Information published in the Journal of the American Medical Association from a national survey of primary care practitioners finds generally unhappy campers. (JAMA Survey) 47% said things were bad enough that they were considering early retirement, although 18% say health care trends have them thinking about delaying retirement. 50% said the increased use of health information technology was a positive for health care quality, while 28% said it was a negative. So after we have spent billions on greater use of HIT, only half of primary care doctors think it has helped, that is really great. Only 22% think increased use of quality metrics to assess provider performance has been a positive and half think it has negatively affected quality. And only 12% say penalties for hospital readmissions improves care. Zealously guarding professional territory, only 29% of the respondents believe increased use of nurse practitioners and physician assistants has been a positive for quality of care. Medical homes and accountable care organizations aren’t looked at favorably either, with only 33% of PCPs saying medical homes have a positive impact and 14% indicating that ACO’s do; although among physicians in a medical home practice, a whopping 43% believe they improve quality and among those in an ACO, 30% see a positive effect. How do these primary care physicians rate the payers they do business with? In terms of payment amount, 46% see reimbursement from private plans as good or excellent, while only 21% say that about Medicare and 11% about Medicaid. Regarding administrative ease of payment processes, 32% rate private plan processes as good or excellent, with 25% finding that to be true of Medicare and 16% of Medicaid. This survey is consistent with similar data points and if we think that these negative perceptions don’t have an impact on care or won’t eventually show up in reimbursement and other demands, we are delusional.
