HealthDay News — Most physicians expect the Affordable Care Act (ACA) to continue as planned and expect further integration in the coming years, according to a report.

“Physicians recognize that ‘the new normal’ may necessitate major changes in the profession that require them to practice in a different setting as part of a larger organization that uses technologies and team-based models for patient care,” Paul Keckley, PhD, executive director of the Deloitte Center for Health Solutions (DCHS), which conducted the survey, said in a statement.

Keckly and colleagues surveyed a nationally representative sample of up to about 600 U.S. primary care and specialist physicians in 2013 to examine their perspectives and attitudes toward healthcare reform.

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According to the survey, only 31% of physicians graded the overall health care system performance favorably. Less than half of those surveyed (44%) believe that the ACA is a good start and 82% believe it will continue as planned.

In 2011, more than half of those surveyed were familiar with delivery system improvement programs, compared with 27% in 2012. Most physicians (66%) believe that physicians and hospitals will be more integrated in the next one to three years.

In terms of satisfaction with practicing medicine, 65% of physicians responded affirmatively, with top drivers of satisfaction including patient relationships, protecting and promoting health, and intellectual stimulation.

Most physicians, 78%, believe nurse practitioners and physician assistants will play a bigger role in direct primary care delivery, and 57 % believe that the practice of medicine is in jeopardy. About half of physicians (51%) expect their income to fall dramatically in the next one to three years.

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