ASN Data Bytes: 2016 Survey Finds American Physicians in a Sour Mood

By Kurtis Pivert

October 2016 ASN Data Bytes

A new survey reports American physicians are pessimistic about the state of health care. Results from the biennial survey conducted by the Physicians Foundation found a workforce that was overextended (80% of respondents), burnt out (49%), and suffering from poor morale (54%).

The most comprehensive survey of its kind was distributed to every US physician listed in the AMA Physician Masterfile, of whom 17,236—or 2.8%—responded. Medical specialists, including nephrologists, accounted for 42.4% of respondents, slightly under their proportional representation among US physicians overall (51.2%).

The full report—2016 Survey of America’s Physicians—details responses to 39 questions on a wide range of issues including patient care, EHRs, and ICD-10 implementation (available at http://www.physiciansfoundation.org/uploads/default/Biennial_Physician_Survey_2016.pdf). Following are several highlights that may be contributing to American physician’s sour mood.

The Decline of Private Practice

In the span of 6 years there’s been a clear shift away from private practice. In 2016, only 32.7% of respondents identified themselves as practice owner/partner/associates, down from 48.5% in 2012. Beginning with the 2014 survey, a majority of US physicians are employed by hospitals (34.6% in 2016) or medical groups (23.3% in 2016).

There are potential effects to this shift. The survey found employed physicians see 19% fewer patients than those in private practice. Physicians also remain wary of hospital employment, with only 44% of respondents agreeing it is likely to enhance care quality and reduce costs.

Figure 1: The Drift Away From Private Practice

 

Increasing Non-Clinical Duties

The increase in the time spent on non-clinical paperwork could be contributing to physician dissatisfaction. After dipping slightly in 2014, the number of hours spent outside of patient care increased regardless of employment setting. Fully one-fifth of respondents’ time is dedicated to paperwork and other non-clinical activities, a total equal to 168,000 physician FTEs.

 

Figure 2: Hours Per Week Spent Outside Patient Care

 

Heading for the Exit?

These and other factors captured by the survey may contribute to many physicians wanting a change, including moving out of medicine. Nearly half (48%) of physicians were planning on reducing hours, retiring, or exploring alternative payer options. Recent changes in maintenance of certification (MOC) could also be a factor, with 44.7% of respondents reporting MOC (as currently structured) doesn’t accurately assess their clinical abilities.

It’s important to note the negative outlook wasn’t universal across physician age and specialty. Physicians starting their careers, women, in primary care, and employed practice settings were generally less negative than their counterparts.

Although the study comes with the usual caveats for surveys (including the potential for sampling and non-response biases to reduce generalizability), the mood captured in this research aligns with other reports of physicians’ concerns about the current state of health care delivery in America. 

What questions do you think should be addressed in future surveys? Email your thoughts to info@kidneynews.org.

Data Source: 2016 Survey of America’s Physicians. The Physicians Foundation

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October 2016 ASN Data Bytes

A new survey reports American physicians are pessimistic about the state of health care. Results from the biennial survey conducted by the Physicians Foundation found a workforce that was overextended (80% of respondents), burnt out (49%), and suffering from poor morale (54%).

The most comprehensive survey of its kind was distributed to every US physician listed in the AMA Physician Masterfile, of whom 17,236—or 2.8%—responded. Medical specialists, including nephrologists, accounted for 42.4% of respondents, slightly under their proportional representation among US physicians overall (51.2%).

The full report—2016 Survey of America’s Physicians—details responses to 39 questions on a wide range of issues including patient care, EHRs, and ICD-10 implementation (available at http://www.physiciansfoundation.org/uploads/default/Biennial_Physician_Survey_2016.pdf). Following are several highlights that may be contributing to American physician’s sour mood.

The Decline of Private Practice

In the span of 6 years there’s been a clear shift away from private practice. In 2016, only 32.7% of respondents identified themselves as practice owner/partner/associates, down from 48.5% in 2012. Beginning with the 2014 survey, a majority of US physicians are employed by hospitals (34.6% in 2016) or medical groups (23.3% in 2016).

There are potential effects to this shift. The survey found employed physicians see 19% fewer patients than those in private practice. Physicians also remain wary of hospital employment, with only 44% of respondents agreeing it is likely to enhance care quality and reduce costs.

Figure 1: The Drift Away From Private Practice

 

Increasing Non-Clinical Duties

The increase in the time spent on non-clinical paperwork could be contributing to physician dissatisfaction. After dipping slightly in 2014, the number of hours spent outside of patient care increased regardless of employment setting. Fully one-fifth of respondents’ time is dedicated to paperwork and other non-clinical activities, a total equal to 168,000 physician FTEs.

 

Figure 2: Hours Per Week Spent Outside Patient Care

 

Heading for the Exit?

These and other factors captured by the survey may contribute to many physicians wanting a change, including moving out of medicine. Nearly half (48%) of physicians were planning on reducing hours, retiring, or exploring alternative payer options. Recent changes in maintenance of certification (MOC) could also be a factor, with 44.7% of respondents reporting MOC (as currently structured) doesn’t accurately assess their clinical abilities.

It’s important to note the negative outlook wasn’t universal across physician age and specialty. Physicians starting their careers, women, in primary care, and employed practice settings were generally less negative than their counterparts.

Although the study comes with the usual caveats for surveys (including the potential for sampling and non-response biases to reduce generalizability), the mood captured in this research aligns with other reports of physicians’ concerns about the current state of health care delivery in America. 

What questions do you think should be addressed in future surveys? Email your thoughts to info@kidneynews.org.

Data Source: 2016 Survey of America’s Physicians. The Physicians Foundation

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