From the desk of the EMD: Taking the pulse of the American physician

August 5, 2019

Bill Finerfrock, the College’s lobbyist in Washington, DC, sent me a survey that had just been published by The Physicians Foundation. I had never heard of this group. They list themselves as a national, not-for-profit grant-making organization dedicated to advancing the work of practicing physicians and to improving the quality of health care for all Americans. No doubt their mission complements the College’s mission. They were founded in 2003 through the settlement of a class-action lawsuit brought by physicians and state medical associations against private third-party payers. Their Board of Directors is comprised of physician and medical society leaders from around the country. One of their research initiatives has been conducting a nationwide survey every two years called Survey of America’s Physicians. The latest, which was just published, was conducted in 2018 and is based on responses of over 8,000 physicians, about a third of those in primary care. There is no information on the number of allergists who took part in the survey. I found some of the results to be surprising and disturbing and I want to share them with you.

1. Physicians are working fewer hours and are seeing fewer patients.

I would have thought it was just the opposite. The survey noted that younger physicians and employed physicians are seeing fewer patients than physicians that are leaving the workforce. Their data showed that employed physicians see 11.8% fewer patients than practice owners even though they work 3.4% more hours. It was thought that employed settings require more paperwork or other duties which limit physician/patient time than do independent practice settings, or that independent practice owners may have more motivation to see a large number of patients than do employed doctors. This is a very disturbing trend with the continued worsening shortage of physicians.

2. 62% are pessimistic about the future of medicine.

Maybe I am too optimistic, but it surprised me that this number was so high. The results are markedly different for employed compared to practice owners and by age. A small majority of the employed physicians (51.5%) expressed positive feelings about their morale, and the current state of the medical profession, while only 36.7% of practice owners did so. Of physicians age 45 or younger, 57.4% expressed positive feelings about their morale and about the medical profession, while only 39% of physicians age 46 or older expressed such feelings. In the long run, this makes me feel better for the future of medicine.

3. 26% of physicians favor a single payer health system, 35.5% favor single payer with a private insurance option, and 27% favor a market-driven system.

I knew there has been a movement by U.S. physicians toward some type of single payer system, but I did not realize it was almost 75% of physicians. Probably the reason for these results is related to the answer to another survey question: How Much Ability do Physicians Have to Significantly Influence the Health care System?

4. 88% of physicians indicate that some, many or all of their patients have a social situation (poverty, unemployment, etc.) that poses a serious impediment to their health. Only 1% of physicians indicate that none of their patients have a social situation that poses a serious impediment to their health.

I suppose I should not have been surprised but these numbers are so high. It’s frustrating and probably contributes to much of the poor morale and high burnout that is seen in U.S. physicians.

There is much more data that is interesting, but I can’t cover it all here. Findings on telemedicine, burnout, relationships with hospitals and patient adherence to treatment plans are worth a look. You can download a copy to see all the results.

Michael Blaiss, MD, FACAAI, Executive Medical Director