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COLUMBIA, SC – Physicians whose practices are at full capacity or even over-extended are not alone. Nor are those who struggle with government regulations, paperwork and their own morale.
According to a survey of 20,000 physicians released this fall by The Physicians Foundation, 81% of respondents said they were either over-extended or at full capacity, with only 19% reporting that they had enough time to see more patients.
In addition, 44% of the doctors surveyed said they were planning on changes that would limit patient access to their services, including cutting back on the number of patients seen, retiring, working part-time, closing their practice to new patients or seeking non-clinical jobs.
Every two years, The Physicians Foundation, a non-profit healthcare advocacy group, conducts a national survey of physicians on professional morale, doctor shortages, Medicare / Medicaid participate rates, electronic medical records patterns and other issues.
One of the most significant changes documented by the survey relates to practice ownership, with only 17% of physician respondents saying they are in solo practice, down from 25% in 2012. At the same time, 53% of physicians describe themselves as hospital or medical group employees, up from 44% in 2012 and 38% in 2008. Only 35% of physicians describe themselves as independent practice owners, meanwhile, down from 49% in 2012 and 62% in 2008.
Another change is that 7% of physicians now practice some form of direct pay/concierge medicine, with 13% indicating they are planning to transition in whole or in part to this type of practice. The trend is especially strong among physicians 45 or younger; 17% of those practitioners indicate they will transition to direct pay/concierge practice.
While morale remains a troubling issue, it seems to be improving a bit, possibly because of the changing demographics in medicine. Younger physicians, female physicians, employed physicians and primary care physicians tend to be more positive about the current medical practice environment than are older physicians, male physicians, medical specialists and practice owners.
The survey found that 29% of physicians would not choose medicine if they had their careers to do over, a decrease from 35% in 2012. In addition 44% of physicians describe their morale and their feelings about the current state of the medical profession as positive, an increase from 32% in 2012, and 50% of physicians would recommend medicine as a career to their children or other young people, an increase from 42% in 2012 and 40% in 2008.
Still, 69% of physicians said that their clinical autonomy is sometimes or often limited and their decisions compromised.
Government programs and regulations appear to be the greatest irritant for practicing physicians, with 46% giving the Affordable Care Act a failing grade of D or F. Just 25% gave it an A or B.
While 85% of physicians have adopted electronic medical records (EMR), up from 69% in 2012, 46% complain that the products have detracted from their efficiency, while only 24% say EMRs have improved their efficiency. In fact, the survey indicated that physicians spend 20% of their time on non-clinical paperwork.
Half of the respondents said that implementation of ICD-10, mandated by 2015, will cause severe administrative problems in their practices.