We continue with a summary of the information presented in the 2018 Merritt Hawkins-conducted physician survey. (link in yesterday’s post) 6.6% of doctors are currently doing a concierge-type practice, while another 12% are planning to move to this style in whole or in part. 18% of responding doctors have at least some telemedicine visits, but only 10% say it is 25% or more of their practice. 62% of physicians report that patient care is greatly or to a good extent adversely affected by prior authorizations, clinical protocols and similar tactics, and 27% more say it is somewhat adversely affected. 66% of physicians say that at least 20% of their patients do not adhere to treatment plans. The opioid crisis has led 70% of doctors to prescribe fewer pain meds. No wonder people are so grumpy. More doctors think relationships between physicians and hospitals are negative and adversarial, than positive. And this in an era where so many are employed by hospitals. Like everyone else, doctors have opinions about how to fix the health system. 26% think we should go to single-payer (they clearly didn’t get the message that paying for this requires a 40% cut in their income); 27% believe we should go to a more market-driven one utilizing health savings accounts, and 35% say we should have a dual system of single-payer with private health plan options. The survey has a number of additional items, including breakdowns of responses by gender, age, physician type and other characteristics. What is most clear is that physicians do not have a positive view of the health system, or of many of the prominent “reform” initiatives, including forced use of more health information technology and the spread of so-called value-based purchasing and reimbursement. We all just have to hope that the negative feelings engendered by these aspects of medical practice don’t affect the quality of the health services we receive.
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MedPAC 2019 Report to Congress
June 18, 2019
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