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¹Strategem of Alabama, Inc., Mobile, USA.

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Surgeons report decreased income and practice satisfaction due to healthcare system changes, including Medicare fee schedules and managed care. Many surgeons express support for a single-payor system.

Area of Science:

Health Services Research
Surgical Practice Management
Healthcare Policy

Background:

The healthcare delivery system has undergone significant changes impacting surgical practices.
Medicare fee schedule implementation and managed care penetration are key influences.

Purpose of the Study:

To assess the impact of recent healthcare system changes on surgeons' reimbursement, income, and practice satisfaction.
To evaluate surgeons' perceptions of care quality under managed care gatekeeper systems.
To gauge surgeon support for a federalized single-payor healthcare system.

Main Methods:

Survey of practicing surgeons regarding practice changes, income, satisfaction, and system preferences.
Analysis of reported effects of Medicare fee schedule and managed care.

Related Experiment Videos

Assessment of referral patterns and perceived quality of care.

Main Results:

Sixty percent of surgeons reported decreased net practice income since 1992.
Fifteen percent of referrals from gatekeeper physicians were perceived to decrease care quality.
Forty percent of surgeons showed enthusiasm for a federalized single-payor system.

Conclusions:

Healthcare system reforms have negatively impacted surgeons' financial well-being and practice satisfaction.
Concerns exist regarding the quality of care influenced by managed care gatekeeper referrals.
A significant portion of surgeons are receptive to a single-payor healthcare model.