EHR vendor CareCloud and QuantiaMD combined to create a survey leading to the physician Practice Profitability Index. (CareCloud Survey) Physician attitudes are always interesting because doctors continue to have so much control over total health care spending. In 2014, 39% of physicians expect declining income from their practices and only 19% expect an increase, compared to 36% and 22% in 2013. Financial concerns cited by respondents were declining payments, 60%, reform law requirements, 49%, rising practice costs, 50% and ICD-10 implementation, 43%. About 70% either didn’t think they would be prepared for ICD-10 or were uncertain about it; which may explain why the implementation date was delayed for a year. The cost of ICD-10 is very high, depending on practice size, from $50,000 to several million dollars. Doctors feel increasingly burdened by administrative chores, 70% say they spend at least one day a workweek on these matters, up from 58% in 2013 and almost a fourth say they spend more than 40% of their time on administration. This limits physicians’ ability to interact with patients as much as they would like, and 40% say greater patient engagement would bring the most benefit to their practices, particularly focusing more on high-cost, complex patients. For now, most physicians see little positive impact from ACO arrangements or other value-based reimbursement schemes. And only 53% say their practice can accept new patients expected under the reform law. Only 43% of doctors say they want to stay independent, compared to 60% last year. Unhappiness with health information technology is high, with cost, 36%, usability 31%, non-compliance with regulatory requirements and lack of vendor innovation cited as the major problems. One-third of doctors are planning to make some systems change this year and only 45% say they are either very comfortable or somewhat comfortable with their current vendors. While overall physicians are well-paid, it is a very difficult time to operate a medical practice and many doctors are looking for less stressful ways to work. There is clearly also an opportunity for vendors who can help relieve some of the stress at a reasonable price.
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