Healthcare Matters

The Physicians Foundation recently sent a survey to 630,000 physicians. That’s every physician in the U.S. that’s registered with the AMA. The Foundation received back close to 14,000 completed surveys and the findings are summarized in the Foundations report, A Survey of America’s Physicians, published just a few weeks ago. If the morale of U.S. physicians is meaningful to you, then you have reason to be severely depressed. Over 75% of the physicians who responded were pessimistic about the future of their profession with 84% expressing a belief that their profession is in decline. Among other things, the survey found that over the next three years more than 50 percent of physicians will cut back on patients seen, work part-time, switch to concierge medicine, retire, or take other steps likely to reduce patient access.

Surprised? Or do you subscribe to the belief that if physicians were not complaining about their profession and the general state of medicine, then something would be horribly wrong? Here’s what they had to say –the source of their discontent:

• 79.2%: Too much regulation/paperwork
• 64.5%: Loss of clinical autonomy
• 58.6%: Physicians not compensated for quality
• 54.4%: Erosion of physician-patient relationship
• 45.9%: Money trumps patient care
• 43.7%: Scope of practice encroachment
• 6.9%: Too many part-time doctors

But the problem seems centered among physicians in private practice where doctors complain about the same kinds of uncertainties you hear from most small business owners. Accenture not only forecasts that the number of independents will drop by another third in 2013, but that these same self-employed physicians will end up happily employed at hospitals or large health systems. According to a research brief published by Morehead Associates (a consulting firm based in Charlotte, N.C.), when asked to score the level of satisfaction with their employers, hospital-employed physicians gave themselves a 4.12 on a scale where 5 was the highest.

In fact, the largest hospital systems in the U.S. are not only doing a much better job acquiring practices and recruiting physicians, they’re driving organizational alignment by engaging their workforces with unusual success. Under current economic circumstances, it’s relatively easy for hospital administrators to recruit doctors with promises of less paper work and more financial security. But keeping them committed is another matter. Data driven discussions exploring the intersection of best clinical and supply chain practice is a rich and engaging hook that is driving the evolution of both professions.

Are we witnessing the death of the independent physician practice? Can hospitals and health systems absorb the number of physicians who are expected, otherwise, to leave the workforce? While the industry consolidation that is going on, vertical integration and new networked care delivery models that dominate current thinking all share some common threads, none of these trends seems to make room for the independent physician.

—Tom Finn