Executive summary
For those working on the front line of US healthcare, the pace of change must seem unrelenting. Powerful forces are affecting physician practice and healthcare institutions, and this has major implications for how we pay for care, how physicians make decisions and deliver care, and how organizations purchase and use drugs and devices. Although we have been talking about change for decades, this time, the trends may be irreversible.
To better explain the magnitude of these changes, in 2015, Bain & Company fielded a national survey of 632 physicians across specialties and 100 hospital procurement administrators in the US. (For a complete description of the methodology and the questions asked in the survey, see the Appendix.) This survey updates our 2011 Physician Attitudes Survey, which is discussed in the Bain publication “The new cost-conscious doctor: Changing America’s healthcare landscape.”
Our latest survey confirmed what we have long assumed to be true: The dynamics of change vary substantially across different regions of the country. To highlight these differences, we over-sampled two regions that have distinct market characteristics—Massachusetts and Mississippi/Alabama. As we expected, in states like Massachusetts, the pace of change is faster because of several factors: more competition among payers and provider organizations, and an activist policy and regulatory environment that promotes change.
Other than the strong regional differences, the most provocative findings were the speed of change since our last survey; the growing dissatisfaction of physicians working in management-led organizations; the accelerated loss of autonomy over clinical decision making; the increasing number of surgeons who report that procurement departments exert more influence now than ever over purchasing decisions; and, for some segments of the market, the corresponding relative decline in the role of the sales representative as an information source on new products.
In this chart digest, we present the results of our survey and outline the implications for three sectors: care financing and delivery, medtech and pharma. We begin each chapter with our key findings, then illustrate the most significant survey responses with charts.