9 Issues Facing Doctors in 2013 (and After)

Heading into 2013, the Sustainable Growth Formula issue remains unresolved. Despite the enormity of the SGR, which proposes reduced payments to doctors, it isn't even foremost in the minds of some physicians because of so many other complicated dilemmas.

A few weeks ago, when top officials of The Physicians Foundation went to Washington, D.C., to visit Congressional offices, they were greeted with: "We know what you're going to be talking about," recalls Lou Goodman, PhD, the foundation president, in a recent conversation with HealthLeaders Media. Sure, it was going to be the SGR. If Congress doesn't impose a "doc fix" to avoid significant cuts, the shortfall is pegged at 27% beginning January 1.

Not so. "No, I'm not going to talk about the S-word," Goodman said, shocking them into listening.

Instead, Goodman wanted to talk about the foundation's annual Watch List, covering major issues confronting physicians. The list is based on a compilation of Physicians Foundation reports over the previous year. For 2013, much of the Watch List is focused on ramifications of the Patient Protection and Affordable Care Act, questions about physician autonomy, hospital consolidation, physician administrative burdens, and the impending 32 million more uninsured into the healthcare system, as well as the overall "despondency" and "unhappiness" of doctors.

The SGR didn't make the list because, Goodman says, it is "a symptom of other issues. It is something we have to figure out, and roll into what we do as we go forward." As more doctors become part of hospital systems and payment models such as bundling or gainsharing are evaluated, the "issue of SGR loses its significance, [and] really [becomes] a focus of individuals and private practice," he says.

As Goodman sees it, 2013 will be a "watershed" year. "So many doctors are unhappy and concerned what the future is bringing," he says.