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Happy but worried, American physicians are sorting through the many changes their profession is seeing.
You like being a doctor, for the most part, though you feel its frustrations. You don’t mind hard work and enjoy caring for patients, but you work more than you should, and wish you had more time for loved ones.
You’re happy. But you’re nervous about the future of your profession - scared, even. How will physicians be paid 10 years from now? And by whom? Will all doctors be employed by hospitals, institutions, and the government, or is there still a role for the physician entrepreneur? And what about the battered primary-care physician? Will there even be such a thing, or will virtually all primary care be delivered by cheaper midlevel providers?
Richard Sutton, a psychiatrist who started practicing in 1970 and now runs an ambulatory care center in Falls Church, Va., is fretful. “The future is not [as] bright for medicine as it has been over the last quarter of a century,” he says, “I think physicians will be replaced by midlevel practitioners because of economics.”
Still, you maintain a better work-life balance than many might suppose, and you’re pretty content overall with your career. Despite the challenges facing physicians today, you wouldn’t advise your children to run screaming from the profession.
“I love what I do and can’t imagine doing anything else,” says Deanna Attai, a breast surgeon and solo practitioner at the Center for Breast Care in Burbank, Calif.
Does all this sound like you? Then congratulations: You are a perfectly ordinary American doctor. And that’s a pretty darn good thing to be, according to the results of our second annual Great American Physician Survey, which is perhaps the most wide-ranging survey of physician attitudes, lifestyles, politics, and general well-being in the world. More than 1,400 physicians this year answered our dozens of questions about what they’re thinking, how they’re feeling, and how they’re living.
The bottom line: despite the image of the overworked, overstressed, at-the-end-of-his-rope physician presented by the media, the truth is that most modern doctors wouldn’t want to be anything else. You’re fearful, maybe, but not regretful.
Let’s dive into the numbers.
More than 1,400 physicians completed this year’s Great American Physician Survey, with respondents largely mirroring the demographics of U.S. physicians generally. About half the respondents were in primary care; the other half specialists. The male/female split was the usual 60/40. Physicians of all generations are well represented, with a nearly even split among age groups, as were doctors from urban, suburban, and rural locations from every part of the country and in every type of practice - large group, small group, and solo.
THE STATE OF MEDICINE AND THE ECONOMY
Even as you express general contentedness with your career, you’re also revealing signs of worry about the future. Nearly half of you think primary-care docs will eventually go the way of the T-Rex, replaced by cheaper nonphysician providers, while even more expect big fundamental changes in the way docs get paid. More than a quarter of you have been sued for malpractice, and defensive medicine is rampant: 73 percent of you admit to having practiced it. Meanwhile, you’re noticing affects the recession has on your patients, who are trying to save money by seeing you less often and not following up on treatment. And many of you are skipping vacations and altering retirement plans as you tighten your own belts.
FAMILY LIFE AND PERSONAL WELL-BEING
You wish you had more time for your personal life. A minority of you eat dinner with your family at least five nights a week and only half of you find time to exercise three times weekly. Still, you take care of yourself reasonably well. Although a lot of you are struggling with weight, like so many of your patients, most of you have a regular physician; you follow his or her advice; and you try to eat right. Almost 90 percent of you say you feel at least pretty good physically and emotionally. Most of you are as happy or happier right now than at any other time of your life.
CAREER AND JOB SATISFACTION
The vast majority of you like being physicians and are satisfied with your choice of specialty. Yet four in 10 would have made some change (perhaps small) in your career path, if you’d known earlier what you know now. Your biggest career complaint is stress. You work a mean of 51.6 hours a week; many (but not most) of you would like to work less, but few are willing or able to earn less in order to get more time off. About a third of you are unhappy with your current employment situation, and this group’s most common complaint is an unhealthy workplace culture. You’d love to stick it to insurance companies, too, including Medicare: Nearly two-thirds of you have or would consider a no-insurance practice, while another 42 percent would even consider switching to a concierge practice.
POLITICS AND PUBLIC POLICY
You’re a voter, and you pay attention to the news. But beyond that you’re not particularly active politically. Maybe it’s because you believe physicians are not well represented in the halls of power, or maybe it’s because your politics are fairly moderate, anyway: Fewer than 13 percent of you consider yourselves “very liberal” or “very conservative.” You are typically American in your political heterogeneity: you’re split pretty evenly between conservative and liberal, nudging left only slightly. Because the healthcare reform debate was in full swing while our survey was ongoing, we couldn’t get a good read on where you stand on the final outcome, but 87 percent of you ranked the issue as very important, second only to the economy.
So, what’s the state of the American physician community in 2010? Our Great American Physician Survey finds you feeling happy yet underappreciated; hopeful yet fearful; connected deeply to your patients, and yet poorly understood by them - as well as by politicians and even your own families.
For example we asked you to tell us, in your own words, what you’d like to tell those groups about your job and your life. Many of you implored them to support your career and professional expertise as the industry struggles to respond to change. “I went to 24 years of advanced education. I deserve to be treated like I know more than a nurse that went to school for [three] years, and I deserve to be trusted more than a politician that thinks they know what’s best for patients,” one physician wrote, in a nice summary of a common sentiment. In the words of another physician, “I would love for everyone to spend a day at our side and see how many issues and decisions we make that affect our patients’ lives, and then I believe you would appreciate our skills more.”
There is a good bit of resentment among doctors these days, our survey finds: You sense that decisions are being made for you, and demands placed upon you by people who don’t know the first doggone thing about being a doctor these days. And you’re none too pleased about it.
That said, it seems, you’re still enjoying the ride. “Despite all the complaining, it is still the best profession around,” says one physician.
Shelly K. Schwartz, a freelance writer in Maplewood, N.J., has covered personal finance, technology, and healthcare for more than 12 years. Her work has appeared on CNNMoney.com, Bankrate.com, and Healthy Family magazine. She can be reached via firstname.lastname@example.org.
Bob Keaveney, the editorial director of Physicians Practice, contributed to this article.
This article originally appeared in the October 2010 issue of Physicians Practice.
For our second annual Great American Physician Survey, we asked more than 1,400 doctors - professionals just like you, in every part of the country, in every style of practice, and in all specialties - dozens of questions about what they think, how they feel, and what they want. Here’s some of what we learned about what it’s like to be you these days.
• The vast majority of you like being physicians and are satisfied with your choice of specialty. Yet a sizable minority would have made some change in their career path, if they’d known earlier what they know now.
• You’re happy: The vast majority of you give yourselves an 8 or 9 on the Happy Scale of 1 to 10. Median score: 7.5.
• You’re healthy: Most of you have a primary-care physician of your own and try to take her advice. You mostly eat right and get regular exercise.
• You’re worried: Nearly half of you think primary-care docs will eventually be extinct, replaced by cheaper nonphysician providers.
• More than a quarter of you have been sued for malpractice, and defensive medicine is rampant: Almost three out of four of you admit to having practiced it.
• Some 87 percent of you believe you are poorly represented in Washington, and that your needs are largely ignored by politicians.