Physician Fear Factor – Should Doctors Be Afraid of PPACA?

Less than one year away, what many consider the eye of the storm of the Affordable Care Act (PPACA) (P.L. 111-148) will be facing many physicians and their practices, but must they face it with fear? Although most folks agree that our health care system is broken, there is also the fear of the unknown.

A recent study by Deloitte makes this same point. According to the study, most U.S. physicians are concerned about the future of the profession and consider changes in the market to be a threat.  In fact, the study indicates that many physicians are willing to close up shop and retire early out of this fear of what might happen.  Nearly two-thirds of doctors say that they or their colleagues will retire earlier than planned over the next few years.

What is it that is causing this scare? Perhaps change. A lack of familiarity with what’s around the corner may be making many physicians uneasy.  Deloitte found that only 3 in 10 physicians say they are familiar with health care delivery system improvement pilot programs and demonstration programs; two in 10 are familiar with value-based purchasing or comparative effectiveness.

For those physicians associated with an accountable care organization, Deloitte found a certain comfort to exist.  These physicians were less likely to be concerned about being penalized because of factors out of their control under an episode-based payment structure. They also had a lot more faith that Medicaid reimbursements will increase to match Medicare rates for primary care services in the next one to three years.

One thing is certain. Change is coming, whether physicians are comfortable with it or not. And although they may not be comfortable, they agree that the Affordable Care Act is a good start to addressing issues of access and cost, and they are curious. Physicians want to know about clinical decision support information technologies that may reduce unnecessary services and increase clinician adherence to evidence-based practices. They are receptive to learning new practices, as long as evidence of safety and efficacy is readily available.

Technologies such as electronic health records (EHRs) are also viewed as helpful. The majority of physicians reported that the system has numerous benefits, such as faster and more accurate billing for services, time saving through e-prescribing, and communication improvement and care coordination capabilities due to interoperability. Seven in 10 physicians believe that in the next one to three years the majority of physicians will adopt EHRs certified for meaningful use.  Physicians believe that those who don’t may suffer, especially when it comes to the physician hospital relationship. According to the study, physicians believe that the hospital-physician relationship will suffer as physician privileges are put at risk to comply with hospital standards for meaningful use.

Physicians may have faith that new technologies may be helpful for their records, but they have less faith in using new technologies to communicate or work with their patients. Only a small number of physicians are taking advantage of modern technology to help with their practices. Just 34 percent of physicians reported that they can communicate with patients using email or texts and even less believe their patients can be directed to trusted health care websites for information. Physicians have little faith that patients can schedule visits or access test results through a website, as 24 percent of all physicians believe that works. Even less believe patients can request prescription refill on the internet.
But what can fix this problem with patients? Education. What can fix this problem with fear about change? Education. And the great part is that many physicians report that they have faith in PPACA to start the change that is needed to fix the health care system in the United States. What we need now is more communication to explain what is needed to stop being afraid and to be successful.