Independent Physician Views on the Affordable Care Act

Though it's been more than six years since it was signed into law, the Affordable Care Act (ACA) is just as hot a topic as ever. With elections right around the corner, everyone has an opinion on the ACA. In March, Donald Trump said he was going to replace it with "something terrific." Hillary Clinton wants to protect it, though she's not opposed to calling it Hillarycare. But what do doctors think about the ACA?

CompHealth recently surveyed nearly 1,000 physicians across the country about their feelings toward the ACA and how it affects their career.

Here are a few things we learned:

1. The majority of physicians view the ACA unfavorably.

According to the survey, 51 percent rate the law either "very unfavorable" or "somewhat unfavorable." Only 30 percent gave it a favorable rating.

2. Private practice physicians view the ACA most negatively.

We surveyed doctors in private practice, groups, and hospitals. Only 20 percent of private practice physicians view the law favorably, compared to 26 percent in group practices, and 35 percent of hospital-employed physicians. This isn't too surprising, given:

• 86 percent of private practice physicians say they're improperly compensated by the ACA

• 55 percent say their salary has been negatively impacted - and 28 percent say it has "decreased greatly" since passage of the law

• 58 percent of private practice doctors think their overall medical practice has been negatively affected by the ACA

3. The ACA provides greater access to healthcare but at higher costs.

Almost half of doctors surveyed think the ACA helps with the accessibility of healthcare for patients. However, they say it also costs patients more and hinders the doctor's ability to help patients. More than 40 percent of surveyed doctors stated that the ACA negatively impacted the cost of healthcare, overall medical practice, the ability to meet patient demand, and their overall salary.

4. The ACA reduces time with patients.

With more accessibility to insurance under the ACA, 35 percent of physicians think that the number of patients they see increased after the statute went into effect. As a result, some physicians have had to cut the time they spend with each patient. According to the survey, 44 percent of physicians think they spend less time with their patients, while 54 percent of physicians say their time with patients has stayed the same.

5. Physicians are dealing with more busy work.

Many doctors feel the ACA has created more billing and insurance paperwork. In fact, 68 percent claim they spend too much of their time at work entering data into EHRs, and 59 percent say they spend too much time doing paperwork. Private practice physicians report being more burdened by paperwork than those in hospital-based practice.

6. More doctors are taking second jobs.

Many physicians are seeking additional employment, mainly to supplement their income. Locum tenens is the most popular second job, followed by moonlighting, and consulting. Among the 41 percent of physicians who took an additional job, almost half of them said they took it because their income had decreased.

7. More than one-third of physicians are more inclined to leave medicine.

According to the survey, 36 percent of physicians are more inclined to quit the medical profession because of the ACA. That number is even higher among private practice physicians, 45 percent of whom said they were more inclined to quit.

Though I found the results of the survey to be interesting, they weren't particularly surprising. I am constantly speaking with doctors who are feeling burned out by mounting paperwork and disheartened by less time with patients. Throw in declining reimbursement and it's easy to see why doctors would think about changing careers.

But with an ever-increasing physician shortage, we can't afford to lose any physicians. Locum tenens assignments - whether they're used as a second job, or a replacement for a full-time job - are one way for physicians to combat some of the frustrations they're feeling with the ACA. Rather than receiving pay based on reimbursement, locum tenens physicians negotiate rates directly with their staffing agency. They don't deal with the same volume of paperwork as practice owners and, as a result, they have more time to spend with patients.

But locum tenens is just part of the solution. Regardless of how each of us feels about the ACA, we all need to find ways to keep doctors in medicine.