Survey: Doctors say reform will hurt quality of care in near term

During the next five years, 65 percent of doctors believe the quality of healthcare will deteriorate, according to a survey of 2,958 doctors released by technology company Thomson Reuters and practice management company HCPlexus.

The survey, conducted in September 2010 with follow-up information gathered in December 2010 and earlier this month, gauged physicians' opinions about the quality of healthcare in the near future in light of the Patient Protection and Affordable Care Act (PPACA), the impact of EMRs and the consequences both physicians and patients may encounter because of the PPACA.

Eighteen percent responded that the quality of healthcare will improve in the next five years and 17 percent said it would stay the same.

“Many cited political reasons, anger directed at insurance companies, and critiques of the reform act – some articulating the strong feelings they have regarding the negative effects they expect from the PPACA,” the report noted.

Seventy-four percent of respondents stated that the PPACA will result in physician reimbursement becoming less fair, with only 9 percent responding that it will affect reimbursement positively.

Overall, 78 percent stated the impact of the PPACA for physicians will be negative and 8 percent responded it will be positive. When asked about the impact of reform on patients, 58 percent were negative with 27 percent saying reform would be positive.

“With regard to who will be handling what may be an increased patient population, respondents indicated that nurse practitioners will see as many patients as primary care physicians,” the report found, with 55 percent suggesting nurse practitioners or physician assistants will administer care.

“Primary care providers expressed concern that hospital and specialty-run care systems would not recognize their value, as specialists see their income and autonomy waning as health systems organize,” the report stated.

Pediatricians and psychiatrists were the most optimistic of the group, with almost half of each believing the PPACA will have a positive effect on patients. The least positive and most negative responses came from surgeons and ophthalmologists. 

Physicians identified both positives and negatives about EMRs. Responses were split evenly, with 24 percent of respondents believing EMR will have a negative effect on patient care. Practitioners who care for patients longitudinally and are less procedurally-oriented were more positive about their use, the report stated.

Forty-five percent of all respondents indicated they did not know what an ACO is, exposing a much lower awareness of ACOs versus the broader implications of the PPACA, the report found. “It appears there has been a lack of physician education in this area,” the report concluded.

Download the report here.

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