Another 55 percent of surveyed doctors believe others will scale back hours

Most physicians have a pessimistic outlook on the future of medicine, citing eroding autonomy and falling income, a survey of more than 600 doctors found.
Six in 10 physicians (62 percent) said it is likely many of their colleagues will retire earlier than planned in the next 1 to 3 years, a survey from Deloitte Center for Health Solutions found. That perception is uniform across age, gender, and specialty, it said.
Another 55 percent of surveyed doctors believe others will scale back hours because of the way medicine is changing, but the survey didn't elaborate greatly on how it was changing. Three-quarters think the best and brightest may not consider a career in medicine, although that is an increase from the 2011 survey result of 69 percent.
"Physicians recognize 'the new normal' will necessitate major changes in the profession that require them to practice in different settings as part of a larger organization that uses technologies and team-based models for consumer (patient) care," the survey's findings stated.
About two-thirds of the survey responders said they believe physicians and hospitals will become more integrated in coming years. In the last 2 years, 31 percent moved into a larger practice, results found. Nearly eight in 10 believe midlevel providers will play a larger role in directing primary care.
Four in 10 doctors reported their take-home pay decreased from 2011 to 2012, and more than half said the pay cut was 10 percent or less, according to Deloitte. Among physicians reporting a pay cut, four in 10 blame the Affordable Care Act (ACA), and 48 percent of all doctors believed their income would drop again in 2012 as a result of the health reform law.
Other findings:

• 26 percent believe Medicare's sustainable growth rate formula will be repealed in the next 1 to 3 years
• One in 10 believe medical liability reform will pass Congress in the next 1 to 3 years
• A quarter of physicians would place new or additional limits on accepting Medicare patients if there were payment changes
• 55 percent of physicians believe the hospital-doctor relationship will suffer as admitting privileges are put at risk to comply with hospital standards of meaningful use
• 31 percent gave the U.S. healthcare system a favorable grade of "A or B" compared with 35 percent in 2011

Despite those pessimistic views, seven of 10 said they were satisfied about practicing medicine, although that number was lower for primary care providers and higher for younger age groups, the survey found. Dissatisfaction was attributed toward less time with patients, long hours, and dealing with Medicare, Medicaid, and government regulations.
Speaking of the ACA, fewer physicians (38 percent in 2012) believe the ACA is a step in the wrong direction compared with 44 percent in 2011. The number who think the law is a good place to start remained the same.
Two-thirds of physicians in the Deloitte survey say they use an electronic health record (EHR) that meets meaningful use stage 1 requirements, but that number has been lower in other surveys. Three in 5 respondents were satisfied with their EHR.
Deloitte mailed the survey to more than 20,000 physicians selected from the American Medical Association's master file. Just 613 returned completed surveys, giving a margin of error of 3.9 percent at the 0.95 confidence level.

Police Departments Beg And Barter For Ammo While DHS Buys Up 1.6 Billion Rounds In Past Year

The nationwide shortage of ammunition has left many police departments scrambling to get their hands on the necessary rounds - with some even bartering among each other.
Meanwhile, Rep. Timothy Huelskamp (R-Kansas) says the Department of Homeland Security (DHS) has failed to respond to multiple members of Congress asking why DHS bought more than 1.6 billion rounds in the past year.
Police Chief Cameron Arthur of Jenks, Oklahoma says, "Ammunition and assault weapons in general have skyrocketed...In addition to the fact, not only is it a lot more expensive, but the time to get it could be six months to a year, or in some cases even longer."
Arthur says he is waiting on an order placed last October and that many departments have begun to trade and barter with each other because of the high demand.
"Most police departments are having a very difficult time even getting the necessary ammunition for handguns, shotguns and especially rifles," Arthur said.
"With the delay in ammunition, some departments are limiting the number of rounds they carry in their handgun because of the shortage of ammunition. We get to the point where it is difficult to have enough ammo to train and also equip the officers."
Chief Pryor of Rollingwood, Texas says of the shortage:
"We started making phone calls and realized there is a waiting list up to a year.  We have to limit the amount of times we go and train because we want to keep an adequate stock."
"Nobody can get us ammunition at this point," says Sgt. Jason LaCross of the Bozeman, Montana police department.
LaCross says that manufacturers are so far behind that they won't even give him a quote for an order.
"We have no estimated time on when it will even be available," LaCross says.
He worries that when ammunition is finally available the high price will squeeze the department's budget.
"The other options are to reduce the amount of training and things like that," he said.
The Hamilton County Sheriff's Department has also cut down on firearm training due to the high cost and low supply of ammunition.
"The concern over firearms availability and ammunition availability and potentials of gun control certainly has impacted the availability of ammunition purchased locally," Sgt. Jody Mays says.
He says the department has cut a third of their normal in service firearm training:
"It's forced us...to use ammunition more economically."
Police Chief John Mabry in Marinette, Wisconsin says, "Ammo is expensive and lot tougher to get. People don't have it in stock and it's back-ordered."
His colleague, Menominee Chief, Brett Botbyl agrees: "We're looking at a four to nine-month wait."
Some departments have even applied for grants to pay for the high-priced ammunition.
"The Florence Police Department is looking for some help filling its clips," reports Cincinnati.com
Chief Tom Szurlinski says the grant would go a long way given the price and limited supply of ammunition.

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