By Sam Foster
I saw this while reading over at my favorite blog and one of my other favorite blogs has it too. It’s a Fox News report from last week below.
Unsatisfied with the video, I decided to find the actual report. It turns out that it was created by The Physician's Foundation, which has a list of credible affiliations including the CA medical association. The report is actually 2 months old and is entitled "Health Reform and the Decline of Physician Private Practice. "You can review the report here.
First and foremost, Fox stretched the 74% finding a little in their report. According to the study, 74% of physicians said they would take steps to change their current practice style in the next one to three years. It should be noted that retiring and working part tiem were among the ways physicians planned on changing their practice. The actual figure regarding doctors dropping out of private practice isn't anything to sneeze at (just not quite 74%):
40% of physicians said they would drop out of patient care in the next one to three years, either by retiring, seeking a non-clinical job within healthcare, or by seeking a non-healthcare related job.
But why stretch, when you can point out that none of the millions of new medicaid patents will be able to get doctors while at the same time denying existing medicare patients?
Of these, 93% said they will close or significantly restrict their practices to Medicaid patients, while 87% said they would close or significantly restrict their practices to Medicare patients.
It's a truly difficult report to swallow given the fact that doctors are kind of important to the whole health care thing, but also should be noted that not every aspect of the law that was reviewed was found damaging.
The report includes results of a physician survey conducted by Merritt Hawkins on behalf of The Physicians Foundation. Some 2,400 physicians who responded to the survey indicated how they reacted to health reform and enumerated ways in which they may alter their practice plans in the next one to three years as reform is implemented.
Key findings of the survey include:
1) The majority of physicians responded unfavorably to passage of health reform.
2) The majority of physicians believe health reform will increase their patient loads while
decreasing the financial viability of their practices.
3) The majority of physicians plan to alter their practices patterns in ways that will reduce patient access to their practices, by retiring, working part-time or taking other steps.
4) Physician practice styles will be increasingly less homogenous. The full-time, independent practitioner accepting third party payment will largely be supplanted by employed,part-time, locum tenens, and concierge practitioners.
Key findings of the survey include:
• 67% of physicians said their initial reaction to passage of the 2010 Patient Protection and Affordable Care Act was either “somewhat negative” or “very negative.”
• With several months to consider the content and direction of the new law, 39% of physicians said they are now more negative about health reform than they were when it initially passed, compared to only 10% who
now are more positive about the law than when it initially passed.
• In response to reform, 74% of physicians said they would take steps to change their current practice style in the next one to three years. Only 26% said they would continue as they are.
• 40% of physicians said they would drop out of patient care in the next one to three years, either by retiring, seeking a non-clinical job within healthcare, or by seeking a non-healthcare related job.
• The majority of physicians (60%) said health reform will compel them to close or significantly restrict their practices to certain categories of patients. Of these, 93% said they will close or significantly restrict their practices to Medicaid patients, while 87% said they would close or significantly restrict their practices to Medicare patients.
• The great majority of physicians surveyed (86%) believe the viewpoint of physicians was not adequately represented to policy makers during the run-up to passage of health reform.
• While over half of physicians said health reform will cause patient volumes in their practices to increase,69% said they no longer have the time or resources to see additional patients in their practices while still
maintaining quality of care.
• The majority of physicians (59%) said health reform will cause them to spend less time with patients.
• Only 10% of physicians said reform will improve the quality of patient care they are able to provide, while 56% said reform will diminish the quality of care they are able to provide.
• About half of physicians (49%) said their attitude toward medicine was “somewhat negative” or “very negative” before health reform was enacted. Since reform was enacted, about two-thirds (65%) said their attitude toward medicine was “somewhat negative” or “very negative.”
• The great majority of physicians (89%) believe the traditional model of independent private practice is either “on shaky ground” or “is a dinosaur soon to go extinct.”
So deconstruct the spin from the real findings and what we are faced with is a report where doctors are certain that health reform changes will impact them negatively, which in turn will impact patients negatively. One of those negative impacts will be restriction in access to health care and specifically those 32 million that now have the wonders of health care coverage. Or to put more simply, Obama's "if you like your doctor, you can keep your doctor" lie is far worse than anyone could have predicted. Not only will you not keep your doctor, you won't be able to find one.
Funny how easy it is to pay for 32 million newly insured citizens when none of those newly insurred will get access to use the coverage.
Correction: minor changes made to original post, related discussion at Memeorandum