Although hospitals and physicians are getting together, they aren't always a comfortable fit, Green says. "What I'm hearing hospital leaders saying is that getting a physician to truly buy into the program is an obstacle. There is the culture of the physician and the culture of the hospital," she says. "The hospital wants more evidence-based medicine, more IT support, more of a point of service delivery system. It's not the way most physicians operate. A lot of them [physicians] are going to be very resistant."
2. Patient Focus: "All doctors want to have access and availability for their patients," says Goodman. That seems like a given. But as he sees it, the added regulations and administrative responsibilities have physicians focusing less on patients. "Only one physician in 10 believes that health reform will enhance the quality of care they are able to provide to their patients," says Goodman, referring to foundation surveys released in 2011. In contrast, about 56% believe it will diminish that quality of care, he adds.
The need to provide higher quality in an environment characterized by increased reporting, problematic reimbursement and high potential liability will place "extraordinarily high stress" on physicians, particularly those in private practice, says Goodman. In 2012, "physicians will increasingly need to balance these competing factors in ways that do not compromise the care they provide to patients," a foundation report states.
Adding to the concerns: the continual, pressing shortages of primary care docs and other specialties, Goodman says. The Association of American Medical Colleges estimates a current shortage of 13,700 doctors nationwide in all specialties. Within the next three years, that number is predicted to spike dramatically to 63,000.