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Survey: One in three PCPs considering leaving their practice


Rapidly-changing reimbursement models, rising practice expenses, and the frustration of not being able to spend more time with patients top the list of PCP concerns in the 2013 Wolters KLuwer physician outlook survey.

Managers and owners of primary care practices may find themselves scrambling to fill vacancies in the next year or so.

            A new survey from Wolters Kluwer Health of the top issues and challenges facing primary care physicians (PCPs) finds that one in three are “very likely” or “somewhat likely” to leave their practice in the next 1 to 2 years. Reasons cited by survey respondents include “hard to make the practice profitable” (29%), “time to retire” (25%), and “field is no longer rewarding” (15%).            

            The good news is that 58% of survey respondents say it is “very” or “somewhat” unlikely that they will leave. The remainder are unsure of their plans.

            Among business practice challenges, 91% of respondents said “managing shifting reimbursement models with payers” was either “very challenging” (47%) or “somewhat challenging (44%.) That was followed closely by financial management in a time of increasing costs and declining reimbursements (90%). Others cited were “spending sufficient time with patients” (88%), dealing with the impact of the Affordable Care Act  (ACA) (84%), and “keeping up with the latest research (83%).

            Asked about specific concerns regarding the ACA, 55% say the legislation will have either a “very negative” (21%) or “somewhat negative” (34%) impact on the nation’s overall healthcare costs, and 50% say it will adversely affect their practice.  On the positive side, 27% feel the ACA will have either a “very positive” (4%) or somewhat positive (23%) impact on patient care and clinical outcomes, and 26% say it will have a positive effect on the “overall health of the healthcare system” where they practice.

            The survey found that mobile communication devices are now commonplace among PCPs, with 80% reporting that they use smartphones in their daily practice, and about 60% using tablet devices such as the iPad or Kindle Fire. The most common use for smartphones is accessing drug information such as dosage calculators and side effects (72%), followed by communicating with nurses and other staff (44%) and accessing medical research (43%.)

Medical research access is the most common use for tablet users (63%), followed by access to drug information (55%) and access to evidence-based clinical reference tools (50%.)

Respondents were mildly upbeat on the topic of adopting health information technology (HIT) in their practices. More than half (55%) said they have seen “significant” or “some” progress in the use of HIT to ensure patient safety and improve the quality of care for patients.

The survey of more than 300 PCPs was conducted in April for Wolters Kluwer by the polling firm Ipsos. The full survey can be viewed at:

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Jennifer N. Lee, MD, FAAFP
© National Institute for Occupational Safety and Health
© National Institute for Occupational Safety and Health
© National Institute for Occupational Safety and Health
© National Institute for Occupational Safety and Health
© National Institute for Occupational Safety and Health
© National Institute for Occupational Safety and Health