A survey of 24,000 physicians finds widespread skepticism about accountable care organizations and certain other components of health care reform.

The reform questions were among multiple topics covered in the annual Physician Compensation Report from WebMD’s Medscape professional Web site for physicians. In addition to salary trends, the survey also covered such issues as time spent with patients vs. doing administrative tasks, and career satisfaction rates. Among reform issues:

* Fifty-two percent of responding physicians believe ACOs will result in a decline in income. Twelve percent say ACOs will have little or no effect;

* Only 3 percent of participants currently participate in an ACO;

* Physicians are not impressed with reform’s goal of reducing “unnecessary care,” with two-thirds saying they won’t reduce the number of tests, procedures and treatments they perform because insurer treatment guidelines are not in the best interest of patients or they continue to feel the need to practice defensive medicine;

* Many physicians believe guidelines are instituted to reduce costs rather than put patients first; and

* Forty-six percent of respondents discuss costs of treatment if the patient raises the issue, 38 percent regularly discuss costs and 16 percent never discuss costs because they think it’s inappropriate or don’t know themselves what the costs are.

The report is available at medscape.com.

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