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Survey: Pessimistic Physicians Down on ACOs, EMRs

September 24, 2012
by Gabriel Perna
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In a recent survey from The Physicians Foundation, a Boston-based nonprofit organization that seeks to advance the work of practicing physicians and help facilitate the delivery of healthcare to patients, revealed that today’s physicians are fairly pessimistic about the future of healthcare. The survey found that 62 percent of physicians say accountable care organizations (ACOs) are either unlikely to increase healthcare quality and decrease costs, or that any quality / cost gains will not be worth the effort.

In addition, while close to 70 percent of physicians have implemented electronic medical records (EMR), 47.4 percent have significant concerns that EMR poses a risk to patient privacy. Meanwhile, 92 percent of physicians are unsure where the health system will be or how they will fit into it three to five years from now.

Overall, the survey discovered that physicians say they are working fewer hours, seeing fewer patients and limiting access to their practices in light of significant changes to the medical practice environment. More than 84 percent of physicians feel that the medical profession is in decline and nearly 58 percent are reluctant to recommend medicine as a career to their children.

The survey of more than 13,000 physicians, called “A Survey of America’s Physicians: Practice Patterns and Perspectives,” says if the patterns continue, 44,250 full-time-equivalent (FTE) physicians will be lost from the workforce in the next four years. Furthermore, over the next one to three years, more than 50 percent of physicians will cut back on patients seen, work part-time, switch to concierge medicine, retire, or take other steps likely to reduce patient access.

 “The rate of private practice physicians leaving the medical field, as well as changes in practice patterns that reduce the number of hours spent seeing and treating patients, is alarming. When these lost hours are added up, we get a much fuller and more ominous picture of the kind of access crisis that patients may soon face,” Walker Ray, M.D., vice president of The Physicians Foundation and chair of its Research Committee, said in a statement.

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Not really...... as Nurse Practitioners have proven themselves to be capable providers of health care. And we are MANY!!!!

Interesting survey of a good number (13,000) of "practicing physicians" who preumably are looking to "facilitate the delivery of healthcare to (their) patients." The article didn't say whether the MDs surveyed were Primary Care or Specialty Care - a VERY important fact. Survey analysis suggests that the average MD is "pessimistic...on ACOs and EMRs" and that this result reflects on "the future of healthcare?" Are these providers in the Boston area only or Nationwide? The 62 percent who believe "ACOs are either unlikely to increase healthcare quality and decrease costs" had best get their heads out of the sand. Our current healthcare (non)system is showing poor quality and untenable costs! "Gains will not be worth the effort," absolutely, if we don't start synergizing our efforts and do something about redundancy and the "fee for service" mentality our payment programs support. When we link up and become a Community providing care for a shared population as an ACO, we will find that we, in fact, do have too much of one kind of Provider, and not enough of another. In general, we need more staffed and trained Primary Care Teams operating in integrated medical home environments centered on patient's needs, rather than on the way our reimbursement focused system has forced us to work. This move will result in decreased need for Urgent Care/ Emergency Room and In-Patient Hospital services...a good thing. The move to "Accountable Care" should also decrease the need for high-cost procedures and tests done by sub-specialists. Are they "the physicians (who) will be lost from the workforce in the next four years?" Is this primary make-up of the "practicing physicians" surveyed?

Concerning the "47.4 percent (who) have significant concerns that an EMR poses a risk to patient privacy," I wonder if they are most concerned about their own privacy and autonomy. EMRs will increase communication and ability to share information with other providers with a "need to know" about a given patient's needs. Referrals will be more effective with information transportable. We need to stop hiding behind HIPAA rules and embrace them for what they are meant to do, allow patients to own their own information (record) and have a say over who sees it. An EMR doesn't threaten that premise but enhances it with proper passwords and encryption. Let's get this done sooner rather than later - a National universal EMR that works for Patients and Providers to provide higher quality healthcare more efficiently.

The only fact from this survey that makes sense is "92 percent of physicians are unsure where the health system will be or how they will fit into it three to five years from now." Amen to that! The 8% who are looking to transform to patient-centered family-focused healthcare delivery in integrated community teams know where they will be...in an ACO! ACOs will improve access, not decrease it. These pessimistic "Private Practice Physicians" had best stop asking "Who moved my cheese?" and look to transforming their practice to the "new normal." It's got to happen!

Is this the biggest boondoggle yet, very expensive implementation ..., a boon for IT for consultants and the industry . If a patient flys in from LAX TO Boston and presents themselves with a cardiac problem or any thing at all , a physician isn't going to look through a complex Emr from across the country to see what this patient had back in LA. RMRS ARE NOT STANDARDIZED IN FORMAT. The physician will re order tests as necessary for the current situation. This is " meaningless use" . It works well if you glued to you desk and do not have other patients, the CPOE ,s also are formatted cu cutesy programmers and there are buttons and ions Alll over the screen. The physician has turned into a iPad nome. It is as time consuming as manual records. However if you have time to input all of this in , it does look good. But I say, do you have any time left over for patient care. We will need to quadruple the amount of very expensive MD, s to perform clerical work...the nurses are certainly not going to do it since they are also busy with direct patient contact. Many hospitals have received a few million dollars by Our tax dollars to begin" meaning less use" it is taking more than that To staff the IT departments.. The meaningful use criteria must have more pages and rules than the Bible. Physicians and Heath care workers are saddled with inane regulatory paperwork.i have counted over 60 leadership staff discussing " are we better off today than we were 20 years ago before all of these "QMS" metrics were on place. there is going to be a severe push back on this madness, am glad that healthcare is becoming less expensive.

ACO's are useless,obstructive,waistful,bureaucratic garbage that will steal dollars away from patient care!!! I am fed up with people who know nothing about practicing medicine telling us how to do our job.I have spent blood,sweat,tears and years learning how to to do my job!! I do not need supervision!!!!!!

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