The American Association of Medical Colleges now estimates a shortage of between 37,800 and 124,000 physicians by 2034.
As the pandemic slowly morphs into an endemic, its impact on primary care physicians continues to tug at the seams of an already fraying healthcare system. Now rising to the top of America’s healthcare challenges is the looming physician shortage, predicted with increasing urgency every year since the early 2000s. Accelerated by a perfect storm of pandemic closures, physician retirements, an aging population and escalating demand for acute and preventive care, the American Association of Medical Colleges now estimates a shortage of between 37,800 and 124,000 physicians by 2034. Simultaneously, the current surging popularity and predicted 10% annual growth of concierge medicine practices, characterized by patient panels kept intentionally small and personalized, appears to intensify the issue at a pivotal time.
However, appearances can be deceiving and statistics can be misleading. Following are reasons to recognize the opposite may prove to be true: concierge medicine is not fueling the physician shortage, but in fact, may represent one of the most viable potential solutions. By presenting a sustainable, autonomous model that eliminates much of the burnout continuing to pummel the spirits of our country’s healthcare community, concierge medicine is both extending the active practice years of experienced, dedicated physicians and inspiring the best and brightest students to enter primary care. The dialogue on how to fix a broken healthcare system, which began well before the pandemic, has shifted to increased recognition of the value offered by this alternative practice model.
For example, Erin Sullivan, PhD, research and curriculum director at Harvard Medical School Center for Primary Care, told Scientific American: “Pre-pandemic, I would have said, 'We don’t have enough physicians choosing to practice primary care. And if those physicians who do choose primary care elect to practice in models such as concierge, then you could see how that would exacerbate a shortage. On the other hand, if these models prove to be more attractive or sustainable ways for physicians to practice primary care, then can we increase the number of physicians electing to practice primary care? And can we learn from these models to build something better and accessible for all patients?"
And when asked about the effect of concierge and direct primary care models on the physician shortage, Dr. Reid Blackwelder, past President of the American Academy of Family Physicians and currently the Chair of Family Medicine at East Tennessee State University, told Medscape: “All of these models are ways of investing in primary care. Primary care is about relationships and communication, and that's really one of the benefits of any model. With the pandemic, we've made some changes in how we interact with our patients that I think were exactly what we needed.”
“Listen to your patient, he is telling you the diagnosis.”
The observation made in the 1890s by internal medicine pioneer Dr. William Osler holds true for today’s physicians, who have accurately diagnosed the major cause of our system’s ills: emphasizing volume-based care with little regard for the individual practitioner trapped on the hamster wheel. Doximity's 5th annual Physician Compensation Report found that over 73% of physicians said they were overworked. As a result, more than half of physicians surveyed by Jackson Physician Search said they were considering an employment change, such as retirement (21%), leaving the profession (15%), or finding a new employer (50%). The most recent report from Medscape underscores the ongoing dissatisfaction, with 55% of physician saying they would take a salary reduction to achieve a better work-life balance.
Failing to care for the caregivers in a traditional fee-for-service practice model or in a large healthcare system group is quickening the exodus of dedicated physicians who feel unheard and unappreciated. The Advisory Board sounded the alarm earlier this year, writing: “Whether it's during the omicron surge or shortly after it passes, there has never been a moment when we think doctors are more likely to quit. And even if they don't quit, we question the quality of care that's being delivered, given that burnout leads to worse patient outcomes and increased medical errors.”
In contrast, concierge medicine physicians are remaining in practice longer than they initially planned, buoyed by an intense satisfaction with their calling and the ability to balance personal and professional needs. Long-time physician search expert and founder of Athenic Group Craig Fowler notes that in his work on succession planning with doctors, those in a concierge practice consider retirement at a significantly older age than those in a traditional model. “They’re able to slow down, enjoy a good quality of work life and retire on their own timetable,” he says. “On the other end of the spectrum, I’m also seeing a real movement toward this type of practice among younger physicians, who are very intrigued by the opportunity to remain independent and provide highly personalized care.”
Not the Retiring Type
At Specialdocs we are privileged to work with many deeply experienced physicians who remain more committed than ever to staying in active clinical practice. Maintaining the irreplaceable wisdom of these doctors benefits everyone in the healthcare system and ensures that hundreds of thousands of patients continue to receive care from the physician they trust most. We share a few highlights below:
Dr. J.W., Riverside, CT: “I’m now starting my 41st year as a physician and have no plans to retire in the near future. I’ve never loved being a doctor more, knowing I can make a real difference in my patients’ lives.”
“Before transitioning with Specialdocs in 2018, I was ready to quit medicine and retire early. My spirit was completely broken by a medical system focused not on the individual, but on giving superficial care to a high volume of patients. The physician-patient connection is sacred to me, and to an entire generation of doctors who were beaten up by a number-crunching approach to healthcare. It not only violates the essence of that relationship, but results in thousands of dollars of potentially unnecessary tests and missed diagnoses. As a concierge physician, I now have the time to take a thoughtful, thorough history at each visit, talk with the ER doctor seeing my patient, or cut through the bureaucracy and arrange an urgent, lifesaving consult with a specialist.”
Dr. W.K., Chicago, IL: “The term ‘burnout’ is no longer part of my vocabulary.”
“When I first thought about concierge medicine in the mid-2000s, I felt I was just a few years away from retirement. I didn’t like the world I was practicing in then, and the pace was such that I feared making mistakes I would regret. Changing to the Specialdocs model eliminated the day-to-day stress so well it’s added years to my practice. I never imagined I’d be working into my 70s, but I am in no hurry to retire now, and am truly grateful that I was able to continue to care for my patients throughout the pandemic. It’s an exceptionally rewarding path and I hope younger physicians, and those in their 50s and 60s consider the model, helping to preserve this high quality of care in the future.”
Dr. E.B., Wantagh, NY: “I undoubtedly would have left medicine earlier had it not been for my change to a concierge practice 2020.”
“Like so many physicians enduring the challenges of 2020, I was burnt out with the current state of the medical system. At 68 years old, I initially felt my choices were limited to early retirement or joining a local large hospital group, but partnering with Specialdocs to launch a concierge medicine practice offered a much better alternative. This model has changed everything - relieving the stress constantly felt by me and my staff, giving me time to provide patients with all the time and information they need, and allowing me to fully enjoy my life outside of the office. I love practicing medicine this way and plan to keep caring for patients as long as possible.”
Terry Bauer is CEO of Specialdocs, a concierge medicine pioneer that has transformed physicians’ professional lives since 2002, empowering them to deliver personalized patient care.
To be continued - Part Two: Keeping the Doors Open with Concierge Medicine