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Unhappy Docs Provide Roadmap for Recruiting, Retention

John Commins, for HealthLeaders Media, December 1, 2008

A just-released and comprehensive survey from The Physicians' Foundation of more than 12,000 primary care physicians in the United States found some troubling—but not entirely surprising—results. America's primary care physicians are very, very unhappy.

Anyone in the physician recruiting business would be advised to take a look at the survey, which was compiled this summer, because it provides a good roadmap for recruiting and retaining.

"This is not necessarily a bad-news survey. It's a great retention tool. Now you know what is frustrating them and you can do something about it," says Kurt Mosley, vice president of business development for Merritt Hawkins & Associates, the physician recruiting firm that compiled the survey for The Physicians' Foundation.

"If I were a hospital HR director, I would have the key findings up. I would circulate them with all the senior leadership, and I would ask ‘how do we fix this?' If this is occurring in our hospital let's do something about it. Let's do focus groups in our hospitals to find out how our physicians feel," Mosley says.

First of all, the source of the primary care physicians' dissatisfaction is not just money, although low Medicaid/Medicare reimbursements were among the top concerns. What jumps out is the overwhelming sense of frustration. Physicians feel they spend too much time on paperwork, to the detriment of their patients; they're tired of hassling with insurance companies over claims discrepancies; and they're very concerned about the financial viability of their practices. They are demoralized.

Here are some key findings from the survey, which has a margin of error of less than 1%:

  • 49% of primary care physicians say they will reduce the number of patients they see over the next three years.
  • 63% of physicians say non-clinical paperwork has caused them to spend less time with their patients, and 94% say that non-clinical paperwork has increased in the last three years.
  • 82% say their practices would be "unsustainable" if proposed Medicare reimbursement cuts were made, with 65% saying they lose money on Medicaid, and 36% saying they lose money on Medicare. Another 33% have stopped seeing Medicaid patients, and 12% have stopped seeing Medicare patients.
  • Only 17% of physicians describe their practices as "healthy and profitable," while 45% say they'd retire if they could afford it.
  • 78% of physicians say medicine is either "no longer rewarding" or "less rewarding," while 76% say they are at full capacity or overextended. Only 6% describe the morale of colleagues as "positive," and 42% describe the morale of colleagues as either poor or very low.

Mosley says he's surprised by the denial within the healthcare industry over the plight of primary care physicians, even as healthcare already faces a growing shortage of primary care physicians. "What's really unnerving to me is when we talk to state hospital associations and they are unaware of it," he says. "This problem affects everybody. If you don't have primary care physicians you don't have anyone feeding your specialists."

The primary care physician shortage could be exacerbated by the move toward the medical home model, which is supposed to be directed by those same physicians.

Some issues are beyond the problem-solving ability of hospitals and their HR departments. There isn't much you can do to improve Medicare/Medicaid reimbursements. For many primary care physicians, however, the primary focus isn't just money.

"A lot of the medical administration of America tries to solve everything with money and that is not necessarily the case," Mosley says.

Obviously, you have to provide competitive financial compensation, but the Physicians' Foundation survey shows primary care physicians care more about issues liken burdensome paperwork, adequate support staff and ancillary services, collegiality with fellow physicians, and even mundane issues like parking. Those are issues any hospital can address.

So take note HR directors. Physicians are unhappy. They're telling you why. Are you listening?


John Commins is the human resources and community and rural hospitals editor with HealthLeaders Media. He can be reached at jcommins@healthleadersmedia.com.
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