Doctors are working less, seeing fewer patients, and many would quit if they could, a sweeping survey of 13,575 physicians from across the nation shows.
The survey, A Survey of America's Physicians: Practice Patterns and Perspectives, was commissioned by The Physicians Foundation. It is the latest, and perhaps the largest and most comprehensive of a number of surveys that have identified wide, deep and increasing discontent among the nation's physicians regardless of their age, gender, specialty, location, or employment status.
"It is downbeat and it is a concern. What we are documenting here is a trend and the trend is pretty solid," Walker Ray, MD, vice president of the nonprofit foundation, told HealthLeaders Media.
"Physicians feel powerless. They don't feel like their voices are being heard. They don't feel like they were heard on the run up to healthcare reform and they don't feel like they're being heard now."
"The problem to summarize it is there is an imparative now for physicians to care for more patients, to provide higher perceived quality at less cost with increased tracking and reporting demands in an environment of high liability and problematic reimbursements," he says.
Physicians report working about 6% less than they did in a 2008 foundation survey. "That doesn't sound like a whole lot until you calculate the full-time equivalent physicians who are lost from the workforce," Walker says.
"If this trend continues that would be 44,250 full-time equivalents lost from the physician workforce over the next four years and there is every reason to think that this will occur."
The survey shows that 52% of physicians have already limited the access of Medicare patients to their practices or are planning to do so and 26% have already closed their practices to Medicaid patients, blaming higher operating costs, time pressures and falling reimbursements.
One hundred thousand physicians will transition to employees over the next four years, and more than 50% of physicians will cut back on patients seen, will switch to part-time, switch to concierge medicine, retire, or take other steps that will result in about 91 million fewer patient encounters, the survey shows.
Walker says that 75% of physicians don't believe that the migration to employment is a positive trend. That includes 62% of employed physicians who consider it a negative. Those physicians who are opting for employment are doing so, he says, for economic security and relief from "an extreme regulatory environment."