Category: Physician Surveys

JAMA Network | JAMA | Views of US Physicians About Controlling Health Care Costs

 

Physicians’ views about health care costs are germane to pending policy reforms.

Objective To assess physicians’ attitudes toward and perceived role in addressing health care costs.

…

Results A total of 2556 physicians responded (response rate = 65%). Most believed that trial lawyers (60%), health insurance companies (59%), hospitals and health systems (56%), pharmaceutical and device manufacturers (56%), and patients (52%) have a “major responsibility” for reducing health care costs, whereas only 36% reported that practicing physicians have “major responsibility.” Most were “very enthusiastic” for “promoting continuity of care” (75%), “expanding access to quality and safety data” (51%), and “limiting access to expensive treatments with little net benefit” (51%) as a means of reducing health care costs. Few expressed enthusiasm for “eliminating fee-for-service payment models” (7%). Most physicians reported being “aware of the costs of the tests/treatments [they] recommend” (76%), agreed they should adhere to clinical guidelines that discourage the use of marginally beneficial care (79%), and agreed that they “should be solely devoted to individual patients’ best interests, even if that is expensive” (78%) and that “doctors need to take a more prominent role in limiting use of unnecessary tests” (89%). Most (85%) disagreed that they “should sometimes deny beneficial but costly services to certain patients because resources should go to other patients that need them more.” …

JAMA Network | JAMA | Views of US Physicians About Controlling Health Care Costs

PLOS ONE: Healthcare Reform and the Next Generation: United States Medical Student Attitudes toward the Patient Protection and Affordable Care Act

PLOS ONE: Healthcare Reform and the Next Generation: United States Medical Student Attitudes toward the Patient Protection and Affordable Care Act

Of medical students surveyed, 94.8% agreed that the existing United States healthcare system needs to be reformed, 31.4% believed the PPACA will improve healthcare quality, while 20.9% disagreed and almost half (47.7%) were unsure if quality will be improved. Two thirds (67.6%) believed that the PPACA will increase access, 6.5% disagreed and the remaining 25.9% were unsure. With regard to containing healthcare costs, 45.4% of participants indicated that they are unsure if the provisions of the PPACA will do so. Overall, 80.1% of respondents indicated that they support the PPACA, and 78.3% also indicated that they did not feel that reform efforts had gone far enough. A majority of respondents (58.8%) opposed repeal of the PPACA, while 15.0% supported repeal, and 26.1% were undecided.

Conclusion

The overwhelming majority of medical students recognized healthcare reform is needed and expressed support for the PPACA but echoed concerns about whether it will address issues of quality or cost containment.

JAMA- AIM | Physicians’ Opinions About Reforming ReimbursementResults of a National SurveyReforming Reimbursement

Physicians’ Opinions About Reforming Reimbursement Results of a National SurveyReforming Reimbursement

Results

The response rate was 48.5% (n = 1222). Four of 5 physicians (78.4%) indicated that under Medicare, some procedures are compensated too highly and others are compensated at rates insufficient to cover costs. Incentives were the most frequently supported reform option (49.1%), followed by shifting payments (41.6%) and bundling (17.2%). Shifting payments and bundling were more commonly supported by generalists than by other specialists. There was broad support for increasing pay for generalists (79.8%), but a proposal to offset the increase with a 3% reduction in specialist reimbursement was supported by only 39.1% of physicians.

Conclusions

Physicians are dissatisfied with Medicare reimbursement and show little consensus for major proposals to reform reimbursement. The successful adoption of payment reform proposals may require a better understanding of physicians’ concerns and their willingness to make tradeoffs.

Physicians’ Views of the Massachusetts Health Care Reform Law — A Poll — NEJM

Physicians’ Views of the Massachusetts Health Care Reform Law — A Poll — NEJM:

Of 2135 practicing Massachusetts physicians who responded to the poll, 70% said they support the Massachusetts Health Care Reform Law, whereas 13% oppose it.

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Temperatures Rise Over Costs Of Care | Worcester Business Journal

Temperatures Rise Over Costs Of Care | Worcester Business Journal: Higher Sentiment For ‘Single Payer’?

Presumably, doctors are more familiar than the general public with the pressures driving up health care costs, and an overwhelming majority of them also say there needs to be some government involvement in the health care system. A survey by the Massachusetts Medical Society this fall found that 41 percent of doctors thought the best option for health care reform in the U.S. would be to adopt a single-payer system like Canada’s. That number was up from 34 percent in 2010.

Another 23 percent favor a mix of public and private plans, while 17 percent support reforms along the lines of the 2010 national health care reform act, including an individual mandate like Massachusetts’. Fifteen percent favor a system in which insurers can sell limited-benefit and high-deductible policies and the government gives subsidies to help low-income people buy insurance.

Lynda Young, president of the Massachusetts Medical Society (MMS) and a Worcester pediatrician, said doctors who favor a single-payer system may see it as a way to avoid administrative burdens. She noted that a recent article in the policy journal Health Affairs found that Canadian doctors spend two or three hours a week on administration, compared with about 10 to 15 hours for doctors in the U.S.

Pretty remarkable, especially when you look at the numbers in the graph. 41% plus 23% for 64% favoring either single payer or a ‘public option’ added to the current mix. 17% OK with the PPACA as it is, and another 15% seeming to favor high deductible plans.

That’s a grand total of 81% favoring PPACA at least, the distinct minority,  with the significant plurality favoring single payer. Wow.

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Doctors Soften Their Stance on Obama’s Health Overhaul – NYTimes.com

Doctors Soften Their Stance on Obama’s Health Overhaul – NYTimes.com:

There are no national surveys that track doctors’ political leanings, but as more doctors move from business owner to shift worker, their historic alliance with the Republican Party is weakening from Maine as well as South Dakota, Arizona and Oregon, according to doctors’ advocates in those and other states.

That change could have a profound effect on the nation’s health care debate. Indeed, after opposing almost every major health overhaul proposal for nearly a century, the American Medical Association supported President Obama’s legislation last year because the new law would provide health insurance to the vast majority of the nation’s uninsured, improve competition and choice in insurance, and promote prevention and wellness, the group said.

As I pointed out here many times over the past couple years, doctors support health reform.

Follow the tags with this to find out more.

Physician’s Perspective on Health Reform Slides

I updated my slides on physicians’ opinions on health reform for a talk tonight for the Pittsburgh Chapter of Drinking Liberally.

The new slides are here. ( I hope I fixed the link!)

I had to strip out the slides of me (and Doctors for America) at the White House, and on our way TO the White House, already in our white coats in order to get under the 5 MB Google docs limit.

Cheers,

NEJM — Doctors on Coverage — Physicians’ Views on a New Public Insurance Option and Medicare Expansion

NEJM — Doctors on Coverage — Physicians’ Views on a New Public Insurance Option and Medicare Expansion:

“Overall, a majority of physicians (62.9%) supported public and private options. Only 27.3% supported offering private options only.”

I realized I didn’t have this posted yet! The 3/4 of physicians ties in nicely with my estimate that physicians groups representing 3/4 of physicians also support health care reform in general and HR 3200 in particular.

The companion article is instructive, too.

a large majority of respondents (78%) agreed that physicians have a professional obligation to address societal health policy issues. Majorities also agreed that every physician is professionally obligated to care for the uninsured or underinsured (73%), and most were willing to accept limits on reimbursement for expensive drugs and procedures for the sake of expanding access to basic health care (67%). By contrast, physicians were divided almost equally about cost-effectiveness analysis; just over half (54%) reported having a moral objection to using such data “to determine which treatments will be offered to patients.

…the 28% of physicians who consider themselves conservative were consistently less enthusiastic about professional responsibilities pertaining to health care reform.

This last bit is a bit interesting, as at our Pennsylvania Medical Society Board retreat we discussed this last bit and the overwhelming consensus, as best I could tell, was that this was not controversial, and that part of our jobs was making these determinations.

Presentation for Medicare 44th Anniversary

I gave a presentation in Avalon, PA on the occasion of the 44th Anniversary of Medicare, Thusday July 30, for Organizing for America. Thanks to everyone who came and were so kinly receptive to the talk, and of course to Terry, Al, Peter and Sylus for organizing things!

‘>The slides are here.

The references in the slides are all on this blog somewhere, just search in the upper left hand corner to find them.