What’s Up With Physicians?

Health Affairs collects a variety of data relating to trends in physician practice and attitudes.   (HA Article)   The article confirms that amazingly rapid decline in independently practicing physicians, from 62% in 2008 to 35% in 2014.  In the next one to three years, 56% say they plan to continue practicing as they currently are; 18% say they will cutback their working hours, 9% say they will retire, 6% say they will go to part-time status, 7% are looking to work for a hospital, 6% in concierge medicine, 9% as a locum tenens and 10% want a non-clinical health care job.  (answers are more than 100% because more than one option was permitted)  81% say they are at full capacity in their work or over-extended, up from 76% in 2008, but this may partly be explained by a fall in average work hours per week from 57 in 2008 to 53 in 2014.  The number of doctors per 100,000 population varies widely, from a low of 185 in Mississippi to a high of 432 in Massachusetts.

In constant dollars, debt upon leaving medical school has risen from $80,000 in 1992 to $ 165,000 in 2012.  While salaries have risen in the same time period, the debt burden is higher.  On average, physicians say non-clinical paperwork takes 20% of their time.  About 70% say if they did it over again they would still choose medicine as a career, finding that the positives outweigh the negatives, but 30% say the negatives are greater than the positives.  In regard to their view of the current state of medicine, 9% are very positive but 18% are very negative.  In terms of perceptions of the future of medicine, 10% are very optimistic and 11% are very negative.  For both current and future perceptions, the negatives have come down considerably from even two years ago, probably because health reform was just kicking in at that time.  When asked what they find most stimulating about the practice of medicine, there are some notable trends.  Patient relationships has held steady at around 78% from 2008 to 2014, but intellectual stimulation has declined from 82% to 68% in that time period, interaction with colleagues from 58% to 23% and prestige from 37% to 17%.  Be nice to your doctor, he or she is having a rough time.