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Physician outlook is glum

Physician Sentiment report indicates doctors are skeptical of the value of EHRs and new payment and care models

Physicians are worried about the future. Some are downright pessimistic.

These physician attitudes are gleaned from health IT services firm athenahealth’s annual Physician Sentiment Index (PSI) report, released earlier this week.

[See also: Survey reveals dour physician outlook]

The company used its Epocrates physician user base to deploy the survey to 1,200 providers. Independent doctors accounted for just over half of the physicians surveyed.

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The PSI revealed a skeptical view among independent physicians regarding accountable care organizations (ACOs) and other models that offer incentives to doctors and hospitals to reduce the cost of care. Surveyed physicians acknowledge that shifting reimbursement models away from fee-for-service arrangements will positively affect the quality of care. However, the majority of respondents said emerging care models will negatively impact profits and create more burden to get paid.

Respondents also indicated a rather startling unfamiliarity with the ACO model. Nearly 75 percent of surveyed physicians said they have either only "heard of" or are "somewhat familiar with" ACOs, and 26 percent said they "don't know" if they are participating in any pay-for-performance programs.

In general, the surveyed doctors reported an unfavorable outlook on the future of healthcare:

[See also: Female doctors more positive than males]

  • More than 60 percent of surveyed providers believe the current healthcare climate is "somewhat to very" detrimental to care. That trend has been consistent over the past four years of the PSI survey, according to athenahealth.
  • Nearly 60 percent think the quality of medicine will decline over the next five years.
  • More than 50 percent do not believe the government's involvement in healthcare will lower costs or improve outcomes.
  • 78 percent of surveyed physicians are not optimistic about the survival of independent/small groups.

"Doctors are besieged by change and requirements, and it's incredibly difficult for them to keep up," said Todd Rothenhaus, MD, the chief medical officer of athenahealth, in a prepared statement. "The findings of the 2013 Physician Sentiment Index send up a number of warning signals. As an industry and country, we need to pay attention to the fact that doctors are overwhelmed and challenged in areas they shouldn't be."

In its survey, athenahealth also asked about physicians’ perceptions regarding electronic health records.

The PSI results showed that 55 percent of independent physicians believe the costs of an EHR outweigh its patient care benefits (compared to 38 percent of hospital-employed physicians), and 60 percent of the same group believe the costs of an EHR outweigh its financial benefits (compared to 45 percent of hospital-employed physicians).

"Clearly, physicians who actually invest their own money in technology see less value,” wrote Rothenhaus in a blog post about doctors being pessimistic about the value of EHRs. "I for one think that these physicians have a more balanced view of technology investment and reward, and perhaps more clarity in return-on-investment than hospital executives and IT leaders."

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