• Half of U.S. Doctors Plan to Retire, Cut-Back or Seek Non-Clinical Roles

  • Physician Practice Patterns Inhibiting Patient Access to Care, Healthcare Reform


    Biennial Research Commissioned by The Physicians Foundation Examines Physician Morale, Practice Patterns, Value-Based Payments, Doctor Shortages, Medicare / Medicaid Participation Rates and More 

    Boston, MA, September 21, 2016 - U.S. Physicians are changing their practice patterns in ways that will inhibit patient access to care, and they are largely disengaged from the mechanisms of healthcare reform such as value-based payments, accountable care organizations, and electronic health records.

    These are key findings of a major new survey of 17,236 physicians commissioned by The Physicians Foundation, a nonprofit organization that seeks to advance the work of practicing physicians and help facilitate the delivery of healthcare to patients. The survey was conducted for The Physicians Foundation by Merritt Hawkins, a leading physician search and consulting firm.

    According to the research, titled “2016 Survey of America’s Physicians: Practice Patterns and Perspectives,” 48% of physicians plan to retire, cut-back on the number of patients they see or hours they work, seek non-clinical, administrative roles or take other steps likely to inhibit patient access to care. These practice pattern changes will reduce the physician work-force by tens of thousands of fulltime-equivalents at the same time that a growing, aging and more widely insured population is increasing demand for doctors, according to the survey report. 

    “Many physicians are dissatisfied with the current state of the medical practice environment and they are opting out of traditional patient care roles,” said Walker Ray, M.D., president of The Physicians Foundation. “The implications of evolving physician practice patterns for both patient access and the implementation of healthcare reform are profound.” 

    Poor Morale, Invasive Regulations Driving Practice Changes

    The majority of physicians surveyed (54%) describe their morale as somewhat or very negative, 63% are pessimistic about the future of the medical profession, 49% always or often experience feelings of burnout, and 49% would not recommend medicine as a career to their children, according to the survey. 

    Physicians identified regulatory/paperwork burdens and loss of clinical autonomy as their primary sources of dissatisfaction. Physicians spend 21% of their time on non-clinical paper work duties, according to the survey, while only 14% of physicians said they have the time they need to provide the highest standards of care. About two-thirds (72%) said third party intrusions detract from the quality of care they can provide. 

    In response to regulatory burdens and other concerns, physicians are seeking alternatives to traditional, full-time private practice. The survey indicates that only 33% of physicians now identify as private practice owners, down from 49% in 2012, while 58% identify as employees, up from 44% in 2012. A growing number of physicians (13.5%) said they will seek non-clinical, administrative jobs, 21% will cut back on hours worked, 11.5% will take temporary (locum tenens) positions, 10% will switch to part-time practice, 14% will retire, and 9% said they will switch to concierge medicine. If pursued, all of these options are likely to decrease patient access to physician services. 

    “It’s not how many physicians there are that determines patient access to care, it’s how physicians choose to practice,” said Mark Smith, president of Merritt Hawkins. “By retiring, taking non-clinical roles, or cutting back in various ways, physicians are essentially voting with their feet and leaving the clinical workforce, to the detriment of patient access.” 

    Physicians Not Buying Into Mechanisms of Healthcare Reform 

    Physician participation is critical to transforming healthcare from a system driven by volume of services provided to one driven by the value of services provided. However, the survey indicates that many physicians do not participate in some of the key mechanisms designed to achieve health reform, including value-based payments. Only 43% of physicians surveyed said their compensation is tied to value. Of these, the majority (77%) have 20% or less of their compensation tied to value. Only 20% of physicians are familiar with the Medicare Access and CHIP Reauthorization Act (MACRA) which will greatly accelerate value-based payments to physicians.

    While 36% of physicians surveyed participate in accountable care organizations (ACOs), which also are thought to be key mechanisms for driving healthcare reform, only 11% believe ACOs are likely to enhance quality while decreasing costs. Physicians also are dubious about hospital employment of doctors, another mechanism for achieving healthcare reform. Two-thirds of physicians surveyed (66%) do not believe hospital employment of physicians will enhance quality of care or decrease costs. Even 50% of physicians who are themselves employed by hospitals, do not see hospital employment of physicians as a positive trend. Though the great majority of physicians have adopted electronic health records (EHR), a further key to healthcare reform, only 25% said EHR has improved efficiency in their practices while 54% said EHR has detracted from efficiency.

    “Clearly, more physician participation in and acceptance of the key levers of healthcare reform will be needed for a true transformation of the healthcare system from volume to value,” Dr. Ray said. 

    Additional Key Findings
    Additional survey findings include:

    • 80% of physicians are overextended or are at capacity, with no time to see additional patients
    • 48% of physicians said their time with patients is always or often limited
    • Employed physicians see 19% fewer patients than practice owners
    • 46.8% of physicians plan to accelerate their retirement plans
    • 20% of physicians practice in groups of 101 doctors or more, up from 12% in 2012
    • Only 17% of physicians are in solo practice, down from 25% in 2012
    • 27% of physicians do not see Medicare patients, or limit the number they see
    • 36% of physicians do not see Medicaid patients, or limit the number they see
    • Only 6% of physicians said ICD-10 has increased efficiency in their practices 

    “The more than 17,200 physicians who participated in this survey also submitted more than 10,000 written comments – demonstrating the eagerness of doctors to voice their perspectives on the critical issues impacting America’s patients and healthcare system,” said Tim Norbeck, CEO of The Physicians Foundation. “With more than one million data points derived from this survey, our hope is that policy makers, healthcare influencers, media and other stakeholders will use the findings as a valuable resource to better understand the underlying challenges facing our healthcare system, and formulate effective policies that will advance the health and interests of our patients.”

    Please visit physiciansfoundation.org for more information or click here to access the full report. 

    About The Physicians Foundation

    The Physicians Foundation is a nonprofit 501(c)(3) organization that seeks to advance the work of practicing physicians and help facilitate the delivery of healthcare to patients. It pursues its mission through a variety of activities including grant-making, research, white papers and policy studies. Since 2005, The Foundation has awarded numerous multi-year grants totaling more than $28 million. In addition, The Foundation focuses on the following core areas: physician leadership, physician practice trends, physician shortage issues, and the impact of healthcare reform on physicians and patients. As the healthcare system in America continues to evolve, The Physicians Foundation is steadfast in its determination to strengthen the physician-patient relationship and assist physicians in sustaining their medical practices in today’s practice environment. For more information, visit PhysiciansFoundation.org.

    About Merritt Hawkins

    Merritt Hawkins is the leading physician search and consulting firm in the United States and is a company of AMN Healthcare (NYSE: AHS). For more information, visit merritthawkins.com.

    Press Contacts:

    Merritt Hawkins Phillip Miller 469-524-1420 Phil.miller@amnhealthcare.com CooperKatz & Co. for The Physicians Foundation Nadia Deba ndeba@cooperkatz.com 917-595-3064