As healthcare reform in the United States continues to evolve, many are assessing the experiences and perspectives of those on the front lines . . . the physicians. It has been well-documented that many physicians are experiencing decreased morale and are struggling to adapt to the various facets of healthcare reform while also trying to provide patients with reasonable access to care.
Physicians Foundation recently concluded their biennial study examining practice patterns and perspectives of U.S. physicians. The examination was based on a survey of over 17,000 U.S. physicians, with a margin of error less than 1%. Here are a few highlights:
80% reported being overextended or at capacity, with no time to see additional patients
72% state third-party intrusions detract from the quality of care they can provide
63% are pessimistic about the future of the medical profession
54% rate their morale as somewhat or very negative
49% state they are either often or always feeling burnt out
48% reported their intentions to cut back on hours, retire, take a non-clinical job, switch to “concierge” medicine or take other steps that will further limit patient access
36% reported they do not see Medicaid patients, or limit the number they see
27% reported they do not see Medicare patients, or limit the number they see
Half of the physicians surveyed stated they would not recommend medicine as a career to their children and nearly one-third claimed they would not choose to be physicians if they had their careers to do over. Walker Ray, M.D., President of the Physicians Foundation and chair of its Research Committee, noted:
“By retiring, taking non-clinical roles or cutting back in various other ways, physicians are essentially voting with their feet and leaving the clinical workforce. This trend is to the detriment of patient access. It is imperative that all healthcare stakeholders recognize and begin to address these issues more proactively, to support physicians and enhance the medical practice environment.”
Regarding Electronic Health Records (EHRs), only 12% indicated the use of EHRs has improved patient interaction, while the remaining 89% say it has had little or no impact or has detracted from patient interaction. Regarding Accountable Care Organizations (ACOs), the percent of physicians that agree ACOs are likely to enhance quality and lower costs decreased, while there was an increase in physicians who feel ACOs are unlikely to increase quality or decrease cost.
Although 74% of respondents list the patient relationship as the most satisfying aspect of their job, they also indicated that they spend 21% of their time on non-clinical paper work duties. Physicians note that issues such as a lack of clinical autonomy, liability concerns, struggle for reimbursement and decreased patient face-time can all negatively impact the patient-physician relationship – thereby undermining physician satisfaction.