Seven out of 10 physicians are unwilling to recommend their chosen profession to their children or other family members, with frustrations over electronic health records (EHRs) and value-based care ranking as key reasons why, according to new research.
The nationwide Future of Healthcare Survey of over 3,400 physicians was released today by The Doctors Company, a the physician-owned medical malpractice insurer. The survey collected 2,291 written responses voicing physicians' frustration at how EHRs and value-based care and reimbursement are compromising the traditional doctor-patient relationship, indicating their advocacy for preserving this relationship and providing high-quality care.
More specific key findings of the survey included:
- 54 percent of physicians believe EHRs have had a negative impact on the physician-patient relationship.
- Half of physicians believe value-based care and reimbursement will have a negative impact on overall patient care.
- 61 percent of physicians believe EHRs are having a negative impact on their workflow, with many suggesting that EHR requirements are a major cause of burnout.
- 62 percent of physicians said they don't plan to change practice models, perhaps indicating that the pace of practice change seen in recent years may have run its course.
The research included several noteworthy quotes and statements from survey respondents. On the topic of burnout, one surgeon from Ohio specifically said, “We love what we do—but we are sick of the mental, physical, financial and emotional abuse...the future of our profession is at stake and we need to restore the dignity back to the physician-patient relationship.” Another specialist from California, speaking to the burden problem as well, stated, “The path of the practice of medicine has become overregulated with unreasonable non-medical demands on the doctor, [including] the EHR plus regulations that have nothing to do with medical care. The automation of fast food medicine has rescinded the joys of medical care.”
One surgeon from California noted, “EHR is a complete waste of time. To ask a physician to function as a scribe is inefficient.”
Meanwhile, as it relates to concerns over the shift to value-based care, the responding physicians seemed to understand the logic behind the concept but did have plenty of apprehensions, nonetheless. Said one primary physician from New Mexico, “It makes sense overall, but if the rewards are insufficient for complying and repaying the years of sacrifice made while training, practicing medicine would not be worth the stress.”
Another PCP in Oregon noted, “I strongly suspect that as the industry shifts more towards ‘value-based care’ and ‘pay-for-performance’ models we will see a significant portion of the population finds themselves unable to find PCPs.” A California surgeon remarked, “I think value-based care may help reduce the huge volume of unnecessary spine surgery, which is a big concern of mine.” An Ohio surgeon stated, “The EHR was supposed to improve care, but it has done the opposite; value-based care will likely also.”
Besides value-based care, another compensation change doctors are facing is bundled payments, which generally provide a single, comprehensive payment that covers all the services involved in a patient’s episode of care. Doctors appear mixed on bundled payments, with 48 percent not planning to participate and 52 percent either planning to participate, undecided, or needing more information.
Though bundled payments have been mandated for health systems providing joint replacement in certain metropolitan areas, recent moves by CMS have halted bundled payment programs in other environments.
The survey further showed that over half of physicians say they are contemplating retirement within the next five years, including a third of those under the age of 50.
While a vast majority of doctors said they would be unwilling to recommend their profession to future generations, the research did also show that they have not wavered in their advocacy for preserving the doctor-patient relationship and providing high-quality care.
