Baku, June 29 (AZERTAC). Here are five trends on physician perspective of the United States healthcare system, addressing healthcare reform, industry consolidation, compensation, accountable care organizations and physician opinions on the future. The data is based on the Deloitte's Physician Perspectives Survey.

Industry consolidation reaches specialists. The healthcare industry has seen a massive trend toward consolidation and although most physicians reported not having considered consolidating in the past, two-thirds foresee physicians and hospitals becoming more integrated within the next one to three years. Around 73 percent of surgical specialists reported consolidation between physicians and hospitals as "likely" or "very likely" in the near future.

Physicians who are later in their career and used to working independently are finding it more challenging to make the adjustments for being part of a larger organization," says Mitch Morris, MD, a leader in Deloitte's U.S. health practice. "Physicians who own their practice are the CEO of their own company and becoming part of something larger is a significant cultural change. Younger physicians more often prefer to be employed and like the idea. They find being in an independent practice would be challenging and they like the security of the employed model."

Compensation remains in the decline. Surgeons are seeing reimbursement declines from Medicare and private payors alike, and employed surgeons rely on a variety of compensation models to sustain them in the future.

"In our experience, physicians are willing to engage and participate in improvement processes, and come to an agreement with the hospital about how to best share compensation," says Dr. Williams. "There is an overall anxiety, as there normally would be any time there is a big change for work and life, especially when it comes to new reimbursement methods because most specialists don't believe their income will be increased. However, some are participating in pilot programs for new payment methods because they feel it's better to be on the bus than miss it entirely. I think the general encouragement for physicians has been to avoid being dismissive and take a careful look at new programs because they are not going away."

Accountable care organization and bundled payment awareness. In 2012, fewer surgical specialists reported familiarity with accountable care organizations. However, around 57 percent of physicians believe that capitation will replace fee-for-service payments within the next three years and physicians already engaged in ACOs report some success in improving quality.

"Most ACOs are really engaging initially with primary care physicians and then will bring in subspecialty physicians as they mature because a lot of initiatives are with improving outcomes through prevention and other means," says Dr. Williams. "Surgical specialists are more involved in bundled payments. They are beginning to participate with the increased assumption of risk based on value."

Around 51 percent of physicians believe their income will fall dramatically over the next one to three years, with the number jumping to 68 percent among solo practice physicians. Around 90 percent of physicians report their greatest concern about financial viability under bundled payment structures as receiving inadequate payment and being penalized for factors outside of their control, according to the report. However, 80 percent of physicians believe trends in the next decade will involve interdisciplinary teams and coordinated care.

Attitude toward the future. Around 70 percent of all physicians are satisfied with practicing medicine, and the percentage is higher among surgical specialists than primary care physicians. Specialists cited the most satisfying aspect about practicing medicine is the patient relationships (41 percent), followed by protecting and promoting the health of individuals (38 percent).