6 in 10 Physicians Would Quit Today

John Commins, for HealthLeaders Media , September 26, 2012

"Physicians think of themselves as being autonomous in making decisions in the patient's best interest, but employed physicians have to have one ear open to what their employer is saying. Otherwise they put their jobs in jeopardy," he says.

Most physicians just want out.

"We found that 60% said they would retire today if given the opportunity. What was worrisome is that this is up from 45% in 2008," Walker says. "We also know from the survey that we disaggregated it into certain categories, 47% of physicians under 40 said they would retire today if given the opportunity."

Walker acknowledges that some physicians could be speaking out of frustration and that they do not intend to leave practice. "But even if only a small percentage follow through on any of that it could be worrisome to the workforce," he says.

"We have 75 million Baby Boomers transitioning to Medicare starting last year over the next 12 or so years. We have a growing population. We have 32 million people who may be gaining health insurance and yet we have the same number of doctors. We have a bottle neck for training. We are training 25,000 or so doctors a year and the fact that we are finally building some new medical schools is not going to increase the doctor supply because the residency level is fixed at 25,000 or 26,000 positions."

The online survey was conducted from late March to early June by Merritt Hawkins with an overall margin of error of less than 1%. Phil Miller, vice president of communications at Merritt Hawkins, says physicians are caught amid crosscurrents in healthcare delivery and it's proven challenging to find incentives that work for everyone.

"We have a doctor shortage, so we want doctors to stay busy and be productive and see a lot of patients. But you are rewarding them with a salary which they know they are going to get regardless of how many patients they see. So you try to build in incentives that will keep them focused on volume," Miller says.

"At the same time, you have this crosscurrent that says 'let's not reward them for volume. Let's reward them for quality and patient satisfaction and these subjective metrics.' So we have two trends working at cross purposes and at the end of the day the doctors are going to take the salary. They may achieve some of their production bonuses, but it is going to be more of a nine-to-five, do-your-job-and-go-home-type of profession," Miller says.

Walker says the issues that zap physicians' enthusiasm run deep. "We have to improve the medical practice environment and the things physicians are most concerned about are autonomy, regulatory issues, liability issues, and reimbursements," he says. "We've got to fix some of those things to keep the workforce together because we not only want to train more physicians, we want to retain more in their practices and that is not happening now."

John Commins is a senior editor with HealthLeaders Media.

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5 comments on "6 in 10 Physicians Would Quit Today"

MargieR (9/29/2012 at 7:25 PM)
My mother quit her practice when she was sued for "malpractice" by a woman who had never been to her office. (the woman's sister's kids were patients of my mother.) She thought she could get a fortune in "damages and claim that the file had been lost. My mother was able to show that the woman had never been there, nor had her kids, but the lawyers went through every one of mom's patient files, looking for something someone could sue her for so that they could collect the big bucks for themselves. No errors were found (Did I mention my mother was obsessive compulsive about her patient records in order to have complete records available to her each time a patient came in.) As soon as the lawyers left, she closed up shop and retired, literally the next day. She took every one of her patient files with her, just in case someone tried the same trick again, all her files would be available. My daughter's pediatrician also retired because he was sick and tired of all the lawsuit threats. Doctors don't quit as much from burnout as from harassment from the legal community. (Ambulance chasers).

Kidydr (9/29/2012 at 7:24 PM)
This article nails the problem with medicine today. The government wants us to provide "medical homes" now where we are expected to do even more for less. As for the gentleman's comment that we don't want to leave because we don't know how to do anything else, the same could be said for any profession, not just medicine. It is IMPOSSIBLE for us to increase our volume without sacrificing quality at some point in time. We train for a minimum of 7 years, after college and accrue $100K plus in debt. We expect fair compensation for that effort. Anyone who says we make too much should go to medical school and see how they feel about compensation afterwards. The fact is that most of us care deeply for our patients and what we do for a living but insurance companies and the government rely upon our good nature and dump on us in the process with substandard reimbursement. Shame on you.

martydiamond1@me.com (9/28/2012 at 2:16 PM)
The findings are significant as they point to increasing dissatisfaction with systems development versus the independent practice option. The latter is rapidly diminishing and will go the way of the buggy whip within ten years. The reimbursement switch is being flipped to quality not piece work. Technology will aid in the measurement of quality and become the basis for meaningful incentives related to evidence-based practice. The next ten years promises to be a period of "adjustment" for clinicians and systems until they learn the benefits of collaborating in order to improve patient outcomes in a patient-centered environment. It took seventy five years to get meaningful health reform, now it will take about twenty five to realize improvements in care. Those motivated to practice medicine will continue to apply in increasing numbers. Marty Diamond




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