athenahealth and Sermo have announced the findings from the third annual Physician Sentiment Index. Five hundred physicians representing a wide range of specialties and practice sizes responded to the survey.
This year’s Physician Sentiment Index (PSI) tells a story of over-burdened physicians who are deeply concerned about the future of medicine. These data suggest the chief distractions affecting physicians’ ability to provide the best care for patients center on government intervention, increased utilization of and frustration with EHRs, and administrative burdens. All told, these distractions have diminished physicians’ optimism around their ability to deliver quality care and remain viable, profitable practices.
“There is a lot of “stuff” going on in health care that is making the noble pursuit of the MD degree a lot less attractive,” said Jonathan Bush, athenahealth CEO and Chairman. “Government involvement, ill-designed EHRs, and administrative complexities are encroaching on the sacred relationship between the physician and the patient and the ability for that doctor to be fully present at the point of care.”
“U.S. health care is changing rapidly, but time and again policymakers aren’t listening to the physician’s perspective,” said Jon Michaeli, VP of Membership for Sermo. “As a result, physicians feel disempowered to influence change, and hence they are more disenchanted with their profession and less connected to patients than ever. At Sermo, we advocate on behalf of our community by voicing their expert opinions to constituents in the healthcare system and helping this country move towards better patient outcomes, efficiently, at a sustainable cost.”
Government regulation: Doctors are skeptical of benefits
- Over half (in 2012 and 2011) say that government involvement in regulation will not yield lower costs and better outcomes, with slightly more pessimism on display this year.
- The Affordable Care Act (ACA) remains unintelligible for many; with a growing number concerned about its impact on the quality of care: — Nearly one-third (29%) say they still do not understand the details and implications, compared to 22 percent in 2011.
- 16 percent said they’d like to see the ACA remain ‘as is’ (versus 11 percent in 2011).
- 53 percent report the ACA will have a detrimental effect on their ability to provide high-quality care, versus 50 percent in 2011 — 43 percent more believe the ACA will be very detrimental to the delivery of quality of care (from 14% in 2011 to 20% in 2012).
- 26 percent want to see the entire ACA repealed (versus 21% in 2011).
- Three-quarters report that the Meaningful Use process is at least somewhat difficult/cumbersome.
- Accountable Care Organization (ACO) model draws concerns: more indicated ACO as having a negative impact on the quality of care (39% in 2012 versus 26% in 2011) and profitability (63% in 2012 versus 48% in 2011)
EHRs – more purchased, more in use, but are they improving care?
- The number who purchased an EHR jumped 10 percentage points between 2011 and 2012 (from 70% to 80%). — Yet, very favorable opinions did not move in line — 18 percent fewer voiced a very favorable opinion of EHRs (from 39% in 2011 to 32% in 2012)
- 36 percent more say they believe EHRs somewhat or significantly worsen patient care (from 11% in 2011 to 15% in 2012)
- The majority (44%) say that the EHR was not designed with physicians in mind (versus 32% in 2011).
- 72 percent reported EHRs as a distraction from face-to-face patient interaction, up 12 percentage points from 2011.
Admin woes — making practice untenable?
- 89 percent said payors have become more intrusive on the patient-physician relationship (87% in 2011)
- 74 percent said payors inhibit the care they would like to provide their patients (76% in 2011).
- 59 percent more physicians see pay-for-performance as negatively impacting the quality of care; 30 percent more believe it will negatively impact their bottom line.
- However, 42 percent are very/somewhat confident their transition to ICD-10 will be smooth.
Independent physicians – fretting about the future of medicine, their viability
- 81 percent do not see the future of independent practice as viable, representing 19 percent more doctors in 2012 than in 2011.
- This year, 50 percent more view the current health care climate as very detrimental to quality care delivery.
- Unchanged from 2011, about two-thirds anticipate that the quality of medicine in the U.S. will decline over the next five years.