Nearly 45% of physicians plan to cut back on seeing patients, to take on fewer patients, to retire, or to restrict new patients within the next 3 years.
Increased workloads, regulatory burdens and ongoing changes to the health care system are drivers of the anticipated career moves, according to a survey of 20,088 physicians commissioned by the Physicians Foundation, a nonprofit research organization.
Dr. Walker Ray
The 2014 Survey of America’s Physicians: Practice Patterns and Perspectives, released Sept. 16, was conducted by Merritt Hawkins and is based on responses from physicians across the United States from March 2014 to June 2014. The survey found 81% of physicians described themselves as overextended or at full capacity, up from 75% in 2012. Within the next 1-3 years, 18% of doctors said they plan to reduce their hours, 10% plan to seek a nonclinical job, 9% will retire, and 8% plan to reduce the number of patients seen. Also, 39% said they will accelerate their retirement plans due to changes in the health care system.
Some of those changes include the Affordable Care Act. Of doctors surveyed, 29% gave the ACA a C grade as a vehicle for health reform; 21% gave the ACA a D, and 25% said the law deserves an F. Just 4% gave the law an A grade and 22% said it deserved a B.
Dr. Walker Ray, vice president of the Physicians Foundation and chair of its research committee, said the survey results suggest a looming physician shortage and decreased quality care for patients.
“America’s physician workforce is undergoing significant changes,” Dr. Ray said in a statement. “Physicians are younger, more are working in employed practice settings, and more are leaving private practice. This new guard of physicians report having less capacity to take on additional patients. With more physicians retiring and an increasing number of doctors, particularly younger physicians, planning to switch in whole or in part to concierge medicine, we could see a limiting effect on physician supply and, ultimately, on the ability of the U.S. health care system to properly care for millions of new patients.”
Electronic medical records have been adopted by 85% of physicians, up from 70% in 2012, the survey found. However, 46% of respondents indicated EMRs have reduced their efficiency, while 24% say the systems have improved their efficiency. Meanwhile, 26% of doctors now participate in accountable care organizations, but only 13% believe ACOs will enhance quality and decrease costs.
As for workload, physicians worked an average of 53 hours a week in 2014, the same number of hours doctors reported working in 2012. Aside from treating patients, physicians spent an average of 20% of their time on nonclinical paperwork in 2014.
Additionally, the study found that 53% of physicians were hospital or medical group employees, up from 44% in 2012 and 38% in 2008. In 2014, 35% said they were independent practice owners, down from 49% in 2012.
“The physician workforce, and medicine in general, is experiencing a period of massive transition,” Lou Goodman, Ph.D., Texas Medical Association CEO and president of the Physicians Foundation, said in a statement. “As such, the growing diversity of the physician workforce will reflect different perspectives and sentiments surrounding the state of medicine. While I am troubled that a majority of physicians are pessimistic about the state of medicine, I am heartened by the fact that 71% of physicians would still choose to be a physician if they had to do it over, while nearly 80% describe patient relationships as the most satisfying factor about practicing medicine.”
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This article was updated on October 1, 2014.