Physicians Are Generally Stressed, According to a New Survey

The Physician’s Foundation conducted a biennial survey with over 20,000 physician responses to a large number of questions about the practice of medicine.  (Physician Survey)  Over 80% of doctors say they are overextended or at full capacity, up from 75% in the 2012 survey.  And 44% said they planned to take steps that would effectively reduce capacity, such as retiring, working part-time or closing their practice to new patients, including 39% who said they are likely to accelerate retirement plans due to changes in the health system.  Doctors report that they work an average of 53 hours a week, about the same as recent surveys.  But on average they say they spend 20% of their time on non-clinical paperwork.  Most doctors, 72%, believe there is a shortage of physicians and that more should be trained.  In a reflection of the revolution in how doctors practice, only 35% say they are independent practice owners, down from 49% in 2012.  53% now say they are hospital or medical group employees.  By a wide margin, physicians view hospital employment of doctors as a not likely to improve quality or decrease costs.  On the more positive side, only 29% responded that they would not pick medicine if they could start over, a decrease from 44% in 2013, and 44% say their morale and the state of the medical profession is positive, up from 32% in 2012.

69% think their clinical autonomy is limited at least some of the time.  25% of doctors now do not see Medicare patients or limit the number in their practice.  38% do not see Medicaid patients or limit their numbers.  Only 33% currently participate in insurance plans offered on the public health insurance exchanges.  7% of doctors practice some form of direct pay or concierge medicine and 13% want to transition to this form of practice, with a larger 17% of doctors under age 45 indicating they intend to make this change.  And 46% give the reform law a D or F grade, while 25% say it deserves an A or B.  85% have an EMR, up from 69% in 2012, but 46% of those with an EMR say it has hurt efficiency and only 24% say efficiency improved with an EHR.  While 26% of doctors participate in an accountable care organization, only 13% think these will actually improve quality or reduce spending.  Younger, female, employed and primary care physicians tend to have a more sanguine state of mind about the medical practice environment, but all subgroups have a majority with low morale and doubts about where the health system is going.  It is not a good thing for patients when doctors feel stressed about their practices and unsure about the value of many of the key initiatives that have been undertaken in recent years with the goal of improving the health system.