Physicians and hospitals will become more integrated in the next three years, according to a survey by the Deloitte Center for Health Solutions (http://tinyurl.com/Deloitte-doc-survey). [Harry Greenspun, MD, senior adviser for health care transformation and technology at the Deloitte Center for Health Solutions, says, “While the term “integrated” was not specifically defined for respondents, physicians commonly interpret it to encompass a broad spectrum from loose affiliation to outright employment by a hospital.”] This, of course, continues a trend whose ramifications for health insurers we’ve explored (http://tinyurl.com/provider-power). Primary care physicians (PCPs) and surgeons are most likely to think that this will happen, but there is clear agreement among all providers.
The Deloitte survey says, “Physicians consolidated in the past one to two years to gain or retain income security (29% of all physicians who had consolidated) or leverage negotiation power with payers (21% of all physicians who had consolidated).”
Most physicians are pessimistic about the future of medicine, with 57% saying that the practice of medicine is in jeopardy and 72% that the best and brightest might not consider a career in medicine. Physicians believe that they face a trade-off between clinical autonomy and bargaining power. “Larger work settings offer better conditions for contracting with third-party payers (89% of all physicians feel this way) whereas clinical autonomy was a valued feature of and more likely to be a feature of solo practices (81% of all physicians).”
Half of physicians think that their incomes will fall dramatically in the next three years and nearly 8 in 10 believe that “mid-level professionals will play a bigger role in direct primary care delivery” and that “insurers will aggressively negotiate to preserve margins....”
Physicians believing that doctors and hospitals will become more integrated in the next 1–3 years, by medical specialty
Most satisfying element about practicing medicine
What keeps physicians going? Patient relationships and doing what they were trained to do: heal.