Posted on May 7, 2015 by
The Physicians Foundation Biennial Survey was published in 2012. Data for 2014 are not out yet, but there is little reason to assume that the trends documented in 2012 have been reversed. The report reflects nothing but a terminal decline of a once proud profession, one of the crown jewels of the post-WWII boom, and of U.S. academic glory. Pace the New York Times, I believe this level of demoralization if indeed true must eventually affect all patients – poor and rich, Obamacare and concierge medicine – alike.
The report “summarizes the results of one of the largest and most comprehensive physician surveys ever undertaken in the United States. The survey was sent by email to over 630,000 physicians (approximately 84 percent of all physicians in active patient care), or to virtually every physician with an email address on file with the nation’s largest physician database.
Responses from 13,575 physicians revealing:
• current morale levels of today’s doctors
• their perspective on healthcare reform and its effects on their practices • physician practice patterns and metrics
• the career plans of today’s doctors
• what they believe is detracting from effective healthcare delivery
• how delivery can be enhanced
and many other issues impacting patient care and the quality of the medical practice environment.
• Over one million data points derived from responses to 48 questions, many of them featuring multi- response answers.
• Selections from some 8,000 written comments on the current state of the healthcare system by physicians reflecting a wide range opinions and recommendations.
• A detailed analysis underscoring survey implications for policy makers and patients
• Responses aggregated by physician age, gender, practice type (primary care vs. specialists) and practice status (employed physicians vs. practice owners) for cross-referencing between different physician groups.
KEY QUESTIONS ADDRESSED
What do physicians think about the current state of the medical profession? How satisfied are they in their careers?
What changes will they make in their practices?
Will they continue to see Medicare and Medicaid patients?
What do they think of ACOs and other emerging delivery models? How many patients do they see?
How many hours do they work?
What do they think about health reform?
A Survey of America’s Physicians provides answers to these and other questions directly impacting quality and access to patient care in the United States.”
The key findings are:
“Responses to the survey combined with some 8,000 written comments submitted by physicians reflect a high level of disillusionment among doctors regarding the medical practice environment and the current state of the healthcare system. How physicians will respond to ongoing changes now transforming healthcare delivery varies. Many physicians plan to continue practicing the way they are, but over half of physicians surveyed have reached a tipping point and plan to make changes to their practices. Many intend to take one or more steps likely to reduce patient access to their services, limiting physician availability at a time when doctors already are in short supply.
Over three quarters of physicians – 77.4 percent – are somewhat pessimistic or very pessimistic about the future of the medical profession.
Over 84 percent of physicians agree that the medical profession is in decline.
The majority of physicians – 57.9 percent — would not recommend medicine as a career to their children or other young people.
Over one third of physicians would not choose medicine if they had their careers to do over.
Physicians are working 5.9% fewer hours than they did in 2008, resulting in a loss of 44,250 full-timeequivalents (FTEs) from the physician workforce.
Over half of physicians surveyed have reached a tipping point and plan to make changes to their practices. Many intend to take one or more steps likely to reduce patient access to their services, limiting physician availability at a time when doctors already are in short supply. Physicians are seeing 16.6% fewer patients per day than they did in 2008, a decline that could lead to tens of millions of fewer patients seen per year. Physicians spend over 22 percent of their time on non-clinical paperwork, resulting in a loss of some 165,000 FTEs. Over 60 percent of physicians would retire today if they had the means. Physicians are not uniform in their opinions – younger physicians, female physicians, employed physicians and primary care physicians are generally more positive about their profession than older physicians, male physicians, practice owners and specialists. Over 52 percent of physicians have limited the access Medicare patients have to their practices or are planning to do so. Over 26 percent of physicians have closed their practices to Medicaid patients. In the next one to three years, over 50 percent of physicians plan to cut back on patients, work part-time, switch to concierge medicine, retire or take other steps that would reduce patient access to their services. Over 59 percent of physicians indicate passage of the Patient Protection and Affordable Care Act (i.e., “health reform”) has made them less positive about the future of healthcare in America. Over 82 percent of physicians believe doctors have little ability to change the healthcare system. Close to 92 percent of physicians are unsure where the health system will be or how they will fit into it three to five years from now. Over 62 percent of physicians said Accountable Care Organizations (ACOs) are either unlikely to increase healthcare quality and decrease costs or that that any quality/cost gains will not be worth the effort. Physicians are divided on the efficacy of medical homes, and many (37.9 percent) remain uncertain about their structure and purpose. Over 47 percent have significant concerns that EMR poses a risk to patient privacy Over 62 percent of physicians estimate they provide $25,000 or more each year in uncompensated care.”
The full text can be found here: