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Physician Survey: Health Reform May Lead to Significant Reduction in Physician Workforce
NEJM Career Center ^ | Mar. – Apr. 2010
Posted on Thursday, March 11, 2010 12:51:53 AM by Ooh-Ah
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What if nearly half of all physicians in America stopped practicing medicine? While a sudden loss of half of the nations physicians seems unlikely, a very dramatic decrease in the physician workforce could become a reality as an unexpected side effect of health reform.
The Medicus Firm, a national physician search firm based in Dallas and Atlanta, conducted a survey of over 1,000 physicians to determine their expectations as to the impact of health reform on their practices, income, job satisfaction, and future career plans. In discussing career plans as part of the recruitment process, physicians have increasingly expressed apprehension and uncertainty regarding health reform’s impact on their practices, and The Medicus Firm wished to investigate this trend further. Additionally, the firm wanted to determine how doctors anticipate health reform to affect physician supply and the quality of medical care nationwide, as these are issues that will directly influence the physician recruiting industry. These factors are in addition to health reform’s more obvious impact on patients and providers of health care services. A total of 1,195 physicians from various specialties and career levels in locations nationally completed the survey.1
The results from the survey, entitled “Physician Survey: Health Reform’s Impact on Physician Supply and Quality of Medical Care,” were intriguing, particularly in light of the most recently published career projections from the Bureau of Labor Statistics (BLS). The BLS predicts a more than a 22 percent increase in physician jobs during the ten-year period ending in 2018. This places physician careers in the top 20 fastest-growing occupations from 2008 to 2018. Meanwhile, nearly one-third of physicians responding to the survey indicated that they will want to leave medical practice after health reform is implemented.
“What many people may not realize is that health reform could impact physician supply in such a way that the quality of health care could suffer,” said Steve Marsh, managing partner at The Medicus Firm in Dallas. “The reality is that there may not be enough doctors to provide quality medical care to the millions of newly insured patients.”
It’s probably not likely that nearly half of the nation’s physicians will suddenly quit practicing at once. However, even if a much smaller percentage such as ten, 15, or 20 percent are pushed out of practice over several years at a time when the field needs to expand by over 20 percent, this would be severely detrimental to the quality of the health care system. Based on the survey results, health reform could, over time, prove to be counterproductive, in that it could decrease patients’ access to medical care while the objective is to improve access.
Furthermore, even if physicians are unable to act upon a desire to quit medicine, there could be an impact in quality of care due to a lack of morale in physicians who do continue to treat patients despite feeling significantly stressed.
Skeptics may suspect that physicians exaggerate their intent to leave medicine due to health reform. Some experts point to the malpractice crisis of years ago, when many doctors also expressed a desire to leave medicine. Some did quit; many did not. However, health reform could be the proverbial “last straw” for physicians who are already demoralized, overloaded, and discouraged by multiple issues, combining to form the perfect storm of high malpractice insurance costs, decreasing reimbursements, increasing student loan debt, and more.
Do physicians feel that health reform is necessary? The survey indicates that doctors do want change. Only a very small portion of respondents — about four percent — feel that no reform is needed. However, only 28.7 percent of physicians responded in favor of a public option as part of health reform. Additionally, an overwhelming 63 percent of physicians prefer a more gradual, targeted approach to health reform, as opposed to one sweeping overhaul. Primary care, which is already experiencing significant shortages by many accounts, could stand to be the most affected, based on the survey. About 25 percent of respondents were primary care physicians (defined as internal medicine and family medicine in this case), and of those, 46 percent indicated that they would leave medicine — or try to leave medicine — as a result of health reform.
Why would physicians want to leave medicine in the wake of health reform? The survey results, as seen in Market Watch, indicate that many physicians worry that reform could result in a significant decline in the overall quality of medical care nationwide.
Additionally, many physicians feel that health reform will cause income to decrease, while workload will increase. Forty-one percent of respondents feel that income and practice revenue will “decline or worsen dramatically” as a result of health reform with a public option, and 31 percent feel that a public option will cause income and practice revenue to “decline or worsen somewhat” as a result. This makes for a total of 72 percent of respondents who feel there would be a negative impact on income. When asked the same question regarding health reform implemented without a public option, a total of 50 percent of respondents feel that income and practice revenue will be negatively impacted, including 14 percent of total respondents who feel that income and practice revenue will “decline or worsen dramatically.” Additionally, 36 percent feel it would “decline or worsen somewhat.”
What do physicians propose for effective health reform? In the survey, physicians were prompted to provide ideas, and some common themes emerged among the hundreds of comments. Tort reform appeared repeatedly, as did patient responsibility and ownership in their health care and costs. Additionally, many physicians emphasized a need for addressing specific issues with separate legislation, as opposed to one sweeping, comprehensive bill.
What does this mean for physician recruiting? It’s difficult to predict with absolute certainty, but one consequence is inevitable. After health reform is passed and implemented, physicians will be more in demand than ever before. Shortages could be exacerbated further beyond the predictions of industry analysts. Therefore, the strongest physician recruiters and firms will be in demand. Additionally, hospitals and practices may be forced to rely on unprecedented recruitment methods to attract and retain physicians. “Health reform, even if it’s passed in a most diluted form, could be a game-changer for physician recruitment,” said Bob Collins, managing partner of The Medicus Firm in Texas. “As competitive as the market is now, we may not even be able to comprehend how challenging it will become after health reform takes effect.”
The survey sample was randomly selected from a physician database of thousands. The database has been built over the past eight years by The Medicus Firm (formerly Medicus Partners and The MD Firm) from a variety of sources including, but not limited to, public directories, purchased lists, practice inquiries, training programs, and direct mail responses. The survey was conducted via emails sent directly to physicians.
1This article was written in January 2010. The survey was conducted by The Medicus Firm, a nationally retained physician search firm, based on the health reform legislation in process at that time.
For more information on the study’s methodology, please contact survey author Andrea Santiago, Director of Communications and Media Relations for The Medicus Firm.
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Anyone supporting MengeleCare deserves the pain pill obama is pushing.
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Just got back from a meeting with a doctor client and he said that ObamaCare will shut him down for good since the carriers will pass off all the bs onto the docs and the reimbursements will go even lower.
I have decided that Obama is not the problem anymore, its those who voted for him and still support him that are the problem. You bammer bots are idiots, dupes, and morons for supporting this communist POFS.
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Sure they can say they aren't going to practice anymore, but once they go from driving their new M3s, AMG CLKS, to driving Hyundai's i'm sure they'll have a change of heart pretty quickly.
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Just got back from a meeting with a doctor client and he said that ObamaCare will shut him down for good since the carriers will pass off all the bs onto the docs and the reimbursements will go even lower.
I have decided that Obama is not the problem anymore, its those who voted for him and still support him that are the problem. You bammer bots are idiots, dupes, and morons for supporting this communist POFS.
What you need to be keeping an eye out for are changes the WHO guidelines, 33. :)
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Sure they can say they aren't going to practice anymore, but once they go from driving their new M3s, AMG CLKS, to driving Hyundai's i'm sure they'll have a change of heart pretty quickly.
Isn't that just nice of you and the govt to impose this on people who spent a small fortune on their education and actually work for a living.
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What you need to be keeping an eye out for are changes the WHO guidelines, 33. :)
This guy was so pissed off today and said that almost every doc he knows is peterified of this takeover.
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This guy was so pissed off today and said that almost every doc he knows is peterified of this takeover.
Imagine someone affording an office while waiting for govt payment, LOL!
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Imagine someone affording an office while waiting for govt payment, LOL!
I swear, what Obama is doing on so many levels is to transparent and obvious, that its unreal that anyone cant see it.
He is pushing a communist takeover of auto/energy/health/fishing/ etc.
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Isn't that just nice of you and the govt to impose this on people who spent a small fortune on their education and actually work for a living.
I work in a field where I speak to 50+ Drs a day and sure they put in the hours for their pre-med but once they got their license they turn into elitist assholes, I feel no remorse for them, they barely do any work, mostly putting everything off on their med assistants, etc.
If you want to see what an honest day of work looks like head over to your local construction site, and watch the guys swinging the hammer.
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I work in a field where I speak to 50+ Drs a day and sure they put in the hours for their pre-med but once they got their license they turn into elitist assholes, I feel no remorse for them, they barely do any work, mostly putting everything off on their med assistants, etc.
If you want to see what an honest day of work looks like head over to your local construction site, and watch the guys swinging the hammer.
When that guy falls are you going to take care of him?
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I work in a field where I speak to 50+ Drs a day and sure they put in the hours for their pre-med but once they got their license they turn into elitist assholes, I feel no remorse for them, they barely do any work, mostly putting everything off on their med assistants, etc.
If you want to see what an honest day of work looks like head over to your local construction site, and watch the guys swinging the hammer.
Cry me a river and grow up. The difference is that the doctor can swing a hammer, the construction worker cant diagnose a disease or illness or save a life.
By your definition, the engineer behind the desk doesnt work hard, but the guy with the jackhammer does.
Without the engineer the hammer swinger doesnt work. There are always more hammer swingers than engineers, the same way in any other profession.
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Cry me a river and grow up. The difference is that the doctor can swing a hammer, the construction worker cant diagnose a disease or illness or save a life.
By your definition, the engineer behind the desk doesnt work hard, but the guy with the jackhammer does.
Without the engineer the hammer swinger doesnt work. There are always more hammer swingers than engineers, the same way in any other profession.
I love posts like his. Occasionally I forget that patients see themselves in an antagonistic relationship with doctors and feel medical care has no value. It's nice to be reminded how many don't appreciate just what it costs/takes to walk in that room to help someone.
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I love posts like his. Occasionally I forget that patients see themselves in an antagonistic relationship with doctors and feel medical care has no value. It's nice to be reminded how many don't appreciate just what it costs/takes to walk in that room to help someone.
I am so sick of this crap. I spent a small fortune going to law school and working my ass off for years with almost no or little money and the minute I make something decent, all the bums and free loaders show up trying to begrudge me anything.
Its the liberal marxist mentality demonizing anyone and everyone over everything.
I am sick of this marxist attitude from people.
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I am so sick of this crap. I spent a small fortune going to law school and working my ass off for years with almost no or little money and the minute I make something decent, all the bums and free loaders show up trying to begrudge me anything.
Its the liberal marxist mentality demonizing anyone and everyone over everything.
I am sick of this marxist attitude from people.
It's better to know than not. Especially when it comes to someone like me, LOL!
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Cry me a river and grow up. The difference is that the doctor can swing a hammer, the construction worker cant diagnose a disease or illness or save a life.
By your definition, the engineer behind the desk doesnt work hard, but the guy with the jackhammer does.
Without the engineer the hammer swinger doesnt work. There are always more hammer swingers than engineers, the same way in any other profession.
A doctor swinging a hammer, now that would be something I would pay to see. lmao.
If doctors were actually concerned with helping people over come whatever type of illness they might have then the story might be different, but they aren't.. instead they are worried that they won't have the same income coming into their pocket, modern day pirates.
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This is why america is contradiction in progress. Everyone thinks they are entitled to best healthcare available, yet at the same time think that highly trained professionals who provide that care should do it for nothing.
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A doctor swinging a hammer, now that would be something I would pay to see. lmao.
If doctors were actually concerned with helping people over come whatever type of illness they might have then the story might be different, but they aren't.. instead they are worried that they won't have the same income coming into their pocket, modern day pirates.
Kinda funny statement considering I know people who are literally mopping floors to finish medical school. :)
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Kinda funny statement considering I know people who are literally mopping floors to finish medical school. :)
we aren't talking about students, we're talking about licensed Doctors who are practicing.
reading comprehension is your friend.
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A doctor swinging a hammer, now that would be something I would pay to see. lmao.
If doctors were actually concerned with helping people over come whatever type of illness they might have then the story might be different, but they aren't.. instead they are worried that they won't have the same income coming into their pocket, modern day pirates.
Oh please. GMAFB!
Cops where I live make as much as the average MD.
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This is why america is contradiction in progress. Everyone thinks they are entitled to best healthcare available, yet at the same time think that highly trained professionals who provide that care should do it for nothing.
Have you ever had an extended hospital visit and taken a look at your bill at the end? or the bill from the Doctors who check up on you every few hours?
It's ridiculous what they try charging, I agree it needs reform.
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we aren't talking about students, we're talking about licensed Doctors who are practicing.
reading comprehension is your friend.
You're not alone in being clueless about what delivering healthcare costs. If reform passes and all of those costs get passed on to the taxpayer there will be wailing and gnashing of teeth at tax time. :)
People honestly think [sic] fees go directly to the doctor and that someone who spent years learning a craft shouldn't be paid. It's a function of perspective and education. I really shouldn't take offense but do wish people had a clue (beyond what shows up on a bill) what delivering healthcare takes before making statements like that.
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Have you ever had an extended hospital visit and taken a look at your bill at the end? or the bill from the Doctors who check up on you every few hours?
It's ridiculous what they try charging, I agree it needs reform.
Are you that naive to believe that what they bill is what they net at the end of the day in their pocket?
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Are you that naive to believe that what they bill is what they net at the end of the day in their pocket?
Yes!! :)
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Are you that naive to believe that what they bill is what they net at the end of the day in their pocket?
Oh I know it's not, but regardless $125 for 5 minutes of their time is a little much, don't you think?
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Have you ever had an extended hospital visit and taken a look at your bill at the end? or the bill from the Doctors who check up on you every few hours?
It's ridiculous what they try charging, I agree it needs reform.
Yeah the reform it needs is for the federal government to repeal the fucked up rules they imposed that create government approved monopolies.
You say you want reform but are going to trust the same bunch off assholes who created this shitburger in the first place.
Maybe its just me but if I hire (elect) someone to do a job and they continually fuck it up, next time I have work available I sure as hell am not going to call the same asshole again.
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Oh I know it's not, but regardless $125 for 5 minutes of their time is a little much, don't you think?
They dont get 125$!
Out of that comes any of the following:
1. Office rent.
2. Malpractice insurance.
3. General Liability
4. Equipment leases.
5. Office supplies.
6. Staff salaries.
7. Medical Biller and accounting.
8. Telephone and computers.
9. Deductions from the carrier or govt.
10. Possible denial of bill for bogus reasons.
Did I include what goes to the doctor?
BTW - what should a doctor make?
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Oh I know it's not, but regardless $125 for 5 minutes of their time is a little much, don't you think?
Dude,
I sincerely wish you knew/understood what that "5 minutes of their time" entailed.
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As someone who has had MANY surgeries from injuries,I must say I love doctors.You go in,they fix you as good as new.The idea that we bash people like this is assanine.The same ones who hate the police but are the first ones to call 911 when they are in trouble.
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You're not alone in being clueless about what delivering healthcare costs. If reform passes and all of those costs get passed on to the taxpayer there will be wailing and gnashing of teeth at tax time. :)
People honestly think [sic] fees go directly to the doctor and that someone who spent years learning a craft shouldn't be paid. It's a function of perspective and education. I really shouldn't take offense but do wish people had a clue (beyond what shows up on a bill) what delivering healthcare takes before making statements like that.
I know exactly what it costs, I deal with HCPC coding and billing issues with Medicare/Medicaid/DMERC all day long.
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It's better to know than not. Especially when it comes to someone like me, LOL!
hey jake..Did you get a good hospital over there in Bmore...
Check this out..I wanted to go to UCLA medical because its near my house...but im at Torrance Memorial Medical instead. Its alright.
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They dont get 125$!
Out of that comes any of the following:
1. Office rent.
2. Malpractice insurance.
3. General Liability
4. Equipment leases.
5. Office supplies.
6. Staff salaries.
7. Medical Biller and accounting.
8. Telephone and computers.
9. Deductions from the carrier or govt.
10. Possible denial of bill for bogus reasons.
Did I include what goes to the doctor?
BTW - what should a doctor make?
are you fucking retarded? no shit they have expenses, JUST LIKE ANY OTHER BUSINESS. 99% of business' require the same type of expenses, THE ONLY REASON WHY Doctors fees are so high is because they can get away with it, when someone is sick and they have the option of paying an outrageous price to be diagnosed and treated or dying in 6 months, I think anyone would go with the first option.
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B'more was nice, Mal.
I'm going to be an hour from home/kids.
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are you fucking retarded? no shit they have expenses, JUST LIKE ANY OTHER BUSINESS. 99% of business' require the same type of expenses, THE ONLY REASON WHY Doctors fees are so high is because they can get away with it, when someone is sick and they have the option of paying an outrageous price to be diagnosed and treated or dying in 6 months, I think anyone would go with the first option.
The average MD makes about 165k - is that too much in your mond? If so, how much should they make?
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I am so sick of this crap. I spent a small fortune going to law school and working my ass off for years with almost no or little money and the minute I make something decent, all the bums and free loaders show up trying to begrudge me anything.
Its the liberal marxist mentality demonizing anyone and everyone over everything.
I am sick of this marxist attitude from people.
Go read Atlas Shrugged. Great read, don't let other getbiggers insult you with lines like, "It's a high school read." It will piss you off but make you think too.
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The average MD makes about 165k - is that too much in your mond? If so, how much should they make?
how ever much our government decides to pay them. ;)
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Go read Atlas Shrugged. Great read, don't let other getbiggers insult you with lines like, "It's a high school read." It will piss you off but make you think too.
I have that on my book shelf. Never read it haha maybe i should.
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how ever much our government decides to pay them. ;)
Then whats next maybe the government decides you make to much and deserver a pay cut, you sure change your tune then.
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how ever much our government decides to pay them. ;)
So you are a communist?
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The average MD makes about 165k - is that too much in your mond? If so, how much should they make?
Not a lot at all considering most take on about $200k in debt for their schooling and then make about $40k for 3-7 years depending on what residency they do.
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They dont get 125$!
Out of that comes any of the following:
1. Office rent.
2. Malpractice insurance.
3. General Liability
4. Equipment leases.
5. Office supplies.
6. Staff salaries.
7. Medical Biller and accounting.
8. Telephone and computers.
9. Deductions from the carrier or govt.
10. Possible denial of bill for bogus reasons.
Did I include what goes to the doctor?
BTW - what should a doctor make?
hahahahaha...this dude is wild..he said 125 for 5 min...
Basically its like this, Shoot and jake can attest...Dude if you wanna be rich. you aint gonna do it being an md. Well not in internal med, GP, Pediatrics,
Now, with Hemo/Onc i think the insurance company gets a lot..
But the real bread is in Plastics in Beverly Hills, New York, and Miami...
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hahahahaha...this dude is wild..he said 125 for 5 min...
Basically its like this, Shoot and jake can attest...Dude if you wanna be rich. you aint gonna do it being an md. Well not in internal med, GP, Pediatrics,
Now, with Hemo/Onc i think the insurance company gets a lot..
But the real bread is in Plastics in Beverly Hills, New York, and Miami...
I'm sure even now those people are not spending as much on that.
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In the UK don't Dr's earn $100K+ in pounds? So right now that's probably $200K US ;D But still this myth that you won't get any money is a joke. I agree costs are high to become a Dr, there should be something in the bill that goes towards lessening the cost of becoming an educated Dr.
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B'more was nice, Mal.
I'm going to be an hour from home/kids.
you back in the islands?
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In the UK don't Dr's earn $100K+ in pounds? So right now that's probably $200K US ;D But still this myth that you won't get any money is a joke. I agree costs are high to become a Dr, there should be something in the bill that goes towards lessening the cost of becoming an educated Dr.
KC - they spend 8 years of education not making anything and going into debt so its a double hit.
They, like other professionals, have to make up those lost earnings over a shorter working peior just to break even.
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I'm sure even now those people are not spending as much on that.
Well not as much as you think. People who get plastics are uber rich (most of the time) and this dosent really effect them as much..
What does suffer is the PCPs and the regular joes because the companies cant afford benefits any more so in a recession, the first thing that goes is the lower level stuff and dental. Because businesses cant afford to give employees health insurance plans
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So you are a communist?
twas a joke buddy.
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KC - they spend 8 years of education not making anything and going into debt so its a double hit.
They, like other professionals, have to make up those lost earnings over a shorter working peior just to break even.
Well what hurts is that, is that you cant get a job like in undergrad...
Unless you get your kai greene on...
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how ever much our government decides to pay them. ;)
Should we regulate the pay of hair dressers?
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KC - they spend 8 years of education not making anything and going into debt so its a double hit.
They, like other professionals, have to make up those lost earnings over a shorter working peior just to break even.
Hence they should have a cheaper education perhaps a bigger government scholarship program. But like i said dr's in the UK live just fine and they too have to be educated, same with in Canada, Australia etc. They earn a very good living.
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Hence they should have a cheaper education perhaps a bigger government scholarship program. But like i said dr's in the UK live just fine and they too have to be educated, same with in Canada, Australia etc. They earn a very good living.
That has nothing to do with what we have here and the reality for docs right now.
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That has nothing to do with what we have here and the reality for docs right now.
That's why i've said it should be included or perhaps in added in the future. Education should not be a life changing experience for the worse, there are far too many universities giving out sh*t degrees and charging up a storm. There needs to be some form of regulation whether by states or government to stop the increasing cost of higher education before it becomes only affordable for those from wealthy means or those with a high debt appetite. Is it any wonder people hurled themselves (with the help of the banking industry) towards financial disaster when by the age of 22 most have the equivalent of a mortgage to pay already?
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Hence they should have a cheaper education perhaps a bigger government scholarship program. But like i said dr's in the UK live just fine and they too have to be educated, same with in Canada, Australia etc. They earn a very good living.
That will ultimately be how any shortage (real or perceived) is solved but will do nothing for people already in practice or entering within the next several years. Unfortunately it will probably create a separate class simply based upon debt load.
It's not all bad. There are cases where this change would lead to improved care in third world countries.
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That will ultimately be how any shortage (real or perceived) is solved but will do nothing for people already in practice or entering within the next several years. Unfortunately it will probably create a separate class simply based upon debt load.
It's not all bad. There are cases where this change would lead to improved care in third world countries.
Well unfortunately it's a case of bad luck if you were born or educated when you paid higher costs. Perhaps there could be some debt forgiveness if the budget allows it.
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Well unfortunately it's a case of bad luck if you were born or educated when you paid higher costs. Perhaps there could be some debt forgiveness if the budget allows it.
There already is a form of debt forgiveness for those willing to work in poor areas. Those slots will just be more competitive.
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