Deloitte Center for Health Solutions recently released results of its 2013 Survey of U.S. Physicians, and the findings suggest that physicians see value in some provisions of the Affordable Care Act (ACA), and that they have a sense that health care is moving in the right direction. The survey was sent to 20,000 physicians and 613 responded.
Survey results showed that many or most physicians:
- Worry about the profession’s erosion of clinical autonomy and income, and its inability to achieve medical liability reform.
- Believe that the U.S. healthcare system is flawed and underperforming, and favor many elements of the ACA to address its problems.
- Foresee increased consolidation of physicians into larger organizations.
- Believe action is required to integrate comparative effectiveness research into patient care.
- Are closely watching innovations in technology and evidence-based practices; physicians are receptive, provided that evidence of safety and efficacy is readily available.
- Think incentives can be effective in changing consumer health if carefully implemented.
Kaiser Health News reported that the study indicates doctors foresee opportunities in integrated health systems encouraged in the ACA, such as accountable care organizations (ACOs). But they are still hesitant to change their practices without more evidence that these systems will work. More than two thirds of physicians surveyed said that even without conclusive studies, large healthcare delivery systems—which include ACOs, medical homes and hospitals—would yield more financial success in the future.
“There’s still uncertainty about how the financial side is going to play out,” said Dr. Bob Williams, a physician and national medical leader at Deloitte, about changes in the health delivery system. “But physicians also see the value in the ACA, and see the value in improving access to care . . . there’s an optimism here, a sense of being headed in the right direction.” (“Doctors Eager for Evidence About Integrated Health Systems,” Kaiser Health News, March 22, 2013)
Deloitte concluded its report by noting emerging relationships between physicians and hospitals, health insurance plans, retail pharmacies, employers and medical device and drug manufacturers. “A transparent business relationship built on mutual respect and trust, with incentives appropriately aligned, is key.” It offered the following elements of an effective relationship with and among physicians:
- Compensation commensurate with the training, experience and effectiveness of the clinician, inclusive of performance-based bonuses based on team and individual goals.
- Integration of physicians in team-based models where clinical and financial decision-making is encouraged and clinical autonomy is balanced between managing inappropriate variation and adherence to evidence-based practices.
- Effective deployment of clinical and administrative information technologies . . .
- Inclusion of physicians in organizational leadership and provision of structured training and experience-based learning . . .
- Access to support tools and resources that assist clinicians in assimilating into the organization.
- A stable organization with a clear vision and strategy for its future, adequate resources to withstand competitive and regulatory pressures, and leadership that capably executes a plan for innovation and growth.
- An organizational culture that reflects mutual respect for the profession and the entities with whom physicians affiliate or partner.
(Deloitte 2013 survey of U.S. Physicians: Physician Perspectives about Health Care Reform and the Future of the Medical Profession, March 19, 2013.)
To view the full report from Deloitte, please click here.
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In the upcoming iProtean advanced course, Employing Physicians, Dan Grauman, Nate Kaufman and Susan Douglas discuss the critical components of working with and employing physicians including: developing an employed physician strategy, establishing a platform of trust, designing the compensation program, the role of the board in establishing compensation parameters, joint performance goals and employed physician math. Look for the course in your course library in May.
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