Top 10 Physician complaints of 2012

Becker’s Hospital Review 12.31.2012

Written by Heather Punke

Having good relationships with physicians is paramount for hospitals, especially if they are implementing coordinated, accountable care. However, physicians have brought up several issues they have with hospitals that can deteriorate that all-important relationship.Rochell Pierce, vice president of physician relationship management for Aegis Health Group, says physicians across the country in virtually every market size have complained the most about these 10 issues in the past year and a half.

1. Financial concerns. Physicians have been hyper-focused on financial issues recently. They seem to be most concerned about decreasing Medicare and Medicaid payments and the increasing overhead and price of running a medical practice. “Revenues are decreasing across the board,” says Ms. Pierce. “It’s a big concern for them.”
Beyond payment, physicians also question the fact that hospital prices for outpatient procedures are much higher than payment they receive if performing the procedure in an office or ambulatory setting. “We hear feedback from physicians wanting [hospital] rates to be comparable to a free-standing center,” Ms. Pierce explains.

2. Lack of practice support. Whether physicians are employed or independent, they want more support from hospitals for their medical practices. “We’re seeing physicians ask for more and more support,” says Ms. Pierce.

Many physicians are specifically looking for more marketing support from hospitals. Hospitals are able to market their employed physicians; however, Ms. Pierce notes that hospitals may not be able to market independent physicians due to legal restrictions.

Further, employed physicians are looking to hospitals to provide better-trained staff members and on-going training of the staff they do have at their practice. Physicians are also looking for IT support. They want technological support from hospitals to help make their practices more efficient.

3. Electronic medical records. Physicians have two concerns with EMRs, depending on where the hospital is in the road to implementation.

Some hospitals have not yet fully implemented EMR systems. In that situation, physicians have issues with access to patient information — they want the easy access to information that comes along with EMR implementation.

Hospitals are not off the hook once they implement EMRs, however. “There are complaints about ease of use and needing more training,” says Ms. Pierce. Also, physicians have found that their office work flow and efficiency are affected when a hospital is in the process of rolling out EMRs. Ms. Pierce notes that this problem will most likely take care of itself in time as systems get fully implemented and everyone gets used to using them.

4. Poor communication related to patient information. In virtually any size market, physicians have difficulty coordinating care and getting clinical information about their patients from hospitals. This is especially important for hospitals to address due to the importance placed on clinical integration by healthcare reform. However, this issue should diminish with EMR implementation.

5. Ease of scheduling outpatient and other procedures. Physicians have complained about how difficult it is to schedule outpatient procedures for their patients. “They feel as if they are referring into a black hole,” says Ms. Pierce. Physicians across the country have also found that admission and registration processes for outpatient and imaging procedures and inpatient tests are not efficient.

6. Access to outpatient services. One part of outpatient access issues has to do with simple availability of the tests. Physicians have had difficulty scheduling same-day, weekend or evening appointments for their patients, which causes frustration. “This is seen as a concern no matter the size or location of a hospital,” says Ms. Pierce.

Another concern about outpatient services is that many hospitals are still using a fax order system to get information to the correct department. “It is outdated and problematic,” says Ms. Pierce. “It leaves referring physicians feeling frustrated.” This problem could be lessened once hospitals begin to implement EMRs.

7. Work/life balance.
Physicians feel as though their workload is increasing, and not with patient care — with administrative duties. “They are spending too much time on the computer and not enough time at the bedside,” says Ms. Pierce.

Physicians also feel as though they are not getting enough time off from work to be with their families.

8. Poor communication from administration. C-suite executive tend to only maintain contact with a handful of physicians, according to Ms. Pierce. That leaves the rest of the hospital’s physicians feeling as if they are not listened to. They want the C-suite to be more responsive to their requests and concerns.

Also, hospital administrators have been communicating their strategy to move forward under healthcare reform to physicians. “Physicians are looking to hospitals to provide leadership, education and information on what is going on,” says Ms. Pierce. Unfortunately, hospitals have not been giving that to physicians because they too are somewhat uncertain on how to proceed. However, Ms. Pierce says giving some information, even if it subject to change, is better than giving none at all.

9. Medical group inclusion. Hospitals across the country are rapidly forming their own medical groups or employing physicians as they fight for dominant market share. Independent physicians are becoming a rare thing, and the trend leaves physicians with two choices: join with other physicians to form larger independent medical groups or join forces with a hospital.

“Physicians are hinging their decision on information provided by the hospital,” says Ms. Pierce, but that information is often not given in a timely manner or is not thorough, leaving physicians frustrated.

10. Availability and quality of specialists. In most networks, primary care physicians are beginning to have to go out of network to find quality specialists and subspecialists, simply because their network doesn’t have them. Ms. Pierce says this relates back to the physician shortage, and the issue will most likely worsen with time.

It is important for hospital leaders to begin to address these 10 complaints, especially because hospitals are competing with one another to align with physicians in their markets. If a physician is unhappy with a hospital or health system, the time is ripe for them to leave. As Ms. Pierce says, “If [you] don’t, competitors will” work to address these complaints.

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