Physicians Pessimistic About Future of Healthcare
By Dr. James Palermo // October 3, 2012
According to a recently released report on a survey from The Physicians Foundation (TPF), a nonprofit organization that seeks to advance the work of practicing physicians and help facilitate the delivery of healthcare to patients, if they could, three in five physicians would quit practice today and one in three would have chosen a different career had they known how the profession was going to evolve.
This Spring the Survey of America’s Physicians was emailed to over 630,000 physicians, representing over 80% of actively practicing physicians. Altogether, 13,575 physicians responded to the 48-question survey, which was designed to assess physicians’ satisfaction with their careers, perspectives on the current state of the medical profession, how changes in Medicaid and Medicare and emerging new care delivery models may change their practice patterns and career plans, and their opinion of the Patient Protection and Affordable Care Act (PPACA).
The survey results show that physicians’ attitudes toward their profession worsened over the past 4 years, with 60.6% saying that they would retire if they were able to, up from 45% in 2008, and 84% of physicians think their profession is “in decline.”
In addition, the survey found that:
- 77.4% are “somewhat pessimistic” or “very pessimistic” about the future of the profession;
- 57.9% would not recommend medicine as a career to their children or other young people; and
- 34.5% would not choose medicine as a career if they had a “do over.”
When the same survey was conducted in 2010, 66.2% physicians said their profession was “somewhat positive/satisfying,” compared to just 39% of physicians in 2012.
Physicians’ concerns are centered around loss of professional autonomy, increasing federal regulation, the ever-present threat of liability and progressively shrinking reimbursement, experts told HealthLeaders Media.
“Physicians feel powerless,” HealthLeaders quoted Dr. Ray Walker, Vice President of TPF, as saying. “They don’t feel like their voices are being heard. They don’t feel like they were heard on the run up to health care reform and they don’t feel like they’re being heard now.”
It is clear that healthcare reform has left physicians uncertain about the future of their profession with more than 59% of the surveyed physicians saying that the PPACA has left them feeling less positive about the future of the U.S. health care system.
Perhaps the most disconcerting survey finding and the one that directly impacts global access to care in this country relates to physicians considering practice changes that would exacerbate the healthcare access crisis. One of the major concerns related to the PPACA is: when an additional 32 million Americans get medical insurance, who exactly is going to treat them?
A physician shortage in the U.S. was expected even before the PPACA was signed into law in 2010, according to the Association of American Medical Colleges (AAMC). Now the group estimates that there will be a shortage of 63,000 doctors by 2015 and 130,600 by 2025.
Meanwhile, the survey found that more than 50% of physicians plan to reduce their patient volume, work part-time, switch to concierge medicine, retire, or take other steps that would reduce access to their services. Over 52% of physicians surveyed have limited or plan to limit Medicare patients’ access to their practice, and 26.7% have closed their practices to Medicaid patients.
That percentage is much lower here on the Space Coast. In a random phone survey of office-based primary care physician practices in Brevard County done by SpaceCoastDaily.com, only 2 out of the 40 (5%) primary care physicians contacted presently accept new Medicaid patients.
With physicians at the vortex of the transformational changes related to how healthcare is delivered and reimbursed, it is a challenging and uncertain time to be a doctor. What physicians think about their profession and how they approach personal and group engagement and alignment related to the inevitable changes evolving in healthcare is profoundly important to both the quality of care patients receive and the access to care they are able to obtain.