Physicians, frustrated by declining incomes and increasing market leverage, are aggressively increasing prices and service volume while providing traditional services that are less lucrative, according to an analysis of 12 metropolitan markets by researchers with the Center for Studying Health System Change. The study, conducted between September 2002 and May 2003, found that most physicians continued to participate in Medicare and Medicaid but were shunning other traditionally provided community service activities, such as accepting on-call duty without extra pay. In addition, more physicians were refusing to accept new patients admitted through emergency departments because of liability concerns and avoiding inpatient care to maintain office volumes. "A common theme across markets was that harsh business realities had left physicians feeling financially beleaguered, forcing them to become more business-oriented," reports the study published in the March/April issue of Health Affairs. The authors suggested that policymakers review antikickback and self-referral laws and consider how physicians' financial interests could be aligned with the larger goals of cost control and quality. Read an abstract. -- by Modern Physician/MP Stat
Editor's note: The Web exclusive on modernhealthcare.com discusses the relationship between EMTALA regulations and on-call duty. Read the story.