U.S. patients are likely to face growing challenges in access to care if shifting patterns in medical practice configurations and physician workforce trends continue. This is one of the key findings of a major new survey of 20,000 physicians commissioned by The Physicians Foundation, a nonprofit organization that seeks to advance the work of practicing physicians and help facilitate the delivery of healthcare to patients
According to the research, titled “2014 Survey of America’s Physicians: Practice Patterns and Perspectives,” 81 percent of physicians describe themselves as either over-extended or at full capacity, while only 19 percent indicate they have time to see more patients. Forty-four percent of physicians surveyed 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, leading to the potential loss of tens of thousands of full-time-equivalents (FTEs). As the ranks of Medicare and Medicaid patients increase – in 2011, more than 75 million baby boomers began turning 65 and qualifying for Medicare – and millions of new patients are insured through the Affordable Care Act, patient access to care could pose significant health delivery and policy challenges.
“America’s physician workforce is undergoing significant changes,” said Walker Ray, M.D., vice president of The Physicians Foundation and chair of its Research Committee. “Physicians are younger, more are working in employed practice settings and more are leaving private practice. This new guard of physicians report having less capacity to take on additional patients. These trends carry significant implications for patient access to care. With more physicians retiring and an increasing number of doctors, particularly younger physicians, planning to switch in whole or in part to concierge medicine, we could see a limiting effect on physician supply and, ultimately, on the ability of the U.S. healthcare system to properly care for millions of new patients.”
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For some, it’s frightening time to be in healthcare.
Given the continual changes related to reform and reimbursements, compounded by the fact that independent practices are being gobbled up by hospital systems and independent practitioners are becoming employees, but a new study commissioned by The Physicians Foundation say that roughly 60 percent of physicians would quit the profession or retire today if given the opportunity.
This is no new trend. And as noted in HealthLeaders Media report, that’s what makes this latest piece of data so much more shocking.
What’s also somewhat shocking about the Physicians Foundation study, which featured more than 13,000 physicians, is that the results clearly reflect this sentiment – that physicians are frustrated with the overwhelming pressure facing them – and that they would rather get out than picture themselves as professional caregivers for the long haul.
Certainly, this is not insignificant. These are not your typical professionals working a job, taking an hour lunch and then heading home to the family. It’s not like they’re working in one field one week and they decide to try a new job at a different company the next week. These are highly educated professionals who have dedicated their lives to a cause and a belief that they could make a difference by helping people “get better.” Simply put, they’ve made a lifelong decision to practice medicine that the majority could sooner walk away from.
Apparently, physicians just don’t feel they are being heard. They feel their opinions don’t matter so the only way they may have to make themselves heard is to pack up and hit the road.
Because of the pressure they face from regulation, reduced reimbursements and providing greater quality at a lesser cost, many feel alienated, and some are beginning to do something about it.
For starters, they’re reducing or eliminating the number of Medicare and Medicaid patients they’re seeing. Some are leaving private practice (some by choice, others not) and becoming employees where they’ll have fewer managerial worries than if they were to stay put in their practices. After all, employees are hired to do a job; managers are required to solve most of a business’ problems. Employed physicians are employed because, for the most part, they got tired of trying to solve the world’s problems.
But, according to the study, becoming an employee is not viewed as a positive move. Especially for what has traditionally been a fiercely independent population.
What’s most troubling about this study is that most physicians just want out. They want to turn in their white coats and head for the sunset. They want to come to Florida, where the sun always shines, hit the beach and play with sand between their toes. (I made that last part up.)
Here’s the heart of it, and I quote the HealthLeaders story: “We found that 60 percent said they would retire today if given the opportunity. What was worrisome is that this is up from 45 percent in 2008,” Walker Ray, MD, vice president of the nonprofit foundation. “We also know from the survey that we disaggregated it into certain categories, 47 percent of physicians under 40 said they would retire today if given the opportunity.”
Almost half of physicians under age 40 would board the windows and find another way to pay their student loans.
In some cases, there are certainly doctors among this population that just got into practice. These are the physicians who are supposed to be changing the way, setting the new normal for the industry; unabashedly accepting that this is the new world order of things and the hells bells, we’re in it to win it.
If this is indeed the truth, that so many young physicians are wondering why they spent so much time in school and spending so much money on their educations just so they could become employees of the “state,” the future doesn’t see that much different than the present and we have bigger problems that we’re anticipating.
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