Healthcare Reform: Loosing Primary Care Physicians

A survey released today by The Physicians’ Foundation depicts widespread frustration and concern among primary care physicians nationwide, which could lead to a dramatic decrease in practicing doctors in the near future. 

 The survey examined the causes behind the doctors’ dissatisfaction, the state of their practices and the future of care.  The resulting findings show the possibility of significantly decreased access for Americans in the years ahead, as many doctors are forced to reduce the number of patients they see or quit the practice of medicine outright.  

·         An overwhelming majority of physicians – 78% – believe there is a shortage of primary care doctors in the United States today.

·         49% of physicians – more than 150,000 doctors nationwide – said that over the next three years they plan to reduce the number of patients they see or stop practicing entirely.

·         94% said the time they devote to non-clinical paperwork in the last three years has increased, and 63% said that the same paperwork has caused them to spend less time per patient.

·         82% of doctors said their practices would be “unsustainable” if proposed cuts to Medicare reimbursement were made.

·         60% of doctors would not recommend medicine as a career to young people.

“Going into this project we generally knew about the shortage of physicians; what we didn’t know is how much worse it could get over the next few years,” said Lou Goodman, PhD, President, The Physicians’ Foundation.  “The bottom line is that the person you’ve known as your family doctor could be getting ready to disappear – and there might not be a replacement.”  

The Physicians’ Foundation believes the future of primary care could have a significant impact on the American healthcare debate.  

“At a time when the new Administration and new Congress are talking about ways to expand access to healthcare, the harsh reality is that there might not be enough doctors to handle the increased number of people who might want to see them if they get health insurance,” said Walker Ray, MD, Vice President, The Physicians’ Foundation.  “It’s as if we’re talking about expanding access to higher education without having enough professors to handle the influx of students.  It’s basic supply and demand.”  

The reported reasons for the widespread frustration among physicians include increased time dealing with non-clinical paperwork, difficulty receiving reimbursement and burdensome government regulations.  Physicians say these issues keep them from the most satisfying aspect of their job: patient relationships.  

“Tens of thousands of primary care doctors face the same problems as millions of ordinary citizens: frustrations in dealing with HMOs and government red tape,” said Sandra Johnson, Board Member, The Physicians’ Foundation.  “The thing we heard over and over again from the physicians was that they’re unhappy they can’t spend more time with their patients, which is why they went into primary care in the first place.”

This is a huge problem, and one that is often dismissed in the healthcare reform and transparency debates, is how many changes can we throw at the medical system at one time without inducing an exodus of primary care physicians, nurses and other healthcare professionals.

This summer I met with a progressive cardiologist who wears a pony tail at a local hospital he works on an average of 80 hours a week, mostly seeing patients and filling out paperwork.   We discussed the coming healthcare changes and his response to me was that if they adopt a national healthcare system where he no longer receives incentive pay for seeing more patients, he will simply work less, he would spend more time with his children and the patients would in the end suffer.

So what may seem like a good idea (universal healthcare, transparency…), may in the end hurt patients by limiting their access to healthcare, which would have the entire opposite effect of what the politicians are hoping for.  Let’s hope that whatever they come up with makes sense and that we don’t loose a whole generation of physicians at the same time as more people are let loose on the healthcare system.

Articles:

CNN: Half of Primary-Care Doctors in Survey would Leave Medicine

Downloads

Press Release: National Survey Finds Numerous Problems Facing Primary Care Doctors, Predicts Escalating Shortage Ahead (35K) [download]

Survey Executive Summary (45K) [download]

Survey Key Findings (46K) [download]

Complete Survey Report & Analysis (795K) [download]

Comments

[Myron]

The health care system is a mess. With all these shortages in primary care providers, the host and the guest physician failed to mention the valuable service that Nurse Practitioners provide to patients. We practice in places that many physicians do not want to practice. We make physicians money!!