U.S. physicians continue to struggle to maintain morale levels, adapt to changing delivery and payment models, and provide patients with reasonable access to care. This finding from our biennial physician survey reverberated amongst the members of the Physicians Foundation. But what amazed us the most were the over 10,000 physicians who took the additional time to provide written comment on the concerns they felt most passionate about. That act alone demonstrates how strongly physicians feel about what is happening today to the practice of medicine. Here’s what they had to say:
“This would be the greatest profession in the world only if the government would not be involved.”
“My comments here in general fall on deaf ears. Health care delivery needs to be a free flowing process devoid of external influences that interrupt good care. The process has become so corrupt that none of us can truly practice medicine.”
“Medicine is not a commodity like soybeans or widgets. Administration needs to be in the business of making it easier, not harder, for clinicians to treat patients.”
“Go ahead and keep looking over our shoulders, paying us less, and asking us to work more. Good luck when we all quit.”
“My interaction with the patient in the exam room has been lost and replaced with lots of data entry on my part. I click away staring at the screen and barely have time to make eye contact with my patient. This is the greatest loss in my opinion.”
“You have backed us into a corner, and you’ll miss us when we are gone.”
“Please discuss quality reforms and requirements and MOC rules with clinicians before implementing them. They and the EHR (which is largely nonfunctional) have largely ruined the personal life of many physicians and imposed unrealistic, impossible time demands that force MDs to spend more time treating their computers than their patients.”
“Becoming a physician and being a doctor are among the greatest of joys. Working in medicine is the greatest of disappointments.”
What else did we learn from the 17,000 physicians who answered questions addressing professional morale, practice patterns, career plans and recently passed government regulations?
According to the research, 80 percent of physicians report being overextended or at capacity, with no time to see additional patients. Not surprisingly, 54 percent of physicians surveyed rate their morale as somewhat or very negative, with 49 percent saying they are either often or always feeling burnt out.
In response to these and other challenges, 48 percent of surveyed physicians plan to cut back on hours, retire, take a non-clinical job, switch to “concierge” medicine or take other steps that will further limit patient access. Clearly, many physicians are dissatisfied with the current state of medical practice and are starting to opt out of traditional patient care roles. So as to stop this trend, it is imperative for health care stakeholders to address the issues of burnout and low morale more seriously, and to rejuvenate the physician workforce.
One common theme from our 2016 survey is that physicians continue to find patient relations to be the most satisfying factor in their medical practice — a full 74 percent. In contrast, 58 percent of physicians agreed that the least satisfying factor in practicing medicine is the regulatory and paperwork burden they are required to shoulder, followed by the erosion of clinical autonomy (32 percent).
Unfortunately, as all physicians know too well, they often find that their ability to choose what is best for their patients is compromised or obstructed by bureaucratic requirements or third parties who are non-physicians and neither have the training nor the knowledge of the patient that the physician possesses.
While regulating medicine is vitally important to the well-being of patients, with new regulations that continue popping up with no end in sight, the physician-patient relationship will continue to deteriorate.
As the physicians quoted above have stated, new regulations and more demanding and costly reporting requirements are seriously diminishing a physician’s ability to do their best for their patients. This regulatory morass forced on the medical profession brings to mind Gore Vidal’s observation that “the U.S. was founded by the brightest people in the country — and we haven’t seen them since.”
Walker Ray and Tim Norbeck are president and CEO, respectively, The Physicians Foundation.
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