Access to care could become much tougher if current physician practice pattern trends continue, according to research commissioned by the Physicians Foundation. Physicians are working fewer hours, seeing fewer patients and limiting access to their practices because of changes to the care delivery system. If these trends continue, 44,250 full-time equivalent physicians will disappear from the workforce in the next four years. The study also found that over the next one to three years, more than 50 percent will cut back on the number of patients seen, work part-time, switch to concierge medicine, retire or take other steps likely to reduce patient access. Among the findings:

  • 52 percent of physicians have limited the access of Medicare patients to their practices or are planning to do so, while 26 percent already have closed their practices to Medicaid patients.
  • 77 percent of physicians are pessimistic about the future of medicine, and 82 percent believe they have little ability to change the health care system. More than 84 percent of physicians feel that the medical profession is in decline.
  • More than 62 percent of physicians believe accountable care organizations are either unlikely to increase quality and decrease costs, or that any quality and cost gains will not be worth the effort. Physicians are divided on the efficacy of the medical home concept, and 38 percent remain uncertain about their structure and purpose.
  • While close to 70 percent of physicians have implemented electronic health records, 47 percent have significant concerns that EHRs pose a risk to patient privacy. Additionally, 50 percent say their EHR either has or will improve quality, 29 percent say the EHR hasn't improved quality and they don't believe it will, 12 percent say it has had no effect on the quality of care, and 4 percent say that the EHR may improve quality but it will not be worth the investment.

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