Most physicians in the United States are concerned about the future of the medical profession and find many marketplace changes threatening, according to a 2013 survey of U.S. physicians by Deloitte. Deloitte believes that “physicians recognize ‘the new normal’ will necessitate major changes in the profession that require them to practice in different settings as part of a larger organization that uses technologies and team-based models for consumer (patient) care. Transparency, data sharing, active engagement, and affirmation of the value of physicians by health care organizations is needed for effective business relationships.”
Some key survey findings, as summarized by Deloitte, indicate that many or most physicians: (1) are pessimistic about the future and worry about the profession’s erosion of clinical autonomy, income, and the inability to achieve medical liability reform; (2) believe that the U.S. health care system is flawed and underperforming, but favor many elements of the Affordable Care Act to address its problems; (3) foresee increased physician-hospital integration; (4) believe action is required in order to integrate comparative effectiveness research into patient care; (5) follow innovations in technology and evidence-based practices closely and are receptive if the evidence of safety and efficacy is readily accessible; (6) have a high use rate and satisfaction with electronic health record systems, but a low use rate of consumer-support technologies; and (7) think incentives can be effective in changing consumer health if carefully implemented.
New Relationships Emerging
Deloitte believes that “new relationships between physicians and hospitals, health insurance plans, retail pharmacies, employers, and medical device and drug manufacturers are emerging.” These relationships, according to Deloitte, must be “built on mutual respect and trust, with incentives appropriately aligned.” Deloitte views the following elements as key to these relationships: (1) compensation commensurate with the training, experience, and effectiveness of the clinician; (2) integration of physicians in team-based models where clinical and financial decision-making is encouraged and clinical autonomy is balanced; (3) effective deployment of clinical and administrative information technologies; (4) inclusion of physicians in organizational leadership and provision of structured training and experience-based learning; (5) access to support tools and resources that assist clinicians in assimilating into the organization; (6) 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; and (7) an organizational culture that reflects mutual respect for the profession and the entities with whom physicians partner.