Why Increasing Physician Morale is an Uphill Battle

Who cares for those who care for us? As US-based physicians face more scrutiny, oversight, regulation and penalty than ever before, the noble profession of saving lives seems to have been reduced to a micromanaged position where ones hand is held by the government and the other by payers.

Given these facts, the very realities of the position, physicians’ morale is in the dumpster. The population of doctors here is struggling, trying to adopt to changing delivery of care and payment models, all the while trying to attempt to meet the expectations of patients. Thus, the combination of these factors is leaving a majority of physicians feeling under pressure. These are the exact findings based on a biennial survey of more than 17,000 physicians conducted by the Physicians Foundation, a nonprofit agency.

The survey, named “2016 Survey of America’s Physicians: Practice Patterns and Perspectives,” suggests that 80 percent of physicians report being “overextended or at capacity,” with little left to give, let alone see new patients; this representing little change to the results collected from two years ago. The majority of US physicians said their morale was either somewhat or very negative, with 49 percent saying they are either often or always feeling burnt out.

How do they plan to adjust, or to heal themselves? Cut back on work and re-group, take a non-clinical job, switch to “concierge” medicine or take other steps, all of which limit patient access even more than it currently is.

“These patterns are likely to reduce the physician workforce by tens of thousands of full-time equivalents at the time that a growing, aging and more widely-insured population is increasing overall demand for physicians,” the study’s authors wrote. No doubt, not the intention of regulators who are managing the programs having an impact on physicians.

“Many physicians are dissatisfied with the current state of medical practice and are starting to opt out of traditional patient care roles,” said Walker Ray, M.D., president of the Physicians Foundation and chair of its research committee. “By retiring, taking non-clinical roles or cutting back in various other ways, physicians are essentially voting with their feet and leaving the clinical workforce. This trend is to the detriment of patient access. It is imperative that all healthcare stakeholders recognize and begin to address these issues more proactively, to support physicians and enhance the medical practice environment. ”

This survey, conducted biennially since 2008, consistently suggests that physician morale is in decline, and the future doesn’t look so bright: 63 percent of those surveyed said they are pessimistic about the future of the medical profession and about half (shockingly or not so shockingly) of survey respondents would not recommend medicine as a career to their children. And, closer to home, about one-third would not choose to be physicians if they had their careers to do over. Who likely to be a better advocate for bringing in new physicians to the fold than physicians themselves? If they are not doing so, the future looks bleak indeed, needless to say anything about the running off of their negative attitude on colleagues (nurses, etc.).

Not surprisingly, physicians reported that regulatory and paperwork burdens and loss of clinical autonomy as their primary sources of dissatisfaction, with 72 percent saying third-party “intrusions detract from the quality of care they can provide.”

However, a bright spot -- the patient relationship; 74 percent of respondents listed this as the most satisfying aspect of their jobs, followed by “intellectual stimulation” at 59 percent. “Physicians noted that issues such as a lack of clinical autonomy, liability concerns, struggle for reimbursement and decreased patient face-time can all negatively impact the patient-physician relationship – thereby undermining physician satisfaction,” the survey suggests.

An apparent barrier, is value-based care. Only 43 percent of physicians surveyed said their compensation is tied to value. Of these, 77 percent have 20 percent or less of their compensation tied to value.

ICD-10 may be a problem for these folks, too, with the majority of physicians not yet realizing the system’s benefits. Also, electronic health records are no better than advertised, if they perform that well, with “physicians stating that it detracts from patient interaction compared to findings of the 2014 survey.” Only 12 percent said EHRs have improved patient interaction.

Finally, almost 50 percent (46.8 percent) said they plan to accelerate their plans to pursue retirement rather than continue to practice.

“It is striking that so many physicians across the U.S. once again took time to respond to our survey, reinforcing key issues but also bringing to light new challenges,” said Tim Norbeck, CEO of the Physicians Foundation. “Since 2008, this survey has allowed us to explore and amplify the voice of America’s physicians in a data-rich, meaningful way. Our goal is to educate stakeholders on the rising concerns related to medical practice in order to encourage change that will better the lives of both patients and physicians, ultimately improving the delivery of healthcare for all.”

The survey was conducted online from April 2016 through mid-June 2016.

Looks like we may have a long way to go, either up or down, for healthcare and its caregivers to get the best out of each other.

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Scott Rupp

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Scott E. Rupp is a writer and an award-winning journalist focused on healthcare technology. He has worked as a public relations executive for a major electronic health record/practice management vendor, and he currently manages his own agency, millerrupp. In addition to writing for a variety of publications, Scott also offers his insights on healthcare technology and its leaders on his site, Electronic Health Reporter.

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