, compared to 56 percent who believe reform will diminish the quality of care they are able to provide.  In 2012, physicians will increasingly need to balance these competing factors in ways that do not compromise the care they provide to patients.

“Proposed changes to our healthcare system have already significantly impacted physicians and patients,” said Lou Goodman, Ph.D., president of The Physicians Foundation and chief executive officer of the Texas Medical Association. “We hope the physician watch list helps to address the core issues under the new legislation and offers doctors and the healthcare community guidance on how to deliver the best care possible to patients in 2012.”


  1. It seems likely that the phrase non-clinical paperwork, and for that matter, non-medical leadership, probably refers to the administration of medical billing procedures within doctor’s offices. This might also be one reason that, as this article points out in its first segment, many doctors are moving from managing their own practices to becoming employees of a group. Many of these changes can be traced back to changes in the relationship between medical providers and the people or parties who pay for their services. It’s no secret to most doctors, or even to most patients, that the administrative burden of medical billing has become a major drag on most areas of medical practice. The key, for those brave physicians who continue to manage their own practices, is to put in place effective upfront policies for medical collections, and get the right staff to manage them, so that doctors and nurses can focus on healing rather than chasing medical payments. Ron McLaughlin, CEO, RMK123.com

  2. Earl W. Ferguson, MD, PhD, FACC, FACP, FACPM

    These issues are the same for all providers, primary care and specialists. While support for primary care providers is “increasing” according to the ACA plan, efficiency is decreasing with marked increases in fixed, mandated costs. Support for specialists is drastically decreasing (no more billing for consults, only for visits, for example) as their administrative costs/overhead also continue to increase from ACA, other government and insurance company requirements. We are on a rapid track to destroying the healthcare system that has lead innovations worldwide. Unless we can simplify the administrative and regulatory requirements mandated by Federal and state governments and insurance bureaucracies, in the near future we will not be able to effectively serve the patients that we all want to serve.

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