The trends physicians fear most: 4 perspectives

Healthcare's ever-changing landscape comes with a host of uncertainties. Here is what four physicians had to say about their fears regarding current healthcare trends:

Editor's note: These responses have been edited lightly for clarity and brevity.

James Bradley, MD. Orthopedic Surgeon at UPMC: The devaluing of the physician with extensive clinical experience and wisdom because of increasing administrative burden to treat our patients, thereby causing early burnout, is the biggest danger to our profession today.

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Kian Eftekhari, MD. Oculofacial Plastic Surgeon at Eyelid Center of Utah (Salt Lake City): As an independent physician, I think the biggest threats right now are scope of practice expansion efforts in optometry, nursing and physician assistants, which would allow state legislatures to make medical school, residency training and clinical experience an "unnecessary burden" for anyone who wants to practice medicine and surgery. Without appropriate input from physicians about how this will affect patient safety, I worry we will worsen clinical care for future generations, including when I need a doctor one day.

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Vikas Patel, MD. Executive Vice Chair of University of Colorado Medicine (Denver): The biggest threat facing physicians right now is the business of medicine. Medical care for physicians has become much more of a business from every aspect compared with what used to be the "art" of medicine. Physicians are now pressured to see more patients in the clinics and document more irrelevant aspects of the visit, far more than spending time getting to know their patients and understanding their patients' problems. Office procedures, such as injections, add to this, as injections garner more reimbursement than just an office visit, not to mention the "ancillaries" of imaging, physician therapy, etc. All of this pressure comes from decreased reimbursements and a need to cover the "overhead" costs of a practice. So if costs go up, physicians are pressured to increase throughput and find other ways to cover the cost of patient care.

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Bradley Shapiro, MD. Gastroenterologist at Duly Health and Care (Hoffman Estates, Ill.): The proposed 4.42 percent pay cut for physicians is appalling and shows lack of appreciation for our profession. Soaring inflation results in increased overhead, including labor and supplies, vital to running a medical practice. I anticipate this will lead to closures of smaller medical practices, as they will not be able to absorb the increasing costs due to decreasing revenues. Some internal medicine physicians will likely turn to concierge medicine in order to enhance revenue. As Medicare puts the squeeze on physicians, many will retire earlier than expected, decreasing availability for patients. More than 43 percent of the physician workforce is 55 and older. These changes will result in physician shortages and decreased access to care for our patients, especially in the primary care setting. I can only hope our medical societies can adequately express these concerns to Congress and amend these proposed changes.

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