Top Five Issues Impacting  Physicians and Patients in 2013

Lest we forget, physicians and patients are what health reform is all about.

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The Physicians Foundation, a nonprofit whose mission is to advance the work of practicing physicians and patients, has released a Watch List of trends to watch on 2013.  The report is based on research studies and policy papers issued by the Foundation in 2012, including the 2012 Biennial Physician Survey, the 2012 Next Generation Physician Survey and the 2012 U.S. Healthcare Highway Report, among others.

1. Ongoing uncertainty over PPACA. Despite the Supreme Court decision upholding most of the provisions in the Patient Protection and Affordable Care Act (PPACA) and the re-election of President Obama, considerable uncertainty persists among patients and physicians regarding actual implementation of the Act. Much of the law has yet to be fully defined and a number of key areas within PPACA – including accountable care organizations (ACOs), health insurance exchanges, Medicare physician fee schedule and the independent payment advisory board – remain nebulous.

2. Consolidation means “bigger.” But is bigger better? Large hospital systems and medical groups continue to acquire smaller / solo private practices at a steady rate. According to a Foundation report on the future of U.S. medical practices, many physicians are seeking employment with hospital systems for income security and relief from administrative burdens. Increased consolidation may lead to monopolities, raise costs, and reduce the number of  solo / private practices.

3. 12 months to 30 million. In 2014, PPACA will introduce more than 30 million new patients to the U.S. healthcare system.

According to the Foundation’s Biennial Physician Survey, Americans are likely to have difficulties finding a physician if  current physician practice patterns continue. If physicians continue to work fewer hours, more than 47,000 full-time-equivalent (FTE) physicians will be lost from the workforce in the next four years. Moreover, 52 percent of physicians have limited the access of Medicare patients to their practices or are planning to do so. As the 12-month countdown to 30 million continues across 2013, physicians and policy makers will need to identify measures to help ensure a sufficient number of doctors are available to treat these millions of new patients – while also ensuring the quality of care provided to all patients is in no way compromised.

4. Erosion of physician autonomy. The Physicians Foundation believes that physician autonomy – particularly related to a doctor’s ability to exercise independent medical judgments without non-clinical personnel interfering with these decisions – is markedly deteriorating. Many of the factors contributing to a loss of physician autonomy include decreasing reimbursements, liability / defensive medicine pressures and burdensome regulatory environment. In 2013, physicians will need to identify ways to streamline these processes and challenges, to help maintain the autonomy required to make the clinical decisions that are best for their patients.

5. Growing administrative burdens. Increasing administrative and government regulations contribute to pervasive physician discontentment, according to the Foundation’s 2012 Biennial Physician Survey. Excessive “red tape” forces many physicians to decrease their time spent with patients to deal with non-clinical paper work and other administrative burdens. In 2013, physicians and policy makers will need to work closely together to determine steps to reduce gratuitous regulations that negatively affect physician–patient relationships.

“2013 will be a watershed year for the U.S. healthcare system,” said Lou Goodman, Ph.D., president of The Physicians Foundation and chief executive officer of the Texas Medical Association. “It is clear that lawmakers need to work closely with physicians to ensure that we are well prepared to meet the demands of 30 million new patients in the healthcare system and to effectively address the impending doctor shortage and growing patient access crisis.”

“We hope that the Foundation’s research and insights serve as a pragmatic resource that will help policy makers, physicians and healthcare providers formulate smart policy decisions that are beneficial to America’s patients and doctors,” said Walker Ray, MD, vice president of The Physicians Foundation and chair of the Research Committee.

Tweet:  Top 5 2013 issues: ACA implementation, hospital/physician consolidations, M.D. patterns of care, doctor autonomy erosions, and red tape.