Access to physicians will continue to shrink, according to doctors’ responses to a recent survey. The Physicians Foundation’s 2014 Survey of America’s Physicians revealed that more than 80 percent of physicians say they are overextended or at full capacity. Additionally, nearly three-quarters of physicians believe there is a physician shortage, that more physicians should be trained and that the cap on funding for graduate medical education should be lifted.

Despite the capacity issue, 44 percent of doctors plan to take one or more steps to reduce patient access to their services, such as cutting back on the number of patients they see, retiring, working part time, closing their practices to new patients or seeking nonclinical jobs. This amounts to a potential loss of tens of thousands of physician FTEs, according to the Physicians Foundation.

Nearly a quarter of physicians either do not see or limit the number of Medicare patients they see, and 38 percent either do not see or limit the number of Medicaid patients they see. Nevertheless, almost 50 percent of patients physicians see are enrolled in Medicare or Medicaid.

The survey also found that a minority of physicians participate in insurance products offered through their state or federal exchanges, and 28 percent have no plans to participate in them. More than a quarter of physicians participate in an accountable care organization, but only half believe ACOs will enhance quality and decrease costs.

The number of younger physicians eyeing concierge practices is up, with 17 percent of docs 45 or younger indicating that they will transition to a direct pay/concierge model, compared with 11 percent of those 46 or older. Currently, 7 percent of physicians practice some form of direct pay or concierge medicine.

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