Top 10 Challenges Facing Physicians In 2017

More than ever before, physicians are facing an abundant amount of challenges. Declining reimbursement, changing payment models, and uncertainties surrounding new administration and the Affordable Care Act just to name a few. While the coming year presents many challenges to physicians, here are some of the top challenges most common among physicians that can also be less intimidating through further education and, of course, much preparation.

 

1.   MACRA

Healthcare reimbursements are migrating from volume to value. MACRA will most likely serve as the road map for other payers, so get used to the reporting requirements. The law directs physicians to choose one of two reimbursement paths—advanced alternative payment models (APMs) or the Merit-based Incentive Payment System (MIPS).

2.   Prior authorizations

Prior authorization requirements have increased steadily in recent years, and the growth trend shows no signs of abating in 2017. A 2015 Kaiser Family Foundation analysis of Medicare data found that 23% of drugs in private drug plans covered by Medicare Part D required prior authorizations, up from 8% in 2007. During the same period, the percentage of drugs carrying some type of utilization management restriction more than doubled, from 18% to 39%.

3.   Negotiating with payers

As payers move to consolidate, physicians find themselves facing the prospect of declining reimbursement and narrowing provider networks. Many doctors lament that payers now come to the table with a “take it or leave it” approach, forcing physicians to agree to one-sided contracts to maintain their patient head count.

4.   Staying motivated to practice medicine

Like everyone else, doctors want to enjoy their work, but they are finding it harder to do so. Physician professional dissatisfaction has been steadily growing in recent years, driven by increasing workloads and frustration at being unable to spend sufficient time with patients. By now the causes of physician unhappiness are well known. They include ever-increasing amounts of time spent on administrative tasks and documentation, frustration with the demands imposed by electronic health records and the feeling they are having to cede control of their practices to government regulators and third-party payers.

5.   Maintenance of certification

More changes are on the way for physicians certifying in their sub-specialties through the American Board of Internal Medicine’s (ABIM) maintenance of certification (MOC) process.Physicians feel as though a “board certification industrial complex” has been created by ABIM and MOC, says Christopher Unrein, DO, an internist and hospice/palliative care practitioner in Parker, Colorado. “Our profession’s very own medical societies, that we pay significant amounts of membership dues to, turn around that membership to sell us products in order to pass the exams and/or gain MOC points,” he says. “So not only is MOC a busy-work, anxiety-laden process, it is also one of financial opportunism. Physicians preying upon physicians — it disgusts me, as we are supposed to be a profession that cares and looks out for others.”

6.   Lack of EHR interoperability

Very few physicians have complete interoperability, which the nonprofit advocacy organization Center for Medical Interoperability defines as “the ability to share information across multiple technologies.”In fact, a study released by KLAS Research in October finds that a mere 6% of healthcare providers can effectively and efficiently share patient data with other clinicians who use an electronic health record (EHR) system different than their own.

7.   Patient frustration with rising costs

The rapid rise in copays, deductibles and prescription drug prices is causing concern among physicians who see patients skipping care as a result of these increasing healthcare costs.

8.   The non-adherent patient and “quality” care

Patients who dismiss medical advice are nothing new, but that attitude increasingly threatens to cost doctors as quality metrics become tied to compensation.

9.   Changing patient attitudes

Today’s patients are educating themselves more, presenting both a challenge and an opportunity for primary care physicians. Some, newly insured by the Affordable Care Act, may be coming to the doctor for the first time, and have questions and concerns they expect their new physician to answer. Other patients are angry. A recent Medical Economics reader poll suggests physicians are seeing that anger manifested during office visits as frustration with the cost of healthcare, from deductibles to surprise charges. Other patients are taking a consumerist approach to healthcare, looking for convenience and quick access.

10. Patient satisfaction scores

Patient satisfaction has become an increasingly important factor in how physicians are treated by their employers and insurers, thanks in part to government regulations. Dealing with the internet-savvy patient—but also attempting to make a personal connection with them—all while entering the data correctly into the practice’s electronic health record (EHR) system is a daunting but necessary task because of value-based care.

It seems like physicians have enough challenges in working with their patients to seek the best clinical outcomes. They really don’t need these other burdensome challenges injected by inefficient insurers, superfluous administrators, bureaucrats and legislative bodies. They need a well-designed single payer system instead – an improved Medicare for all.

-The Leading Physician of the World