Fewer than 25 percent of physicians say electronic health records have made them more efficient, and not even 33 percent of them say EHRs have improved care quality, according to a new survey.

[See also: ICD-10 cost a 'crushing burden' for docs]

The poll of 20,000 physicians was commissioned by The Physicians Foundation. It found that, while 85 percent of docs had implemented EMRs, nearly half of respondents (47 percent) complained that the systems detract from patient interaction.

Meanwhile, the report paints a picture of a medical practice industry in flux, with doctors stretched thin – and many planning to close-up shop thanks to the regulatory and technology changes unfolding all around them.

[See also: Practices embracing HIE, replacing EHRs]

More than 80 percent of physicians say they're over-extended or at full capacity, while only 19 percent indicate they have time to see more patients, according to the poll. Forty-four percent plan to take steps that would reduce patient access to their services, including cutting back on patients seen, retiring, working part-time, closing their practice to new patients or seeking non-clinical jobs.

Other findings from the survey:

• Thirty-nine percent of physicians say they'll accelerate their retirement plans due to changes in the healthcare system
• Twenty-six percent of physicians now participate in an accountable care organization, though just 13 percent believe ACOs will enhance quality and decrease costs
• Fifty percent of docs say the ICD-10 switchover will cause "severe administrative problems" for their practices
• Physicians spend 20 percent of their time on non-clinical paperwork
• Physicians surveyed said they work an average of 53 hours per week and see approximately 20 patients per day

In the 2012 poll, many docs said high levels of government regulation, malpractice liability pressures, inadequate and inconsistent reimbursement and eroding clinical autonomy were adversely affecting their outlook on care delivery. In 2014, survey questions focused more on clinical autonomy, given the significant patient implications. When asked about levels of clinical autonomy and the ability to make the best decisions for patients, 69 percent of physicians indicate that their decisions are often compromised – demonstrating a strong potential bearing on quality of patient care.

Fifty-six  percent of physicians still describe their morale as "somewhat to very negative." Nonetheless, optimism levels increased between 2014 and 2012: This year, 44 percent of physicians characterize themselves as somewhat or very positive about the current state of the medical profession, compared to 32 percent in 2012.

"The state of the physician workforce, and medicine in general, is experiencing a period of massive transition,” said Lou Goodman, PhD, president of the Physicians Foundation and CEO of the Texas Medical Association, in a press statement.

"While I am troubled that a majority of physicians are pessimistic about the state of medicine, I am heartened by the fact that 71 percent of physicians would still choose to be a physician if they had to do it over, while nearly 80 percent describe patient relationships as the most satisfying factor about practicing medicine."

Access the full report here.