Universal Health Care: More Patients and Fewer Doctors?

Physicians voice concerns that under a Universal Healthcare System the number of new patients will increase dramatically, while the doctors available to treat them may decrease leading to quality and wait time issues.

Quality of care would decrease further--as it already has with lawyers and politicians forcing directed medical decisions.

Alpharetta, GA (Issues Wire / PRWEB) April 4, 2008 --The vast majority of practicing physicians in America favor some form of healthcare reform, However, they have serious concerns about how a revamped healthcare system will be implemented and how it will affect their practice management, earning potential and career plans, according to a recent survey commissioned by Jackson & Coker.

The 26-question survey, entitled Jackson & Coker's 2008 Healthcare Professionals' Opinions on Presidential Health Plans was e-mailed during March to thousands of physicians and health professionals across the nation, with over 1,000 participants responding. The survey polled physicians in major medical specialties regarding their views concerning "Universal Health Care," the specific healthcare proposals touted by the three presidential candidates, and the best ways to implement changes to the current healthcare system.

Although practitioners spanned the gamut in terms of professional experience, 62% of physicians indicated that they have practiced medicine fifteen years or more. With such a seasoned perspective on issues related to healthcare delivery, these doctors--as well as younger providers--voiced strong opinions regarding their ability to practice quality medicine and earn a good living.

The survey responses pointed out what physicians perceived as both favorable and unfavorable features of any proposed Universal Health Care system.

Favorable aspects of Universal Health Care

Among survey respondents, there was a near-consensus concerning intended favorable consequences of healthcare reform:

• Make health care more accessible to the uninsured
• Reduce costs associated with medical care
• Make prescription drugs much more affordable
• Streamline all facets of healthcare delivery.

--Increased standardization of regulations concerning patient care         6%
--More efficient processing of electronic medical records          46%
--Greater access to affordable prescription drugs             51%
--Doctors spending more quality time with each patient          43%
--All of the above.                   14%.

Clearly, those who favor some sort of healthcare reform--whether it's called Universal Health Care or something else--envision the potential for a number of positive changes occurring.

Possible unfavorable aspects

On the other hand, a sizeable amount of respondents expressed reservations concerning the practical implementation of healthcare reform and possible unintended, unfavorable consequences.

When asked whether the number of medical office support staff would likely increase or decrease, 37% felt the number would probably increase, 21% believed there will be little change, whereas 28% forecast a decrease in support staff.

Coupled with this was a question concerning possible wait time for medical procedures. A small number of physicians (4%) felt wait time might decrease. Sixteen percent believed that it might say the same. However, a whopping 60% selected "probably increase dramatically."

These questions should be put into context of how many persons would be covered under Universal Health Care. If healthcare coverage is "absolutely mandatory" (favored by 26% of respondents) versus "totally voluntary (37%), then theoretically over 300 million men, women and children would have access to some sort of patient care. Seen in another light, this would include approximately 46 million currently uninsured who would be brought into the system and "entitled" to receive medical treatment.    

What makes the issue particularly problematic is the current doctor shortage that is expected to worsen over the next several decades. The American Medical Association (AMA) forecasts a shortage of 85,000 physicians around 2020. There are many factors that account for such a dire forecast:

• The millions of Baby Boomers reaching retirement age and requiring greater medical care.
• Anticipated dramatic cuts in Medicare / Medicaid reimbursement.
• Decrease in medical school enrollment in certain physician specialties.
• Medicine viewed as a less-desirable career choice by college graduates.
• Doctors opting for a non-clinical career change--or leaving medicine altogether.

• No difference -- 7%
• Not sure - 14%
• Probably better - 32%
• Possibly worse - 47%

The bottom line is that many physicians are concerned about the amount of clinical work they will be expected to perform under UHC--with possibly decreased medical office support--resulting in increased waiting time for patients.

All of these potential factors influencing healthcare reform point to the potential for occupational burnout and /or a dramatic change in career plans, as evidenced by the comments of respondents.    

To capture their deep-seated feelings on these matters, the physicians surveyed were asked to comment on two related questions:

1.   "Do you feel that you, as a medical professional, will see personal benefit in an overhauled system proposed by your [favored presidential candidate?"

2.   "If universal health care is adopted, what factors might have a bearing on your career plans?'

The voluminous, unedited comments offered by respondents indicate their passionate opinions concerning how any proposed healthcare reform will affect them personally and professionally.

Respondents' Comments

A sampling of comments related to key survey questions illustrates the diversity of opinions expressed by physicians and other caregivers:

• "Luckily, I am at a point in my career that I will be retired before too much is changed. So I don't think it will play a terrific impact on my practice, but it will play a significant role in my health care."
• "No bearing. A physician should treat the sick."
• "I would seriously consider retiring from medicine."
• "The resultant increase in work load, brought about by giving access to health care to all citizens, would require many more professionals in the future to deliver the care, including longer careers."
• "I will not change careers since I work as a medical director for an MCO. I will, however, likely never return to clinical practice as the life-style of an Internist is too demanding. I do not believe free market forces should be removed from health care. We are already seeing a huge decrease in medical student applications and almost a quarter of the U.S. physicians are IMG's (International Medical Graduates). If we get a universal system we will increase our dependence on IMG's right at the time we need more trained providers with the aging baby boomers."
• A revamped healthcare system "must increase use of midlevel providers for more efficient care."
• "Making health care an entitlement of everyone would make me leave health care altogether. We are too much of an entitlement society."
• 'I actually think that use of Nurse Practitioners should increase and use of physicians would become more for specialized care. As a result, routine medical visits would decrease plus nursing has always had a strong providing of prevention."
• "I suspect that MDs in private practice may have some reductions in their income if a more universal health insurance is implemented."
• What matters is "the reaction of my group to the changes in the environment. If they increase the workload to maximize profits, I will burn out."
• "I presently work in a Community Health Clinic and I don't expect any change in that with a National Health Program.
• "Quality of care would decrease further--as it already has with lawyers and politicians forcing directed medical decisions."
• "At my age, I will continue to work. I think that medicine as a career will become less desirable."
• 'If there is no student loan relief, and if physician salaries decrease or expectations increase with UHC, I will no longer be able to practice medicine."
• "I have recently retired (at age 60) because I could not earn a living with 80% Medicaid practice. I would welcome discussion of UHC models, with options for purchase of more extensive care."
• "Since I specialize in providing care to the uninsured, my job might change a great deal; I might be able to participate in a practice more like most other physicians' practices."

"The wide variety of views expressed by the survey participants express how complex the notion of Universal Health Care really is," mentions Sandra Garrett, president of Jackson & Coker.

"Hopefully, the survey responses and specific comments will be taken seriously by the presidential candidates and anyone else who has serious input into the ongoing healthcare reform debate," she adds.

About Jackson & Coker

Begun over 30 years ago, Jackson & Coker is a prominent physician recruitment firm headquartered in Alpharetta, GA. The firm has two divisions: Locum Tenens (temporary staffing) and Retained Search (permanent placement). The company offers physician jobs such as: anesthesiology jobs, psychiatry jobs, surgery jobs, internal medicine jobs, radiology jobs, and family practice jobs.Additionally the company matches physicians in over 40 medical specialties--as well as advanced practitioners--with appealing temporary or permanent practice opportunities.

Jackson & Coker is a member of a "family of companies" known as Jackson Healthcare (JH). The corporation provides information technology and human resources solutions to hospitals and healthcare organizations around the nation. Jackson Healthcare was selected by Atlanta Business Chronicle as among "Atlanta's Top 10 Fastest-growing Companies" and designated by Inc. Magazine as one of the "Top 100 Health Companies" in the Inc. 5000's ranking of growing entrepreneurial organizations.

More information concerning Jackson & Coker--along with the monthly Jackson & Coker Industry Report --can be found at the Jackson & Coker website.

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