NEW YORK – Twenty-four percent of the 2,958 physicians responding to a survey about the new healthcare reform law and the impact of electronic medical records indicated EMRs would have a negative effect on patient care. Respondents also indicated they were worried that healthcare reform would result in less pay for them and lower-quality care for their patients.

Physicians cited privacy and security issues and doctor-patient relationship as concerns. Practitioners who care for patients longitudinally and are less procedurally oriented were more positive about EMR use, the survey noted.

The 2011 National Physicians Survey (NPS) polled physicians of varying specialties and practice types in all 50 states. Thomson Reuters and HCPLexus conducted the survey in September 2010, and updated in December 2010 and January 2011.

Thomson Reuters-HCPlexus executives say the NPS is the most comprehensive survey of physicians surrounding their thoughts on the future of healthcare, including ideas on the healthcare reform law, EMRs and Accountable Care Organizations (ACOs).
 
The NPS data show doctors fear that the quality of care will deteriorate under Patient Protection and Affordable Care Act (PPACA) and that their reimbursements would go down as well.

When asked about the quality of healthcare over the next five years, 65 percent of the doctors believed it would deteriorate, with only 18 percent predicting it would improve. Consumer perception is more optimistic, with close to 30 percent of consumers believing care will improve under PPACA.

When asked who would treat the 32 million Americans receiving healthcare under PPACA, 55 percent suggested a nurse practitioner or physician assistant would administer care.

"It is likely that with increased demand for general surgeons, rising overhead costs and decreasing reimbursement, there will be many of us simply retiring or finding other opportunities rather than accept the risks of surgical practice and below minimum wage benefits," said one surgeon from Arizona.

Impact on patients
When asked about the impact of reform on patients, 58 percent were viewed it negatively, with 27 percent saying reform would be positive. They also indicated that primary care providers and nurse practitioners would treat most patients.

"I believe that specialists feel that the PCP's will allocate the majority of their time to the patients with commercial insurance or sources that have higher reimbursements and leave the lower level payers for their PA's and nurse practitioners to manage the majority of the time. These patients also have a history of being less likely to take an active role in their own care and have more 'self inflicted problems,' i.e. smoking, obesity etc," responded an Illinois-based orthopedic surgeon.

"It is clear that many physicians feel strongly that the proposed future state is counter to what they believe is the best way to serve patients," said Raymond Fabius, MD, chief medical officer at Thomson Reuters. "As practicing physicians are genuinely concerned for the health of their patients and their ability to serve them, any sustainable efforts to reform healthcare delivery would benefit from their inclusion and support."

Key findings:

• During the next five years, the quality of health care in this country will improve (18 percent), stay same (17 percent) deteriorate (65 percent)
• The Affordable Care Act will result in physician reimbursement becoming more fair (9 percent) neither fair nor unfair (17 percent) less fair (74 percent)
• Overall, the impact of the Affordable Care Act for patients will be positive (27 percent) neutral (15 percent) negative (57 percent)
• Overall, the impact of the Affordable Care Act for physicians will be positive (8 percent) neutral (14 percent) negative (78 percent)

"The National Physicians Survey tells us that physicians have not been enlisted in the healthcare reform process," said David L. Shrier, CEO of HCPlexus. "The message they've taken from healthcare reform appears to be 'do more with less'. Doctors are telling us they feel disenfranchised and overburdened. In order for healthcare reform to succeed, physicians need to be engaged in dialog, and need to be communicated the benefits of the PPACA as part of a continuous messaging campaign."