We follow surveys of physician attitudes closely, because they are still the cornerstone of the health system–the deliverers and orderers of most health care. We probably would all feel better if our doctor is happy in his work. Well, a lot of them aren’t, as confirmed in a Leavitt Partners survey of over 600 doctors. (Leavitt Survey) The physicians surveyed included those in solo practices, small practices, larger groups and employed by hospitals or health plans; and included primary care doctors and specialists. When asked about their overall perspective about the practice of medicine today, with 6% each being very optimistic and very pessimistic and 35% being somewhat optimistic and 32% being somewhat pessimistic. The rest of the survey was aimed at deciphering whether certain factors were or weren’t linked to pessimism. A larger percent of solo practitioners were pessimistic. Physicians in hospital-owned practices tended to be slightly less pessimistic. Doctors who worked for more than 20 years were more negative on medicine than were those with shorter careers, in fact there was a very direct correlation between years out of medical school and pessimism. Apparently the more time you spend in medicine, the worse you feel about it.
There is little difference based on reimbursement methods, fee-for-service versus salary or value-based. Very understandably, doctors who had a negative view of the financial stability of their practice or its management competence were more likely to be pessimistic. And our old friend the EHR comes in for its usual share of blame. 54% of those who aren’t satisfied with their EHR were pessimistic as were 56% of those who thought EHRs hindered the ability to provide quality care. There was no difference between clinicians serving more or fewer low-income patients. And unrealized expectations or motivations for entering medicine were also not linked to level of negativity. Doctors who were more pessimistic were generally less likely to engage in or plan to engage in new efforts in medicine, like telehealth, price transparency, use of physician extenders or use of value-based payments. Notwithstanding their views on the state of medicine, many doctors feel personally satisfied with their careers, but that number has declined and all the burdens placed on physicians probably isn’t improving their outlook. If you think physicians aren’t happy now, wait til they find out that the only way to pay for the scam of “Medicare for All” is to reduce their income by 25% to 40%. That will really improve the quality and productivity of our health care work force.