Deloitte survey: Physicians pessimistic about future
U.S. physicians expressed pessimism about the future of medicine, citing concerns about eroding clinical autonomy and income, and an overall struggle to achieve medical liability reform, in a 2013 survey published March 18 by Deloitte Center for Health Solutions. Nearly three-quarters of physicians surveyed felt “the best and brightest” may avoid a career in medicine, while more than half indicated that physicians will retire or scale back practice hours due to changes in the medical landscape, according to the report. They widely considered Medicaid and Medicare reimbursements problematic, which is spurring many physicians to limit or close practices to these enrollees.
“Physicians recognize ‘the new normal’ will necessitate major changes in the profession that require them to practice in different settings as part of a larger organization that uses technologies and team-based models for consumer (patient) care,” concluded lead author Paul Keckley, Phd., executive director at the Deloitte Center for Health Solutions, and colleagues.
While the outlook is pessimistic, physicians found that the Patient Protection and Affordable Care Act is a positive start to addressing access and cost issues, according to the survey. Physicians predicted that accountable care organizations will achieve some success in improving healthcare quality and reducing costs, with the majority agreeing that medicine over the next decades is shifting to interdisciplinary teams and care coordinators.
Among the many findings reported in the annual poll:
- Physicians ranked patient relationships as the most satisfying aspect of the job.
- Most physicians believe that financially-based consumer incentives could motivate patients to engage in healthy behaviors.
- Physicians felt health insurance exchanges are unprepared for the 2013 enrollment deadline.
- Physicians report increasing competition with mid-level professionals in primary care.
- Physician-hospital integration is expected to increase.
- Physicians are interested in clinical decision support information technologies.
In addressing physicians' concerns and input, Keckley et al asserted that transparency, data sharing, active engagement and affirmation of the value of physicians by healthcare organizations is needed.
“A transparent business relationship built on mutual respect and trust, with incentives appropriately aligned, is key,” the researchers wrote. They offered a slew of related recommendations, including:
- Integration of physicians in team-based models;
- Effective deployment of clinical and administrative information technologies;
- Inclusion of physicians in organizational leadership and provision of structured training and experience-based learning; and
- Formation of a stable organization with a clear vision and strategy for its future, with leadership and resources to back them up.