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The Attitude of Hand Surgeons toward the Affordable Care Act: A Survey of Members of the American Society for Surgery of the Hand

Shubinets V, Gerety PA, Pannucci CJ, Butler PD, Mirzabeigi MN, Chang B, Levin LS3 and Lin IC

Abstract

Background:

The purpose of this study was to examine the current attitude of hand surgeons toward the

Act (ACA), assess their self-described knowledge of the law, and ascertain projected changes in practice plans.

Methods: An electronic survey was sent to members of American Society for Surgery of the Hand (ASSH).

Results: A total of 974 ASSH members responded to the survey (33% response rate). The majority of respondents were male (89%), trained in orthopaedic surgery (81%) and in private practice (75%). 41% of respondents rated their knowledge of the ACA as average. 84% reported receiving no education on the law. In general, respondents disagreed that the ACA would improve healthcare in the United States (median 2, mean 2.06, scale 1-5), while agreeing that the ACA would decrease reimbursements specific to hand surgery (median 4, mean 4.11). They also disagreed that the ACA would improve access to emergent (median 2, mean 2.10) and elective hand surgery (median 2, mean 2.30). 37% of respondents believed that implementation of the ACA would cause them to retire earlier than planned. Stratified analysis revealed that private-practice and male respondents had a more negative outlook on the ACA compared to academicpractice and female surgeons.

Conclusion: The majority of responding hand surgeons have an unfavorable attitude toward the ACA, particularly private-practice and male members. Only a small percentage of respondents reported sufficient preparation for the coming changes related to the ACA. These findings suggest an opportunity for increased education and advocacy from professional organizations.