More than half of American physicians participating in a recent survey say they plan to significantly modify their practice patterns over the next one to three years, new research suggests. They report plans to cut back on patients seen, work part-time, switch to concierge medicine, retire, or take other steps likely to reduce patient access, according to the latest survey by The Physicians Foundation. Three-quarters of respondents (77 percent) are pessimistic about the future of medicine and even more (82 percent) believe they have little ability to change the healthcare system. One bright spot of the study: about as many physicians (80 percent) cited “patient relationships” as the most satisfying part of their job.  The survey was fielded online from late March to early June 2012 by Merritt Hawkins for The Physicians Foundation and includes responses from 13,575 physicians across the US.  It found that more than half of physicians (52 percent) have limited the access of Medicare patients to their practices or are planning to do so, while 26 percent have already closed their practices altogether to Medicaid patients. Physicians cited rising operating costs, time constraints, and diminishing reimbursement as primary reasons they are unable to accept additional Medicare and Medicaid patients. The survey found that a majority of physicians have implemented electronic medical records (EMR). Close to 70 percent of physicians have EMRs in practice, but 47.4 percent have significant concerns that EMRs pose a risk to patient privacy.