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Physicians Pessimistic on Benefits of Health Care Reform

A new Deloitte study reveals physicians are skeptical about core promises associated with the Patient Protection and Affordable Care Act.  Only 27 percent of physicians surveyed believe the PPACA is likely to reduce costs by increasing efficiency, and only 33 percent feel it is likely to decrease disparities.  Moreover, half say access to health care will decrease because of hospital closures that result from the law.

The report, “Physician Perspectives about Health Care Reform and the Future of the Medical Profession,” also shows that the majority of doctors (73 percent) are not excited about the future of medicine and believe (69 percent) the “best and brightest” who might consider a career in medicine will think otherwise.

“The data confirms that physicians are resistant to reform and are frustrated with the direction of the profession,” says Paul Keckley, Ph.D., executive director of the Deloitte Center for Health Solutions and lead author of the report.  “Understanding the view of the physician is fundamental to any attempt to change the health care model – this is the person prescribing the medicine, ordering the test and performing the surgery.”

The negativity is driven in part by concern over the pressure primary doctors will face from millions of newly-insured consumers seeking care and the reverberations this sudden impact could create on the larger system.

Another stumbling block for physicians is the view that reform will mean a loss of autonomy and more costs and administrative burdens in adopting processes and technologies.  For decades this sense of autonomy has been sacrosanct to the profession, and it’s difficult to uproot that overnight, continues Keckley.

“Effective reform has to consider the physician’s view as a starting point,” says Keckley.  “We not only have to design the right model, but we have to create the right incentives and processes for implementing that model.  The concept of change management is just as important for doctors in the health care system as it is for employees in a corporation.”

Additional key findings from the study include:

  • Nearly three-quarters of respondents think that emergency rooms could get overwhelmed if primary care physician appointments are full as a result of the Patient Protection and Affordable Care Act.
  • More than 80 percent believe it is likely that wait times for primary care appointments will increase because of a lack of providers.  More than half indicate that other medical professionals (physician assistants, nurse practitioners) will deliver primary care both independently and as an adjunct to physician services.
  • Surgical specialists (57 percent) are much more likely to support the law’s repeal compared to primary-care providers (38 percent) and non-surgical specialists (34 percent).  They are also more likely to say the legislation is a step in the wrong direction and believe their net income will decrease as a result of reform.
  • There is a disparity among generations, as 59 percent of physicians 50 to 59 years old feel PPACA is a step in the wrong direction while only 36 percent of those ages 25 to 39 share this sentiment. Younger physicians (ages 25 to 39) are also more likely than older doctors (ages 40 to 59) to think the transition to evidence-based medicine will improve care.

For more information about Physician Perspectives about Health Care Reform and the Future of the Medical Profession, visit www.deloitte.com/us/physiciansurvey.

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