Many American doctors are pessimistic about the practice of medicine. This unease includes concern about their practice's financial stability and administrative management, as well as use of EHRs, according to a new Leavitt Partners white paper.
Leavitt Partners, which conducted a national survey of 621 physicians between June 2017 and July 2017, found that 38% of doctors surveyed had an overall pessimistic outlook on the practice of medicine today. That feeling was evident among all types of physicians, though some doctors were more negative than others.
The survey found that long-time doctors and solo practitioners were more likely to be pessimistic than other doctors.
Physician satisfaction can influence patient safety and quality. Low morale can also lead to health problems, burnout and high turnover.
David Muhlestein, one of the authors of the paper, told Healthcare Dive in a statement that one key to the survey results is that there isn't one specific type of physician who is pessimistic.
"If there were, we could focus on those physicians and how we could improve their circumstances. Instead, we found that a pessimistic outlook can affect any physician and that a lot of factors associated with pessimism are on the practice-level," said Muhlestein, a chief research officer at Leavitt Partners.
The survey found that 41% were either very optimistic or somewhat optimistic, 21% were neutral and 38% were somewhat pessimistic or very pessimistic.
Muhlestein said one strong trend was that older physicians were more likely to be pessimistic. Nearly half of doctors surveyed with at least 20 years practicing medicine said they have a negative view. That's compared to one-third of pessimistic physicians with less experience.
Other survey results include:
- Nearly two-thirds of physicians said they're not confident in their practice's financial stability.
- Slightly more than half aren't confident about their practice management.
- A little more than half believe their EHRs hurt the ability to provide quality patient care and a similar amount aren't satisfied with their EHR system.
Doctors not happy with their EHR were significantly more likely to be pessimistic.
The study authors warned that pessimistic providers are also cool to the idea of value-based payment models. Most pessimistic physicians don't plan to transition to global or bundled payments and are also less likely to want to change care delivery. Nearly half of those physicians said they're not expanding the role of non-physicians to deliver care. Only about one-quarter of optimistic doctors were resistant to the change.
The study authors suggested some ways to reverse pessimism, including strengthening organizations (such as dissatisfied solo practitioners merging with small group practices) and improving EHRs, so they're more user-friendly and fit into a doctor's daily workflow.
They also suggested that policymakers and stakeholders must keep in mind how value-based payments may affect physician satisfaction. "Empowering a variety of physicians to help shape new programs and initiatives may help to improve physician satisfaction, thereby hastening the move toward value," they wrote.
The results are the latest to show morale issues for physicians. A recent study by JAMA found that physician burnout starts as early as medical school and residency.
A recent Doctors Company National Survey of Physicians found that seven out of 10 doctors wouldn't recommend healthcare as a profession. Respondents to that survey blamed EHRs and regulations for causing burnout. That survey also found little interest in bundled payment programs.
The recent Medical Group Management Association 2018 Regulatory Burden Survey also cited concerns about regulations and EHRs. That survey found that 86% of 426 medical group practices surveyed said regulatory burdens increased for their medical practice over the past year. The MGMA survey respondents also said Medicare and Medicaid value-based programs increased regulations. More than three-quarters added that those value-based payment initiatives didn't improve quality of care.
All of these studies point to not just physician wellness and quality of care problems, but burnout also costing health systems and hospitals as much as $1.7 billion a year. This problem goes beyond morale and patient safety. It can also hurt a hospital's bottom line.