Physicians Pessimistic About Health Reform Changes

Physicians are pessimistic about the benefits of health care reform, according to a study by Deloitte. The majority of respondents (73%), are not excited about the future of medicine.

Primary care physicians believe that they will face too much pressure from newly-insured consumers and that overall the Patient Protection and Affordable Care Act won’t reduce costs.

"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.”

According to the study, most physicians believe payment reforms (e.g., bundled payments, performance-based incentives) will reduce their incomes and increase their administrative costs for needed infrastructure and quality measurement. Only 33% believe that health reform will eliminate disparities in health care.

Only 4% believe their income will increase next year, and nearly half believe that income will decrease next year as a result of health care reform. Part of this is because of the shift from fee for service to value-based payments/performance-based compensation, which physicians also feels exposes them to higher risk.

"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."

Half of the respondents believe that the reform will actually lead to decreased access to health care. The reform will lead to hospital closures and 70% said that there will also be longer wait times at emergency rooms. More than 80% believe it is likely that wait times for primary care appointments will increase.

ith current physicians’ outlooks to be mostly pessimistic, 70% believe that because of health reform the best and brightest who might have considered medicine as a career will now think otherwise.