Survey predicts 'silent exodus' of physicians amid health reform

Thu Oct 4 22:04:16 PDT 2012

September 25, 2012

Survey predicts 'silent exodus' of physicians amid health reform

Fierce Practice Management

With the United States in the midst of overhauling its healthcare system, most of the physicians who provide the care within it are in some way planning to or already pulling back from medicine, according to a survey of 13,575 practicing physicians conducted by physician staffing firm Merritt Hawkins for the Physicians Foundation, a Boston-based nonprofit that advocates for physicians.

In particular, the foundation's third biennial survey found that, given the current practice environment, physicians are curtailing their practices in the following ways:

• Physicians are working 5.9 percent fewer hours than they did in 2008, resulting in a loss of 44,250 full-time-equivalents (FTE) from the physician workforce.

• Physicians are seeing 16.6 percent fewer patients per day than they did in 2008, a decline that could lead to tens of millions of fewer patients seen per year.

• Fifty-two percent of respondents have reduced the access of Medicare patients to their practices or are planning to do so, while 26 percent have alreadyclosed their practices altogether to Medicaid patients.

• In the next one to three years, more than half of physicians plan to cut back on patients, work part-time, switch to concierge medicine, retire or take other steps that would reduce patient access to their services.

At the root of this "silent exodus of physicians," as analysts call it, may be an even more serious decline in physician morale. According to the survey, 77.4 percent of physicians said they were somewhat pessimistic or very pessimistic about the future of the medical profession.

Perhaps most tellingly, however, is that 82 percent of respondents said they believe doctors have little ability to change the healthcare system. Thus, an overwhelming number of survey participants--59 percent, or 8,000--seized the opportunity to provide written comments at the end of the 48-question survey. The remarks ran the gamut from short to long, positive to outraged. Here is a small sampling of what some physicians had to say:

• It is still a very honorable profession that takes a lot of smarts, skills and patience to be truly good at, and it needs to be respected as such.

• Medicine died. As long as we are not physicians but "healthcare providers" and there are no patients but "healthcare consumers," the situation will not get any better. As long as people with no medical training are dictating how we should practice medicine, none of us will get proper care. As long as people do not understand that you cannot put a price on a person's life and you cannot expect to make money out of sick people, the system will continue to deteriorate.

• As long as trial attorneys continue to rampantly impinge on our ability to care for patients, we have no reason for optimism.

• A once honorable, hard-working profession is being assassinated by insurance inefficiency, federal mandates and a lack of voice.

While this survey, like many others, paints a bleak picture of medical practice today, the silver lining, according to the Physicians Foundation, is that the information gathered may help continue the national discussion surrounding health reform.

Bryan Sloane
Deputy Editor, CAL/AAEM News Service

Brian Potts MD, MBA
Managing Editor, CAL/AAEM News Service

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