Struggling Primary Care Physicians Could Undermine Affordable Care Act

Primary Care Physicians Facing Financial Difficulties
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26 percent of primary care physicians report poor financial health in the most recent QuantiaMD Physician Wellbeing Index. This financial instability, coupled with mounting professional challenges, and a dearth of incentives, are major factors driving new physicians away from primary care and into more lucrative subspecialties. This trend is especially worrying at a time when key aspects of the Patient Protection and Affordable Care Act (ACA) rely heavily on primary care physicians for success.

81 percent of physician practice owners report profits are down from last year and 43 percent are having trouble covering their costsQuantiaMD primary care physicians paint an alarming picture of their financial status. Some key findings from the 26 percent of physicians reporting poor financial health include:

  • >>A decrease in reimbursements is cited as the top negative financial impact to their practices (80 percent), followed closely by a rise in operating costs (71 percent).
  • >>49 percent of employed primary care physicians have not had a salary increase in one to two years and an alarming 18 percent have experienced salary cuts.

These findings are particularly distressing in light of the recent Supreme Court decision to uphold the ACA, which focuses on preventative services and continuity of care and relies on primary care-centric models such as the Patient-Centered Medical Home. Major provisions of the ACA may become effective as early as 2013 and will expand access to primary care for millions of new patients. With the possibility of 30 million currently uninsured Americans entering the system, it is estimated that over 60,000 new physicians will be needed.

For many primary care physicians, the motivation to remain in the profession is diminishing due to years of little to no increases in reimbursements that are not at all keeping pace with rising costs. Business operating expenditures and implementation fees for new technologies such as EMRs and CPOEs are crippling practices and leading many to question the long-term sustainability of the profession.

"The financial struggles of a number of primary care physicians is disturbing news," said Richard Roberts, MD, JD, President of the World Organization of Family Doctors, Past President of the American Academy of Family Physicians. "Even more concerning is that health reform depends on having more primary care doctors playing an even more important role in health care, through new models such as the Patient-Centered Medical Home. If financial challenges dissuade young physicians from entering careers in primary care or cause established primary care physicians to leave their practices, will there be enough primary care doctors for the influx of patients expected to enter the system?"