By Clive Riddle, December 15, 2011

The Deloitte Center for Health Solutions released their latest study this week: Physician perspectives about health care reform and the future of the medical profession.

Paul Keckley, Ph.D., the Center's Executive Director tells us "the data confirms that physicians are resistant to reform and are frustrated with the direction of the profession. Understanding the view of the physician is fundamental to any attempt to change the health care model – this is the person prescribing the medicine, ordering the test and performing the surgery."

While Deloitte concludes physicians are not happy campers in this respect, it should be noted their positions are not that different than many other stakeholder groups.

Their findings are based on a survey commissioned by Deloitte of 501 physicians obtained as a random sample from the AMA database, with responses weighted by years in practice according to gender, region and practice specialty to match AMA demographics.

The 40 page report paints the following picture:

• Physicians gave the U.S. health system a grade as follows: A - 8%; B 27%; C - 45%; D 15% and F - 5%. Older physicians rates the system higher (40% over age 60 gave an A or B grade compared to 29% for under age 39.) Midwestern physicians also rated the system higher (44% gave an A or B; compared to 29% in the Northeast.)

• 71% say they are somewhat informed about the Affordable care Act while 23% say they are very informed

• 44% feel the Act is a good start, 44% feel it is a step in the wrong direction; and 12% don't know

• "Consumer behavior such as unhealthy lifestyles that can lead to obesity" was the most often cited factor influencing overall health care costs (multiple answers allowed - with 94% citing this factor) followed by "defensive medicine" (91%) and "Insurance company administrative costs" (89%)

• "Increased government managed care programs for Medicare and Medicaid" was the most often cited expected result of the Act (multiple answers allowed with 85% citing this result) followed by "Increased "wait times for primary care appointments due to lack of providers" (83%) and "fewer uninsured (77%)

• 73% believe there is a high likelihood ERs could be overwhelmed if PCP visit slots are full due to changes in the health care reform law

• 13% of physicians felt very engaged in the health reform debate and 44% felt somewhat engaged

• 78% of physicians say they would be comfortable if the model for liability reform involved a separate medical court system with binding arbitration and victims’ fund

• 4% believe their income will increase next year as a result of health reform; 48% believe their income will decrease

• "An administrative role (i.e., Chief Medical Officer, Chief Executive Officer, etc.) in a large health care delivery system" was cited most often as the ideal practice setting (multiple answers allowed with 70% citing this setting) followed by "concierge medicine practice that does not take insurance" (64%) and "large integrated health system that owns its own health insurance plan, hospitals and medical practices" (60&). The settings at the bottom of the list were employer based clinics (19%) and retail clinics (21%).