In the largest survey of its type since one conducted by the Doctor Patient Medical Association a few months back, an even more extensive survey by the Physicians Foundation that generated 13,575 responses from practicing physicians is equally sobering.
The survey was conducted by the recruiting and consulting firm Merritt Hawkins in an e-mail containing 48 questions to 630,000 physicians in active care, 8,000 of which included comments by the respondents ranging from positive to defeated. I believe that the key statistics, quoted directly from the report below, clearly show that the U.S. healthcare system, which has become increasingly out of control year after year for decades, is in real danger of collapse, and that the Affordable Care Act is more the last straw than culprit.Conclusions verbatim from the report:
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 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 percent fewer hours than they did in 2008, resulting in a loss of 44,250 full-time-equivalents (FTEs) from the physician workforce.
Physicians are seeing 16.6 percent 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 year 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.
But, help may be on the way from an unlikely source. More on that next week.
Editor’s Note: To read more about the Physicians Foundation report, see Dr. Richard Reece’s blog for an interview with Walker Ray, MD, chairman of the research committee of the Physicians Foundation.
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