The Top Five Issues to Affect Physicians and Patients in 2013

As the New Year approaches, The Physicians Foundation has identified five issues that are likely to have a significant effect on patients and physicians in 2013:

1. Ongoing uncertainty over PPACA– Despite the Supreme Court decision upholding most of the provisions in the Patient Protection and Affordable Care Act (PPACA) and the re-election of President Obama, there is still considerable uncertainty among patients and physicians about implementation. A number of key areas within PPACA have yet to be fully worked out including accountable care organizations (ACOs), health insurance exchanges, the Medicare physician fee schedule, and the independent payment advisory board. The Foundation’s 2012 Biennial Physician Survey found that uncertainty surrounding health reform was among the key factors contributing to 77% of physicians being pessimistic about the future of medicine.

2. Consolidation – Large hospital systems and medical groups continue to acquire smaller and solo private practices at a steady rate. Many solo physicians are seeking employment with hospital systems. However, consolidation could lead to monopolistic concerns, raise the cost of care, and reduce the viability and competitiveness of solo and private practice.

3. New Patients Entering the System – In 2014, PPACA will introduce more than 30 million new patients to the U.S. healthcare system.  If physician practice patterns continue, Americans are likely to experience significant challenges getting care. If physicians continue to work fewer hours, more than 47,000 full-time-equivalent physicians will be lost from the workforce in the next four years. Also, 52% of physicians have limited the access of Medicare patients to their practices or are planning to do so.

4. Erosion of physician autonomy – Physician autonomy is deteriorating markedly, particularly related with non-clinical personnel interfering in medical decisions. Many of the factors contributing to a loss of physician autonomy include problematic and decreasing reimbursements, defensive medicine, and an increasingly burdensome regulatory environment.

5. Growing administrative burdens – Increasing administrative and government regulations were cited as one of the chief factors contributing to pervasive physician discontent, according to the Foundation’s 2012 Biennial Physician Survey. Excessive red tape regulations are forcing many physicians to spend less time with patients in order to deal with non-clinical paper work and other administrative burdens. The Foundation suggests creating a Federal Commission for Administrative Simplification in Medicine to evaluate cumbersome physician reporting requirements that do not save money or reduce patient risk. For more information, visit

Last Updated 05/25/2022

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