Managed Care Pressures Resulting in Unhappy Docs
Mounting managed care pressures are taking their toll on physician attitudes, creating dissatisfaction with their practices, according to a survey by the University of California-San Francisco. The pressure to see more patients, limit referrals or limit what they can tell patients are among the top concerns that doctors say affect their ability to deliver high-quality patient care.
The survey of 766 physicians in managed care systems found that:
- 75% felt pressure to see more patients;
- 57% felt pressure to limit referrals; and
- 24% felt the pressure to see more patients compromises patient care and and 17% felt pressure to limit referrals compromises patient care.
On the other hand, managed care organizations that offer incentives for boosting patient satisfaction are more likely to result in "very satisfied" physicians, according to the survey, published in the Nov. 19 issue of The New England Journal of Medicine.
In other industry news, flat compensation may contribute to increased frustration among primary care physicians and specialists. In 1997, compensation inched up.86 percent to $135,791 for primary care physicians and decreased.48 percent to $220,476 for specialists, according to the 1998 Physician Compensation and Production Survey by the Medical Group Management Association (MGMA) in Denver. The study finds that while the number of primary care physicians has increased nationwide, salaries have not.
(UCSF, 415/476-9000; MGMA, Dennis Barnhardt, 303/397-7870)
Report Card Shows Need For Lifestyle Changes
American's health got mixed grades in the new Gallup "health report card." The results reflect the aggressive strides made in promoting health screenings and medical checkups and highlight areas where improvement is needed, namely in lifestyle changes.
The majority of Americans are dying of self-inflicted problems, not from incurable diseases, says George H. Gallup, the Gallup Institute's co-director.
The survey of 3,140 people, was commissioned by the American Medical Association, is a point of comparison for other health report cards.
Among the good news:
- More than 80 percent of Americans had a medical checkup and health screening in the past year.
- More than 25 percent changed their eating habits to lower cholesterol levels.
- 90 percent of women had a Pap test and nearly 75 percent of women did regular breast exams.
And the bad news:
- 50 percent of those surveyed are overweight.
- 26 percent smoke.
- Only 60 percent of those between the ages of 25 and 64 engage in strenuous exercise.
(AMA, 312/464-5000)
Despite Cancer Risk, Cigars Get Good Press
The increasingly cool, often sexy portrayal of cigar smoking is a concern among public health officials, particularly in the cancer advocacy community. A new study by the University of California-San Francisco, which tracked 391 articles on cigar smoking, found that 63 percent of articles portrayed smoking in a positive way for men and women while only 13 percent conveyed a negative image. Twenty-four percent of the coverage was neutral.
The articles often focused on celebrity smoking and implied an association between cigar smoking and upscale affinities for fine wine, gourmet food and financial success.
To demystify this intriguing stogie image, researchers suggest:
- counter-advertising that creates a climate of cigar-smoking being unsophisticated; and
- including cigars in tobacco control efforts.
(UCSF, 415/476-9000)