The Physicians Foundation has compiled a survey of America’s Physicians to examine professional morale, practice patterns and perspectives on today’s physicians. The results have been aggregated by age, gender, primary care vs. specialist and practice owners vs. employees (or hospital-based practitioners).
The survey was sent to over 630,000 physicians (over 80% of physicians in active patient care) and 13,575 physicians responded.
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.
Key findings of the survey include:
- Over 84% of physicians agree that the medical profession is in decline.
- 57.9% 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 FTEs from the physician workforce.
- 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.
- Over 59% 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.
- Close to 92% of physicians are unsure where the health system will be or how they will fit into it three to five years from now.
Physicians are working fewer hours on average and seeing fewer patients than four years ago. If these patterns continue, over 44,250 full-time-equivalent (FTE) physicians could be lost from the workforce in the next four years.
Survey respondents share some of the characteristics of the population of all practicing physicians but are different in several ways:
- The physicians sample is disproportionately older than the national population, with the sampled physicians plausibly experiencing profound changes in the medical practice environment during the course of their careers.
- The sample is also significantly more male and rural than the total physician population, and is more likely than the population to operate a solo practice or be an AMA member.
The survey clearly shows a pattern of older physicians, practice owners, specialists and male physicians being more pessimistic about the medical profession and in general more negative about the current state the healthcare system than are younger physicians, employed physicians, female physicians and primary care physicians.
The survey suggests that physicians are fairly unanimous regarding the factors that provide them with professional satisfaction. When asked to identify the two most satisfying aspects of medical practice, 80.2% of physicians indicated Patient Relationships, followed by 69.7% who cited Intellectual stimulation. Only 11.7% of physicians identified Financial rewards as one of the two most satisfying aspects of medical practice.
Physicians identified Liability/defensive medicine as the least satisfying aspect of medical practice, followed by Dealing with Medicare/Medicaid/government regulations, Reimbursement Issues, and Uncertainty/changes of health reform. These factors and others cited in the survey tend to interfere with or distract doctors from patient relationships and therefore diminish their professional satisfaction.
How physicians feel about the practice of medicine has significant real world implications for America’s patient population, particularly as it pertains to access to medical care. This survey suggests that physicians are at a pivotal crossroads where they can continue as they are or reduce their hours and decrease the number of patients they see– trends that should be of great concern to patients and policy makers alike.
What are your thoughts on these survey results? Do you agree with the respondent’s concerns and future plans? How can we improve the health care system and reinvigorate America’s physicians?
Click to read the rest of the survey results as well as the full report, A Survey of America’s Physicians from The Physicians Foundation.