The good news: Patients love their primary-care physicians.
What's worrisome: They still don't always get as much as they want out of their visits to the doctor’s office. And in an era where physicians are under increasing pressure to deliver great care for a lower cost, meeting patient expectations while also meeting financial benchmarks will only become more challenging.
According to a patient survey conducted via phone April 13-15 by Practice Fusion and GfK Omnibus of 1,000 adults age 18 or older, 62 percent of respondents said they receive better care at their primary-care physician than they do when visiting a specialist or at the hospital. Another38 percent of respondents say increased communication between doctors would improve their medical-practice experience, followed by more appointment availability (31 percent) and ease of access to medical records (15 percent).
The study’s findings are, no doubt, refreshingly nice to hear for primary-care physicians, who have been plagued by pressure from managed care providers to focus on giving quality care at a lower cost. And the price of having to do that is often patient satisfaction, an April 15 article published in The Daily Beast points out.
In a recent Consumer Reports survey, 70 percent of physicians reported that since they began practicing medicine, the bond with their patients has eroded. At least part of the blame, according to The Daily Beast, began with managed-care revolution of the 1980s and ’90s, “an initially well-meaning effort intended to improve the quality of medicine and control costs, but which ended up fracturing the doctor-patient bond.” Many insurers focused more on cost at the expense of quality, negotiating lower and lower fees for doctors, who slashed the time spent with patients to fit more of them into a day.
Practice Fusion and GfK Omnibus study authors seem to agree, noting that that although doctors deliver an estimated 80 percent of patient care in the United States, practices are increasingly facing financial hardship, burdensome debt, and even bankruptcy. Increases in the cost of operating a medical practice, up 52.6 percent since 2001, have compounded recent drops in reimbursement rates.
"Primary care providers are the medical backbone of our communities," said Ryan Howard, CEO of Practice Fusion, in a press release. "These doctors provide the personalized care and preventative medicine that improves patient health and drives down costs. Unless they are supported by innovative health technology and fair policies on reimbursements, however, many communities may be left without one."
To try and offset some of the reimbursement constraints and other financial stressors, physicians should focus on trying to improve efficiency.
Neil Baum, urologist and clinical associate professor of urology at Tulane Medical School in New Orleans, not so long ago recorded a podcast full of great take-away tips for productivity-minded doctors.
But perhaps the best way to improve physician productivity is through the use of technology. Many physicians have told us that their EHRs and mobile technology have helped them do their jobs better. And patient portals, which allow a physician to send secure electronic messages and lab results to patients (among other things) can help eliminate many of the back-and-forth time sucks that are part of doctors’ daily lives.
It behooves physicians to do as much as they can to explore all the ways they can make the most out of their time with their patients, and provide the most efficient care possible, for the lowest cost. With an increasing emphasis by the federal government on shared savings (through ACOs) and detailed documentation (through ICD-10), pressures are only going to increase.