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Physicians Rate Healthcare Access Report: Ongoing Problem for Patients

Jennifer Nelson | August 24, 2022 | Contributor Information

The United States is now sharply divided on many important questions, and physicians are part of the dialogue. We asked physicians for their opinions on 10 controversial social issues that Americans feel strongly about — where they stand, their relative importance, and how each issue has affected their work lives and families.

At a time when 1 in 10 people lack health insurance in this country, according to the US Department of Health and Human Services, physicians should be particularly attuned to how healthcare access affects their patient care and practices.

Over 2340 physicians in more than 29 specialties gave their opinions on healthcare access issues.

(Note: Some totals in this presentation do not equal 100% due to rounding.)

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Physicians Rate Healthcare Access Report: Ongoing Problem for Patients

Jennifer Nelson | August 24, 2022 | Contributor Information

Why are physicians under age 45 somewhat likelier to see healthcare access as an important issue than older doctors are?

The Association of American Medical Colleges reports that the COVID-19 pandemic highlighted many disparities in access to healthcare services and exposed vulnerabilities in our healthcare system. Perhaps some physicians in the trenches and younger doctors were more attuned to those weaknesses.

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Physicians Rate Healthcare Access Report: Ongoing Problem for Patients

Jennifer Nelson | August 24, 2022 | Contributor Information

Why a physician in one region of the country may rank access to healthcare higher or lower than in another region is largely dependent on personal views and how they perceive access in their part of the country.

For instance, access to convenient care — such as extended clinic hours, availability of transportation for patients living in rural areas, and the cost of healthcare across regions — may all play a role in where physicians rank healthcare access among social issues.

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Physicians Rate Healthcare Access Report: Ongoing Problem for Patients

Jennifer Nelson | August 24, 2022 | Contributor Information

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Physicians Rate Healthcare Access Report: Ongoing Problem for Patients

Jennifer Nelson | August 24, 2022 | Contributor Information

About 7 in 10 physicians (69%) would like a single-payer system, either standalone or in combination with health insurance. This aligns as the majority of physicians (67%) prefer a single-payer option in addition to more traditional private insurance, rather than Medicare for all, according to a 2020 Survey of America's Physicians.

Many of the physicians in that survey believe that their insights are crucial to healthcare policy reform and improving access to quality care.

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Physicians Rate Healthcare Access Report: Ongoing Problem for Patients

Jennifer Nelson | August 24, 2022 | Contributor Information

Although strong majorities of both male and female doctors favor a system that includes single-payer delivery at least in part, women feel more strongly about that approach. Male physicians are more likely than female physicians to support the current health insurance system or to feel that guaranteed healthcare is unnecessary.

"It seems like our healthcare system here is structured in tiers and caters to 1) the affluent, 2) the middle class, and 3) Medicaid," said Vipindas Chengat, MD, an internist with MountainView Hospital in Las Vegas.

Chengat is married to a physician and they are both originally from India, where most healthcare is funded by the government, and they say it is more accessible and lower cost. Physicians' views on the healthcare system may be colored by their upbringing and life experience, among many other factors.

"I do see change coming in our healthcare system from the recent wave of innovation, AI, and digital technology. Hopefully, more and more people adopt and utilize these new digital tools and telemedicine services that offer lower-cost opportunities," said Chengat.

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Physicians Rate Healthcare Access Report: Ongoing Problem for Patients

Jennifer Nelson | August 24, 2022 | Contributor Information

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Physicians Rate Healthcare Access Report: Ongoing Problem for Patients

Jennifer Nelson | August 24, 2022 | Contributor Information

With 1 in 10 Americans owing medical debt, including 11 million who owe more than $10,000, according to the Kaiser Family Foundation, it's no surprise that at least half of the physicians in each region report patients having difficulty paying over the past 5 years.

"I have noticed that a decent number of patients over the past few years delayed care due to the pandemic, and some patients delay care due to fears of sticker shock and potential debt," says Chengat, who practices in the West North Central region.

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Physicians Rate Healthcare Access Report: Ongoing Problem for Patients

Jennifer Nelson | August 24, 2022 | Contributor Information

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Physicians Rate Healthcare Access Report: Ongoing Problem for Patients

Jennifer Nelson | August 24, 2022 | Contributor Information

About 7 in 10 doctors report that their workplace offers alternative ways for patients to pay their bills and medical expenses. These may include installment plans or charity care, such as healthcare provided for free or reduced cost.

There are also discount programs like GoodRx and RxHope for prescriptions, and organizations like the PAN Foundation, which helps the uninsured with life-threatening illnesses. GoFundMe is a fundraising platform to solicit help from friends and family to pay healthcare expenses.

"The prices of medications, even generic, are continuously escalating. Several patients could not afford to buy a medication, which even when buying generic was costing between $300-400 monthly," says Oleg Bess, MD, an ob-gyn in Los Angeles and CEO of 4medica, a leading provider of clinical healthcare software management. "That just needs to be fixed."

(The response option "unsure" was excluded from the chart.)

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Physicians Rate Healthcare Access Report: Ongoing Problem for Patients

Jennifer Nelson | August 24, 2022 | Contributor Information

Although over half of US doctors think that healthcare access is a top social concern (see slide 2), this issue probably doesn't affect them or their families as much it affects families with lower incomes, those in rural parts of the country without access to doctors, and those with language barriers that make it difficult to seek care.

Further obstacles for families accessing healthcare include disabilities, inability to take time off work, and transportation issues, as well as a shortage of primary care doctors in some parts of the country as noted in Patient Engagement HIT. Over a third of physicians say that they or their families have been affected by healthcare access, too.

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Physicians Rate Healthcare Access Report: Ongoing Problem for Patients

Jennifer Nelson | August 24, 2022 | Contributor Information

The leading responses by physicians who are highly concerned with healthcare access are to donate money and volunteer. Physicians under 45 years old are more likely than their older counterparts to be activists on social media.

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Physicians Rate Healthcare Access Report: Ongoing Problem for Patients

Jennifer Nelson | August 24, 2022 | Contributor Information

The American Medical Association Center for Health Equity provides articles and resources so that healthcare access and equity become part of physicians' practice, process, performance, and outcomes.

Families USA is a national nonprofit working to ensure affordable healthcare for all Americans. Resources include initiatives, legislation, articles, reports, and advocacy guides. Toolkits include how to advocate for change.

The Association of Clinicians for the Underserved provides professional education, clinical tools, training, and technical assistance to enhance the development of clinicians who care for the underserved.

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Physicians Rate Healthcare Access Report: Ongoing Problem for Patients

Jennifer Nelson | August 24, 2022 | Contributor Information

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Physicians Rate Healthcare Access Report: Ongoing Problem for Patients

Jennifer Nelson | August 24, 2022 | Contributor Information

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