Young physicians see storm clouds in ACA uncertainty

Doctors in the 40-and-under set worry about the Affordable Care Act (ACA) having a negative on their practice of medicine, according to a new study conducted by the Physicians Foundation, a nonprofit organization that supports doctors.

Fifty-seven percent of surveyed doctors said they are pessimistic about the future of the healthcare system in the United States, citing the ACA as their number one reason for their gloomy outlook.

“I am skeptical that everything that the Accountable Care Act is stating that it will accomplish will actually occur,” said Kevin Joseph, MD, 37, vice president of UC Health and CEO and president of UC Health West Chester Hospital in Ohio. “I don’t think the health savings will be what they’re proposed to be. I think that it’s also going to cost more to implement their plans than what is expected.”

Five hundred physicians age 40 and younger were surveyed by Medical Marketing Research on behalf of the Physicians Foundation. The purpose of the survey was to create a profile of young physicians in terms of their practice arrangements and attitudes and opinions about the healthcare system. Of the 500 surveyed, 250 were primary care physicians, 175 were medical/surgical and 75 were hospital-based specialists.

Forty-nine percent of surveyed doctors said they believed the ACA will negatively impact their practice while 23 percent looked at the ACA in a more positive light. Twenty-nine percent were neutral about the ACA’s impact on their practice of medicine.

While the ACA may increase the quality and coordination of care, said Joseph, overall, it doesn’t bode well for the healthcare system.

“As more burden is shifted to healthcare providers and [more] difficulties with the delivery of healthcare, that’s going to mean less individuals want to become a physician,” he said. “More people are going to leave the field, and I think that the expertise that we currently have, the innovation, will decrease over time.”

Kamal Patel, 37, a radiation oncologist at the Cancer Treatment Centers of America’s Midwestern Regional Medical Center in northern Illinois is more optimistic about the future of healthcare but understands the unease his fellow medical professionals are feeling.

“A lot of it comes out of confusion and uncertainty,” he said. “Any time there’s confusion and uncertainty, people are going to be more cautious and that can affect both patient care and the overall status of a physician.”
The high percentage of doctors in the survey saying they feel pessimistic about the future of healthcare may have more to do with expectations coming down to earth, said Lou Goodman, PhD, president of the Physicians Foundation and CEO of the Texas Medical Association.

“There’s so much going on right now that I think coming out of a residency program where the focus is taking care of patients and medicine and going into the real world, the amount of bureaucracy and regulation is not something they expected,” Goodman said.

Adjusting one’s perspective is what is needed as new doctors leave the buffered world of residency behind and enter the working world, said Stephen “Koji” Sparks, 36, an emergency medicine physician and assistant medical director at St. Anthony’s Hospital in Oklahoma City, who says he’s optimistic about the future of healthcare.

Sparks equates the transition the healthcare system is undergoing right now – and the perceived constraints related to that transition – to the game of basketball. When the three-point line in basketball was changed, the players may have grumbled about it but it didn’t make them any less excited about playing the game, Sparks pointed out.

“I think it really is on how you look at those constraints,” he said. “Some [young doctors] feel that ‘oh, here’s another edict coming down for socialized medicine’ or ‘now I’m getting less reimbursement because I have to jump through six hoops instead of three hoops to get my general reimbursement back.’ ... I think the ability to look at that and say ‘OK, this is a new challenge. How do I approach that challenge to be successful?’ is more of an attitude than anything else. I think the younger generation is looking at that and saying ‘OK how do I evaluate this?’”

Follow HFN associate editor Stephanie Bouchard on Twitter @SBouchardHFN.