Physicians assess their concerns about their practice, determine their morale and gauge their satisfaction level.
Through a recently launched landmark survey, physicians — 650,000 of them, to be exact — are being given a voice. The Physicians Foundation, a nonprofit, grant-making organization composed of 17 state and three county medical societies, is surveying physicians nationwide to assess their concerns about their practice, determine their morale and gauge their satisfaction level.
But according to Walker Ray, MD, vice president of the The Physicians Foundation, the survey is much more important than simply determining whether or not physicians are happy.
“In the final analysis, is there a robust, energized medical profession that’s able to meet the demands of current medical practice conditions?” Ray asks, rhetorically. “If the survey indicates that the medical profession feels like it’s in jeopardy, then that urgent message needs to be heard by policymakers and political leaders.”
A critical time
Ray points out that trends over the last several years, including market factors and legislation such as the Affordable Care Act, have put additional stress on physicians — particularly those in private practice. Some have responded by opting out of private practice or abandoning medicine completely, further contributing to the already existing physician shortage.
“I think the specter of [the physician shortage] hangs over everything we do,” Ray says. “Seventy-five million baby boomers will become eligible for Medicare over the next 20 or 25 years. The population in the United States is still increasing, and we still have the same number of doctors. How are we going to do all this at less cost?”
The survey to gauge the pulse of the physician population is the third of its kind that the organization has conducted since 2008, and Ray explains that one of the goals is to examine trends.
For example, the survey asks physicians: What is the financial health of your practice? In 2008, just over one-third of respondents — 34% — said their practice was either breaking even or unprofitable. Furthermore, approximately hald said they planned to make changes to their practice, including retiring, becoming hospitalists or seeking a job inside health care unrelated to patient care.
“The commonality there is that all of this would reduce access to patients,” Ray says. “These are the issues we’re concerned about.”
The survey also tracks medical practice metrics. For example, physicians are asked whether their practice is operating at full capacity, whether they’re overextended and overworked, or if they have time to see more patients and assume more duties. In 2008, 50% of responding physicians said they were at full capacity, while 25% said they were overextended and overworked. Those percentages, Ray says, are disconcerting.
“We are told again and again that physicians need to be more efficient,” he says. “In the past that meant seeing more patients. And that is something that you can only take to a certain point and then you compromise something. You compromise the time that you spend with patients, which eventually may compromise quality.”
Ray says that the health care industry is training the same number of physicians today that it did 15 years ago. That has to change, he says, but not just by training more physicians.
“We need to look at the medical practice workplace environment so that we can retain the physicians that we have,” he says. “So that we don’t have early retirements or we don’t have people seeking jobs outside of health care.”
To that end, the survey will ask physicians what they know and understand about Accountable Care Organizations and risk sharing. Ray does not believe that the public, in general, is well versed in this area, and is curious to see not only what physicians know about ACOs, but whether or not they plan to participate.
“We don’t have all the answers,” Ray admits. “I wish we did. But we’re simply an interested party who wants to be involved and wants to help our patients. That’s really what we, as physicians, should be about, is what is the best for patients and how can we best take care of them.”
Physicians are being invited via email to take the survey, but they can also do so on the organization’s website. The survey will be available through early May, and Ray anticipates having a full analysis of the responses and implications by the fall of this year.
“Part of our mission is to present a forum for the physician’s perspective to be heard by the policy makers, the media, and the general public,” Ray says, “because how physicians view the practice of medicine and how they choose to practice is of fundamental importance to the quality and access to medical care that all Americans get.”