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State of Primary Care in 2012

Low reimbursements, rising costs fuel physician concerns

Reimbursements, the costs of running a business, and regulatory complexities rank as the top three most pressing issues facing primary care physicians (PCPs).

New data, from a Medical Economics State of Primary Care survey, show that these business-related issues trump concerns related to malpractice, competition, and consolidation of practices within the community.

Top business challenges and Top issues facing physicians
The state of the healthcare in 2012 could be characterized as one in the throes of major transition, says Glen R. Stream, MD, MBI, FAAFP, president of the American Academy of Family Physicians (AAFP).

Although healthcare expenditures represent nearly 18% of the United States gross domestic product for 2010, the highest of any country in the world, physicians in 2012 are feeling the pinch from low reimbursements from private and public payers, especially within the primary care sector. Nearly 46% of the 619 physicians responding to the Medical Economics survey cite overall reimbursement rates as the one source posing the most significant challenge to their practices.

The Centers for Disease Control and Prevention (CDC) estimates that 956 million physician office visits occur each year, and about 60% of those visits are directed to PCPs. The most frequent reason for the visit remains the general medical examination, the CDC adds, with hypertension ranking the second most frequent reason for an office visit.

According to a 2012 Health Affairs report, doctor and clinical services represented 20% of the $2.3 trillion spent on healthcare in the United States, and hospital care comprised 31% of the pie.

The 10,000-foot view of healthcare services might depict a robust and growing specialty economy. For some, it is. At the ground level, you and your colleagues are experiencing a much different reality.

In fact, healthcare in 2012 could be characterized as going through a kind of bipolar disorder: While the emphasis is on reducing costs, the U.S. government, through the adoption of the Affordable Care Act (ACA), is opening up access to care. The demand, some doctors say, doesn't necessarily translate into enough income to keep some primary care practices economically viable.

In the public sector, further evidence is reported from a Physicians Foundation report titled "The Future of Medical Practice" calling for Medicare reimbursement increases.

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