Despite high satisfaction with EHR software and continued interest in tools like clinical decision support and e-prescribing, physicians are generally pessimistic about the future of medicine, with half believing that incomes will take a nosedive in the next one to three years, and 60% believing that many physicians will retire earlier than planned due to the frustrations of dealing with Medicare, Medicaid, the loss of independence, and the burdens of malpractice suits and liability laws.
A new survey by the Deloitte Center for Health Solutions reveals the opinions of more than 600 primary care and specialty physicians and shows that while a majority of practitioners are satisfied with the clinical work, the uncertain state of the industry is causing worry and upset like never before.
The loss of clinical autonomy, a lack of sustainable finances, and an impending shortage of physicians topped the list of concerns among those surveyed. Nearly three quarters believe talented students will avoid medicine due to those negative factors, and established physicians will leave the field or reduce their hours to avoid the headaches of interacting with the government and being sued by unhappy patients.
And yet few were familiar with the direction medicine is heading: while 80% agree that interdisciplinary care teams will become increasingly common, only one in three reported being actually knowledgeable about accountable care organizations (ACOs), and a mere 25% of specialists were aware of the concept of patient-centered medical homes. Those who knew about ACOs were generally positive, however, envisioning better management of population health and high-risk patients, improved quality, and reduced costs.
EHRs fared well among participants, two-thirds of whom had already adopted the technology and use systems that qualify for the first stage of meaningful use, and three-fifths are satisfied with their EHR product. Eight out of ten believe that access to clinical decision support must increase, and financial incentives are useful in encouraging adoption. “The majority of physicians report numerous benefits to using an EHR system,” the study states, “[including] faster and more accurate billing for services (74%), time saving through e-prescribing (67%), and communication improvement and better care coordination (67%).”
While 72% believe that EHR adoption will keep increasing, more than half are worried that the hospital-physician relationship will suffer as physician privileges are sacrificed to allow hospitals to attest to meaningful use, especially as physicians become less autonomous and more likely to seek employment due to falling revenues and the need for increased investment in technology.
Despite an interest in integrating technology into clinical practice, and having hope that the Affordable Care Act (ACA) will address some of their concerns, many physicians believe that medicine is heading for disaster. A quarter might limit Medicare and Medicaid patients to dodge the associated paperwork, even as tens of thousands of patients become eligible under the ACA, and 80% fear being overshadowed by cheaper mid-level professionals who will increasingly take over their job duties.
Shrinking revenues, the changing role of doctors, and an unfamiliar landscape might spark an early exit for many established physicians, leaving healthcare short of experienced professionals just when they are needed most.