Doctors are working less and are seeing fewer patients; and many would quit if they could, a sweeping survey of 13,575 physicians from across the nation shows.
The survey, “A Survey of America’s Physicians: Practice Patterns and Perspectives”, was commissioned by The Physicians Foundation. It is the latest and perhaps the largest and most comprehensive of a number of surveys that have identified wide, deep, and increasing discontent among the nation’s physicians regardless of their age, gender, specialty, location, or employment status.
“It is downbeat, and it is a concern. What we are documenting here is a trend and the trend is pretty solid,” Walker Ray, MD, vice president of the nonprofit foundation, told HealthLeaders Media.
“Physicians feel powerless. They don’t feel like their voices are being heard. They don’t feel like they were heard on the run up to healthcare reform and they don’t feel like they’re being heard now.”
“The problem to summarize it is there is an imparative now for physicians to care for more patients, to provide higher perceived quality at less cost with increased tracking and reporting demands in an environment of high liability and problematic reimbursements,” he says.
Physicians report working about 6% less than they did in a 2008 foundation survey. “That doesn’t sound like a whole lot until you calculate the full-time equivalent physicians who are lost from the workforce,” Walker says.
“If this trend continues that would be 44,250 full-time equivalents lost from the physician workforce over the next four years and there is every reason to think that this will occur.”
The survey shows that 52% of physicians have already limited the access of Medicare patients to their practices or are planning to do so; and 26% have already closed their practices to Medicaid patients, blaming higher operating costs, time pressures, and falling reimbursements.
One hundred thousand physicians will transition to employees over the next four years; and more than 50% of physicians will cut back on patients seen, switch to part-time, switch to concierge medicine, retire, or take other steps that will result in about 91 million fewer patient encounters, the survey shows.
Walker says that 75% of physicians don’t believe that the migration to employment is a positive trend. That includes 62% of employed physicians who consider it a negative. Those physicians who are opting for employment are doing so, he says, for economic security and relief from “an extreme regulatory environment.”
“Physicians think of themselves as being autonomous in making decisions in the patient’s best interest, but employed physicians have to have one ear open to what their employer is saying. Otherwise they put their jobs in jeopardy,” he says.
Most physicians just want out.
“We found that 60% said they would retire today if given the opportunity. What was worrisome is that this is up from 45% in 2008,” Walker says. “We also know from the survey that we disaggregated it into certain categories, 47% of physicians under 40 said they would retire today if given the opportunity.”
Walker acknowledges that some physicians could be speaking out of frustration and that they do not intend to leave practice. “But even if only a small percentage follow through on any of that it could be worrisome to the workforce,” he says.
“We have 75 million Baby Boomers transitioning to Medicare starting last year over the next 12 or so years. We have a growing population. We have 32 million people who may be gaining health insurance and yet we have the same number of doctors. We have a bottle neck for training. We are training 25,000 or so doctors a year and the fact that we are finally building some new medical schools is not going to increase the doctor supply because the residency level is fixed at 25,000 or 26,000 positions.”
The online survey was conducted from late March to early June by Merritt Hawkins, with an overall margin of error of less than 1%. Phil Miller, vice president of communications at Merritt Hawkins, says physicians are caught amid crosscurrents in healthcare delivery, and it’s proven challenging to find incentives that work for everyone.
“We have a doctor shortage, so we want doctors to stay busy and be productive and see a lot of patients. But you are rewarding them with a salary which they know they are going to get regardless of how many patients they see. So you try to build in incentives that will keep them focused on volume,” Miller says.
“At the same time, you have this crosscurrent that says ‘let’s not reward them for volume. Let’s reward them for quality and patient satisfaction and these subjective metrics.’ So we have two trends working at cross purposes and at the end of the day the doctors are going to take the salary. They may achieve some of their production bonuses, but it is going to be more of a nine-to-five, do-your-job-and-go-home-type of profession,” Miller says.
Walker says the issues that zap physicians’ enthusiasm run deep. “We have to improve the medical practice environment and the things physicians are most concerned about are autonomy, regulatory issues, liability issues, and reimbursements,” he says. “We’ve got to fix some of those things to keep the workforce together because we not only want to train more physicians, we want to retain more in their practices, and that is not happening now.”
Photo credit: terrellaftermath.com
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I do not blame any of these physicians… If a ball player can make $5000 a game for catching and throwing a ball then a doctor should make quite a bit more since he is in fact saving lives… which is far from a game… Obama has screwed america up so bad… It is obvious to me that his whole purpose is to destroy america.. i cant think of anything else it could be… yeah sure, he is giving everyone health care but its no good if there is no doctors to see.. hooray hooray we have healthcare.. boy obama is the man huh….. now where’s the doctors…..
I have said over and over that if this Nobama care were to pass so many Dr’s would quit practicing or they would cut back on Medicade and Medicare. I know how hard it is to find a Dr when you are on Medicare because I am on it and I know how much they cut from the bill and I use to work in the AFS medical billing and I could not believe how much was cut from the Dr and what he billed. Even when the Nobama care is up and running (if it ever is) then there will be at least 30 million who still will not have healthcare and the ones who do will have to pay big premiums and if they don’t they will be fined. I do not think it is the governments business to be involved in any citizens health care and it is not up to them to force us into it. The way I read it the government will have a panel (death panel) I say who will either allow something of deny it so they need to worry about finding jobs and getting the economy on recovery and stay the hell out of our business and health care
I believe that its all about control.. this way they can control your whole life.. they decide wether you live or die.. they have complete controll if they have your life in their hands.. I used to be on medicare but, now I am on my husbands insurance .. and I think our prices are gonna go so high that we wont be able to afford it and like most others will end up having to get on the goverment obamacare.. they will force everyone on it in the end. i believe its more about the control than anything.. I really cant believe that this is happening in america.. Its shocking how bad things have gotten in the past few years.. it like a nightmare that I cant wake up from. I am really afraid of how things will end up here in america the free..I agree with you completely skygirl… i am afraid it will get alot worse as time goes by… especially if obama wins the election.. i pray that he wont… but, yeah they should stay out of our business… we losing more freedoms everyday.. they are watching everything we do on the internet, tapping our phone calls, they can arrest us and detain us for no reason and no lawyer, trying to take our guns, our first amendment, i guess we are free anymore.. they are taking everything and we dont seem to even realise it.. I cant believe this is happening……i am afraid of the future..
From what I heard, obamacare is cause doctor’s to cut back on the number of Medicare patients and cut back on medicaid patients. How is that giving everyone health care? If you’ve been seeing a doctor for a while and he cuts you out because you’re on Medicare or medicaid, how is that gonna help with the healthcare problem. It’s gonna make it worse for the patients. Obama is using close to 700 billions dollars from medicare to fund his deadly Obamacare law. That’s gonna hurt seniors and the disabled on Medicare. Obama is hurting seniors far worse than Romney and Ryan will. Seniors, voters, you need to wake up and NOT vote for obozo again.
oh no you have read my comment all wrong.. i was being sarcastic….. i hate what obama has done… i am disabled but thank the good lord i am not on medicare or medicaid.. and i truly feel sorry for anyone who is.. I meant that sure it is great to have healthcare but, what good is it if you dont have a doctor that will see you … .. I honestly believe obama is trying to destroy america… my mother is on medicare and I know that this is gonna affect her alot.. but, she cant afford anything else.. I sometimes believe obama is wanting to kill off all the seniors and disabled.. if we dont get him out of the white house this election then i am afraid we will lose america as we know it.. its very frightening to me..
As of Jan. 2012 sign posted in most primary & specialty doctors offices read “Medicaid patients no longer accepted in this office”. Because of the major cut in refunds to doctors, my guess regular medicare will be next. Everyone will be moved to medicare/HMO’s or obamacare.
Says a lot about his promise:
“if you like your doctor you can keep him, if you like your insurance plan you can keep it”.
If people think it is bad now wait until the full Nobama care is in place. I wrote to one of the Senators for Oregon and told him what I thought and how hard it was to find a Dr when on Medicare and that when this bull Nobama care was up and running 30 million people would still not have insurance and that it was just going to add to the national debt and that if this was such a good plan then why don’t all of the elected liars and crooks have to use it also and save the tax payers the cost of their insurance which is the best of best. This liar emaild me back telling me how good this was for the people and a bunch of BS so I emailed him right back and said then you and your family use it also as well as Nancy P and Harry R and he told me that the Drs would take the plan and give just as good of care as they do now. How stupid are these elected liars and crooks? Do they not understand the Drs are not going to take it but will quit first. Go into the video that Fox could not show on TV and see Nobama telling the world he is a Muslim and that he has always been one and shows him bowing to the head of the Muslims and he took the American flag off of his coat because he is a Muslim. The video is out there and everyone needs to see it. God Bless America because if Nobama gets it again it will be The Muslim God and we will become a Muslim nations. Have a good week and everyone of the elected officials who voted for this Nobama care needs to be out of office and new people elected because not one of them has the balls to investigate or do anything about the Muslim president (small letters by choice) as he is not my President
skygirl,I’m with you. If Obamacare is so damn good, then all of Congress as well as the prez and his family should also be bound to it just like we are! R&R 2012!
Skygirl and ladyceo ,,, you guys are both so right… I think that when they pass a new law , it should be mandatory that they abide by the same laws that they expect us to abide.. then we would get so great laws that we will all enjoy… there are two classes.. us and them… they seem to think that they are in charge of us.. they have forgotten that they were elected and we are their boss not the other way around.. we are the only ones that can fix this… its up to the american people.. we are in charge.. if we dont start standing for our rights and america then we will lose…we cant just sit around and hope things will get better..I think that we have to start letting these jerks know who they are working for.. and I also think that their wages should be based on what we make… if we can survive on 50 k a yr. then they can too.. that way our wages will be enough to survive on.. they are making 170k a yr. while the average american has to make it on 50k.. there is something wrong with that.. plus they get everything for free… and all the benefits.. free trips.. heck they should love america enough to work for what we work for.. think about it.. these people are in charge of our lives… they are deciding on everything we do .. i dont know about all this.. it just doesnt seem quite fair to me.. there is alot wrong in america..
As a (retired) physician, I can tell you that the insane increase in medical costs over the years has been solely caused by governmental interference in what was a noble profession. Its very difficult to detail the progression, but essentially it began when the government mandated employers to provide an insurance plan for employees. Health care was affordable before that time, but as soon as regulations implementing this required insurance took hold, the costs began escalating. Medicare with the all encompassing regulations that attend it put the lid on healthcare’s coffin and Obamacare is in the process of driving the last nail home. When I first began practicing, I was of the mind that a single payor would be a good idea. It took a few years of experiencing the evils of regulated healthcare before I realized that I was totally wrong.
Healthcare MUST be between one patient and one doctor with NO ONE between. That means no insurance company dictating treatment and most assuredly no government entity dictating anything. I’m not even considering here the deleterious effects of giving up your right to any privacy, which is the end result of the government paying the bill, nor am I touching on the fact that the nation will be bled dry by Obamacare.
Obama’s healthcare system, in addition to everything else above, can only exist by enslaving physicians. Someone said to me once; “Yea but mighty well paid slaves they would be”. Not really, most of what people believe about physicians pay is greatly exaggerated, and consider the entertainment industry as a form of comparison. Entertainers are much more highly paid for what? Making you laugh or cry, or what? Certainly not for helping to mend your body or saving your life. visit http://www.gov-truth.com for more of my outlook on how government interference has damaged this country.
My Doctor has already informed me that he intends to quit the practice of full time medicine and go back to truck driving; a job he used to do before he went to Medical School. Said he is tired of working patients with no reinbursement, being required to work essentially free at hospitals just to get priviledges there. He said that although he was gone a lot, he spent just about as much time with his family as he does now and enjoyed truck driving a lot more than medicine; said it pays better – at least now. Said Obamacare will require him to work patients for whatever they wish to give him and he has to accept it. He says he would rather drive a truck. Having seen a lot of his patients – I can’t blame him. It will be a loss to medicine as he is an experienced GP with surgical experience.
Obamacare will probably run a lot of them out of the business. Obamacare has a sectionthat says “we will determine how much to pay you and all doctors will receive the same pay”.