The most recent survey of physicians sponsored by The Physicians Foundation provides a predictable “snapshot” of their opinions concerning the state of our evolving healthcare environment. Physicians have had to adapt to several new and ongoing events which profoundly impact their practices. For instance, the Affordable Care Act has expanded coverage to include 20 million people. The Medicare Access and CHIP Re-authorization Act (MACRA) has been passed which will change reimbursement from pay for “volume” to pay for “value”. ICD implementation has increased the number of disease codes that physicians use from 14,000 to 68,000. Furthermore the healthcare environment is one of ongoing consolidation with merger activity amounting to about $400 billion and involving over 100 hospitals/health systems. In total 17,236 doctors responded to the survey and as might have been predicted morale is low, patient access to care is limited and physicians’ adaptation to changing delivery and payment models continue to be problematic.
54% of respondents would classify their morale as “somewhat or very negative”. Only a little more than a third of physicians feel positively about the future of medical practice. Nearly one-half of doctors experience some feelings of burnout and an equal number would not recommend that their children pursue a career in medicine. One factor that contributes to the level of dissatisfaction indicated in the survey is that practitioners spend 21% of their time on “non-clinical paperwork” and only 14% of doctors have the time that they deem necessary to deliver high quality health care.
The findings of the survey convey the frustration that physicians feel as they continue to practice medicine. In order to pay for “quality” certain criteria must be demonstrated to have been met. In order to do so, data points must be recorded, retrieved, analyzed, and reported. To achieve this, physicians must spend even more time in front of computer screens and less time with patients. The proliferation of disease codes have further complicated practices by increasing the number of man hours required to correctly file for reimbursement. These factors are compounded by decreases in physician income and increases in the overhead of maintaining a private practice that is forcing doctors to become employed. So physicians are experiencing increased workloads with paradoxically insufficient rewards along with a loss of autonomy and control over their life’s work. No wonder morale is low!
