(HealthDay News) — The top issues and challenges facing physicians include managing changing reimbursement models with payors and financial management, according to a report published by Wolters Kluwer Health.

Researchers from Wolters Kluwer Health conducted a survey by Ipsos of more than 300 practicing physicians in the fields of primary care, family medicine, and internal medicine to examine the top issues and challenges facing physicians.

According to the report, the main challenges relate to managing shifting reimbursement models with payors (very or somewhat challenging, 91%) and financial management (90%). Other challenges include spending sufficient time with patients (88%) and dealing with the effects of the Affordable Care Act (ACA; 84%). Thirty-four percent of respondents report being very or somewhat likely to leave their practice in the next 1 to 2 years, with the top reasons related to profitability and time to retire.

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Most physicians report seeing no effect or negative effects from the implementation of the ACA, mostly related to costs and financial stability. Sixty-eight percent of physicians report that the cost of care status is increasing, with 67% reporting that the ACA is a contributory factor. More than half of respondents felt that progress is being made in leveraging health care information technology to improve patient care and advance evidence-based medicine; however, most report little or no progress in ensuring ease-of-use, improving patient relationships, increasing efficiency, and managing health costs.

“Increasing practice efficiency is the number one focus area for physicians over the next 3 to 5 years, cited by 48% as a top focus,” according to the report. “Interestingly, patient safety comes in last.”