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20-11-2012 | Article

Physician survey identifies the good and the bad

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medwireNews: A study gauging physician experience in light of health reform policies has found that 59% of US physicians have patients who often face difficulty paying out-of-pocket costs for medical care.

The proportion is similar to that observed in a 2009 US physician report, yet exceeds other high-income countries, according to the Commonwealth Fund survey; which identified the Netherlands as the nation with the next highest volume of patients with financial difficulties, at 42%.

"US physicians are still telling us that patients often have difficulty paying for care," primary author and Commonwealth Fund (New York) Senior Vice President of policy, research, and evaluation, Cathy Schoen, told medwireNews. "We really stand out on this, and we have in the past [too]."

The study also found US doctors at the bottom of the list with regard to after-hour primary care service arrangements, with just 34% providing an alternative to hospital emergency care units.

Yet US physicians showed major progress in their implementation of health information technology. "The big finding this year," Schoen observed, "is how rapidly the use of electronic medical records has spread in the US, which we were delighted to see." A total of 70% of US physicians reported using electronic medical records, compared with 46% in 2009.

The Commonwealth Fund study included interviews with primary care physicians from a handful of developed countries to gain a "frontline view" of how various policies contribute to their experience with treating patients. The assessment also looked at communication across sites of care, feedback on practice performance, satisfaction, and physicians' overall views of their respective health systems.

Administrative distractions were a prominent problem, with US doctors and their staff spending 52% of their time ensuring patients get the care they need despite health coverage restrictions. "This is a major time concern, which is up from 3 years ago," Schoen said. "I think it reflects a very complicated insurance system."

Schoen argued that despite other countries in the survey having multiple competing private insurance plans, including Switzerland, Germany, and the Netherlands, "they don't ask for different versions of the same report or pay in a slightly different manner," she explained. "The systems are much simpler to work with. I think the survey is telling us that [the US] needs to focus on simplifying and streamlining."

Getting payers on the same page, according to Schoen, might appease the 85% of US doctors who expressed the need for fundamental changes to the American health system.

"We're absorbing physician and staff time that can otherwise be spent taking care of patients", she said. "This should be something that's easy to do if we have the will to do it."

By Peter Sergo, medwireNews Reporter