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The shifting medical practice may decrease access to care

by Lauren Dubinsky, Senior Reporter | September 17, 2014
Patients in the U.S. may have a harder time getting access to care in coming years if the findings of a new survey commissioned by The Physicians Foundation is any indication of what to expect.

The survey conducted by Merritt Hawkins over the course of four months, included responses from 20,088 physicians across the U.S. and their views on the physician workforce situation and medical practice configurations.

Of the physicians surveyed, 81 percent described themselves as either over-extended or at full capacity in regard to their workloads. In even more alarming news, 44 percent are planning to cut back on the amount of patients seen, retire, work part-time, close their practice to new patients or search for non-clinical jobs.

In 2011, the first of the over 75 million baby boomers hit 65 years of age, qualifying them for Medicare. Additionally, millions of new patients are insured though the Affordable Care Act, meaning the need for health care professionals has grown substantially, even as the number of practicing professionals seems to be ebbing.

Compared to the findings of the 2012 survey, more physicians today are younger, with an average age of 50, female (33 percent), employed through hospital systems, and working in primary care.

Additionally, there are a lot of changes in physician workforce patterns and practice settings. Only 17 percent of physicians are currently in a solo practice, but in 2012, 25 percent were. Only 35 percent of the recent survey respondents referred to themselves as independent practice owners, but in 2012, 49 percent did and in 2008, 62 percent did.

"These trends carry significant implications for patient access to care," Dr. Walker Ray, vice president of The Physicians Foundation and chair of its Research Committee, said in a statement. "With more physicians retiring and an increasing number of doctors, particularly younger physicians, planning to switch in whole or in part to concierge medicine, we could see a limiting effect on physician supply and, ultimately, on the ability of the U.S. health care system to properly care for millions of new patients."

While increased government regulation, malpractice liability pressure, insufficient and unpredictable reimbursement and declining clinical autonomy were the reasons for discontentment among the 2012 respondents, the 2014 survey questions focused more on clinical autonomy and found that 69 percent of the respondents reported that their decisions are often compromised.

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