Posted on 06/08/2008 4:33:55 PM PDT by neverdem
Almost two-thirds of primary care physicians would choose another field if they had their careers to do over, a new survey indicates, while more than 50 percent consider themselves "second class citizens" compared to surgical and diagnostic specialists.
The survey was conducted for Physicians Practice, an award-winning practice-management journal read by more than 275,000 physicians nationwide. Conducting the survey was physician search and consulting firm Merritt, Hawkins & Associates. The annual survey is intended to measure the career satisfaction levels and concerns of primary care doctors, defined as family practitioners, general internists, and pediatricians. The survey suggests that though primary care doctors are both busy and in increasing demand, they are not necessarily satisfied with their place in the medical hierarchy.
"Between declining reimbursement, rising overhead, and loss of autonomy and respect, primary care physicians are feeling battered," notes Pamela Moore, senior editor of Physicians Practice. "That makes it more crucial than ever for them to create the sort of practice they can actually enjoy."
Only about 40 percent of primary care physicians surveyed said they would stay in primary care if they had their medical education to do over again. About 39 percent said they would become surgical or diagnostic specialists, while about 22% said they would not choose medicine as a career.
Over 80 percent of primary care physicians surveyed indicated that they have busy practices, while fewer than 17 percent stated that they are not busy enough. Over 57 percent said they are contacted about job opportunities about 50 times per year by physician recruiters. Both these findings suggest that primary care physicians are in robust demand and that the job market for their services is favorable.
However, about 60 percent of those surveyed felt that the income they derive from their practice is disappointing. About 50 percent of primary care physicians indicated they earn $150,000 or less a year. By contrast, Merritt, Hawkins & Associates' data indicate that cardiologists, radiologists and other medical specialists commonly earn $300,000 or more. Not surprisingly, fewer than 15 percent consider themselves equal partners with surgical and diagnostic specialists, while 85 percent consider themselves either "junior partners" or "second class citizens."
Practice overhead is a concern for many of the primary care physicians surveyed. The majority (62 percent) said overhead in their practices runs at 50 percent of their income or more. This can make a practice difficult to sustain, Moore notes. Almost 40 percent expressed doubt that their practices could support projected overhead over the next five years.
Complete results of the survey are included in the September/October issue of Physicians Practice magazine, and online at http://www.physicianspractice.com.
About Physicians Practice. Physicians Practice provides award-winning practice-management advice to more than 275,000 physicians through partnerships with 60 medical centers throughout the United States. For more than 17 years, doctors have trusted Physicians Practice for expertise on billing, coding, collections, technology, workflow, staffing, compensation, and much more. Physicians Practice is published by CMP Healthcare Media, LLC, a division of United Business Media.
About Merritt, Hawkins & Associates. Merritt, Hawkins & Associates is a leading physician search and consulting firm. Based in Irving, Texas it is a division of AMN Healthcare (NYSE: AHS), the largest health care staffing firm in the United States.
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Main News Category: Primary Care / General Practice
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As a 20+ year physician in a large multispecialty group, I can tell you that we are seeing these things already.
Yeah, life’s pretty miserable for a doctor...but they’ll keep trundling their paychecks to the bank.
Actually, the point of the article is that many of the primary care physicians won’t.
The employer will be the government. The government will determine what you can earn and redistribute the rest. It's also starting to be outsourced. For example, MRI's can easily be read in India. The time change is perfect. They read it over there and email the analysis back. They are U.S. trained so you can't complain about that. They're happy to learn HERE and then go home and live like kings and queens.
Look for that 22% that wouldn’t go into medicine at all to jump to over 50% with national health care. Any transition would be a disaster for years, with HUGE shortages of doctors. Of course, the media would tell us everything was fine and better than private health care. Those able to leave would leave the profession, and I wouldn’t be surprised if that was immediately 25% or more of the physicians. And that would include that better paying specialties that no longer would be better paid.
This healthcare shortage was engineered by liberals who needed an excuse to socialize the healthcare system.
Not exactly, the debt they took up for their medical education will take years to repay before they get anything out of it. And the work just eats up your life like no other.
this is about as much as a Hospital community outreach administrator makes in Chicago (guess who?)
“This healthcare shortage was engineered by liberals who needed an excuse to socialize the healthcare system.”
The politicians need socialized medicine to show up before Medicare/Medicaid goes belly-up as is projected in the not-so-distant future.
Expect both parties to support it, because neither has the balls to say “government can’t take care of you”.
Then lawsuit mania hit, and they didn't get to have the fun of delivering babies anymore. "Urgent care" clinics opened up. The intimacy of FPs and their patients deteriorated through the defensiveness of the doctors who no longer trust their patients.
Primary care physicians are supplanted by the rise in PAs and NPs. A PA with lots of experience is actually more desirable to a hospital or outpatient clinic than an MD fresh out of school.
Also, talented diagnosticians in primary care devote hours of time to analysis and protocols only to watch the real $$ go to the specialist or surgeon who does the next stage of the patient care. Procedures are highly compensated--excellent diagnoses are not. Resentment of this is natural--human nature. Brains verses brawn sort of thing.
The shortage of specialists is more acute than FPs. The most pressing is the lack of trauma surgeons. ERs across the country are welcoming the downgrading of their Trauma levels.
Litigiouness and the knee-jerk resentment by the public (the attitude that somehow a doc comes by his MD through privilege rather than hard work) is going to create a doc shortage for boomers because the boomer docs are longing for retirement and are preparing well for it.
The problem is that, for many years, medical schools pushed primary care to the point that it was Politically Incorrect to choose specialty training.
As a result, there is now a glut of primary care M.D.'s, nurse practitioners and physician assistants and a shortage of specialists.
In addition, many primary care physicians opted for clinic practices with one day off during the week and with "Hospitalists" taking care of their patients if they need hospital admission. In short, they made themselves interchangeable with outpatient clinic nurse practitioners and outpatient clinic physician assistants.
So, with the Laws of Supply and Demand being what they are, specialists are now swamped with work but very well paid while primary care physicians are treated as somebody that can easily be replaced by a nurse practitioner or a physician assistant and paid accordingly.
I'm not certain. But all of those crooks have the same M. O.
Aren’t most non-primary care residencies currently restricted to graduates of American medical schools, thus guaranteeing a pool of FMGs for the less renumative specialties?
.
I don't think you appreciate the aggravation or the 60 - 70 hour work week that many in primary care have to endure.
Every doctor who goes through rotations in med school should have figured that one out early.
I work for trauma services in a Level 2 center that has been searching for another trauma surgeon for over a year. These people don't grow on trees. Neither do neurosurgeons. We don't want to be downgraded, but a hospital must meet certain staffing requirements to qualify as a trauma center and many centers nationwide are on life support.
We’ve got a couple dozen doctors in our town and everyone of them are greedy little SOB’s. I don’t exaggerate. Somewhere along the line “care” has been taken out of “healthcare”.
No. Also there are many more foreign medical graduates in specialty training than I remember. I’m coming the conclusion that not as many of our best American graduates are going into medicine anymore. The medical school admissions data would not support my position but we certainly hire people here that we wouldn’t have hired 20 years ago. Most of them are in the primary care areas.
Exactly...why go to school for 4 years, residency for 4 years and then a fellowship for a year, if I can go to law school for 3 and make more $$$....
Tens of thousands, perhaps even a hundred thousand of more of qualified US applicants to US medical schools were turned away over the last few decades. Academic and political medicine IS at fault for that if there is a real “shortage” now.
Tell your kids to go to law school, work directly for the government outside of medicine, or run for public office.
National health care will mean less qualified doctors and more care done by non doctor caregivers, no doubt about it. US kids will no longer be motivated to put up with the ever increasing crap and capped salaries that national health care would bring. This is ALREADY HAPPENING WITHOUT NATIONAL HEALTH CARE.
You can’t be “greedy” in medicine...price is regulated...The government and the private insurance companies determine the cost of services...I don’t understand your point.
Just in time for the boomers. Dr. Ken's advice: Don't age and don't get sick or injured.
In my tiny, insignificant life, I personally know four physicians who have either walked away from their practice or retired very early. A lot of the reasons are disgust with HMO proceedures and paperwork, micromanagement, and second-guessing where accountants practice Medicine. One even wrote a book castigating his career.
No, make that five. So here are people who dreamed of a noble, respected profession and put in the time, money and abuses of internship and residency, who essentially say, "I should have been a plumber".
“The government and the private insurance companies determine the cost of services..”’
What planet are you on?? We have a dentist in this town that charges $250 for a routine extraction. The others were charging $75. Now all charge $250. Doesn’t look like regulation to me.
Further hints: her first name is Michele and she formerly attended the church where Rev. Jeremiah Wright preached.
FPs don't see patients in the hospital anymore!! They don't have hospital privileges. They don't want hospital privileges, and who can blame them? Without privileges, they don't have to be "on call" to non-paying patients. When the patient calls the FP after hours, he tells them to "go to the ER."
If the patient comes to the clinic and needs to be admitted to the hospital, the FP says "go to the ER and get admitted." They then have to wait to be seen by the ER doc (hours and hours)--then the hospitalist must come down to formally examine and admit the patient (hours and hours).
re: I work for trauma services in a Level 2 center that has been searching for another trauma surgeon for over a year.
Yup--drive carefully, folks. Not only are trauma centers accepting the downgrading of their ERs, but many hospitals are considering not having a trauma center at all.
Americans don't know how good they have it right now--but this system has got to collapse. When and how, who knows?
But, in the meantime, it's really helpful to resent hospitals and their personnel.
Lawyers always survey among the tops in job dissatisfaction. Now that I think of it, not too many accountants are fired up about their choice of careers and engineers and IT guys are always posting here with advice not to follow in their footsteps.
What’s a guy or gal to do?
Yes, do drive carefully. In addition to staffing issues trauma centers hemorrhage money. It’s hard for hospitals to absorb the cost of this very high priced care. The typical patient is injured because of risky behavior. Not the sort of person who worries about carrying health insurance. Personally, I’d hate to live in an area without a trauma center. Minutes count and the clock is ticking if you’re loaded on a helicopter for a flight to the nearest large city for treatment. Your description of hospitalists was on the money.
I propose "Universal Law Care." The government can regulate every aspect of legal service. That way everybody will get the same quality of legal care...except for those who are "more equal then others...
What planet are you on?? We have a dentist in this town that charges $250 for a routine extraction. The others were charging $75. Now all charge $250. Doesn’t look like regulation to me.
I think that everybody else on this thread is on the planet where M.D.'s are not called "dentists", do not fill cavities and do not pull teeth and the planet where Medicare does not cover either routine dental care or most dental procedures such as cleanings, fillings, tooth extractions or dentures.
M.D.'s do not treat your dog either. Those guys are called "veterinarians". Medicare doesn't cover that either.
Your mileage on your planet may vary.
Sounds like we have a couple of closet democrats commenting here. I was married to a surgeon for 30 yrs until his death. He worked 7 days a week rarely less than 14 hours a day. Missed almost all family holiday meals and celebrations due to emergencies. Missed many of our children’s events and almost missed the birth of our last child. He didn’t set his fees the insurance companies and gov. medicine did. When a call from the ER came he never asked if the patient had insurance took care of them and if they had no coverage and couldn’t pay he wrote it off. He was greatly loved and respected in our community. So I’d like to tell the a$$hat that worries about physicians banking their fees that they earn every damn dime. Incidentally 40% 0f what he earned went for office overhead and malpractice insurance. He provided health insurance for his office staff as well as profit sharing plans.
I refer to dentists as doctors. Perhaps I should have used a different example-there’s plenty of them.
And, I should add, I’m sure there are exceptions.
If all you want is to make money, you can do as well or better than a primary care physician over your entire career by working as a UPS truck driver. The doctor may make more per year, but there are fewer years in his career. The benefits for the UPS driver are WAY better, too.
There are plenty of New York City cops or DC bus drivers or Boston educrats who knock down more money than many doctors, with much less stress and sweat.
-ccm
I agree. Unfortunately, the media and Democrats are hell bent on “fixing” a problem that doesn’t exist (insurance) and they are using the mess caused by the doctor shortage as an excuse. If the media would spend only 1% of its effort trying to fix the problem that DOES exist, we would have solved this problem long ago.
Come to think of it you’re all right.
I think the world is changing much to quickly for the vast majority of even the best and brightest to deal with it.
This makes it difficult for many who may overeat and gain weight and not exercise, or worse yet, abuse alcohol and drugs to try to cope. This makes it difficult to stay healthy, exacerbating the boomer health care problems.
We were told 20-30 years ago that those who got a good education and trained for a good profession, whether it was medicine/related health care professions, accounting, engineering, or law, would not be facing the same kinds of problems that the uneducated and unmotivated would. We were convinced that there would not be the outsourcing of the highly skilled work force. But it seems that there has been a “dumbing down” of the skill necessary for the lowest paid positions that can’t seem to be outsourced. Employers seem to care more about these people who are likely to not show up the first day or leave before the first day’s shift’s end. They seem to find a myriad of similar positions that they wander to aimlessly and seem to somehow survive. Maybe they live in their parent’s basement or on our taxes through govenrment subsidies.
Not to mention the prospect of watching everything you own vanish with the tap of a gavel, and then rematerialize as John Edwards' Learjet.
-ccm
That's nice but this article does not use the generic term "doctor" that can be used to refer to anybody from a neurosurgeon to a Ph.D. in "Women's Studies" at your local university.
This article refers specifically to "Primary Care Physicians" which means something very specific and who are under the price setting situation of Medicare and the insurance companies which you claimed was not the case because of something your local dentists were doing.
In the case of physicians, they can charge whatever they please, $567,967.93 for an office visit is they want to, but the bottom line is that the insurance companies and Medicare will then pay the price that they decided to pay everybody, not a penny more, and that's that.
Even if physicians could collect whatever they wanted, at the slightest suspicion of price fixing with other physicians, the Feds would be on them for "safe harbor" regulations violations like pit-bulls on a pork-chop.
ping
Heh heh!
Exactly right. When I was in med school in the early ‘90s there was a huge push to encourage primary care and discourage subspecialty training.
re: “We’ve got a couple dozen doctors in our town and everyone of them are greedy little SOB’s”
You’ve got a couple dozen doctors in your town, and you know every one of them, and have come to the conclusion that every one of them is a greedy little SOB?
Fascinating.
On a possibly unrelated topic, there’s a saying that if more than three people in one’s life are a**holes, then maybe the problem is one’s own attitude. Perhaps a perception that every single doctor in ones town is “a greedy little SOB” might form a corollary to that saying.
If they bail, pay (=respect) goes up and more move into the job.
Actually, its the AMA. Keep the number of Doctors low, so those that are make big money.
Medicare and insurance reimbursements to primary care physicians are pitiful. On the other hand, my dermatologist gets a fistful of cash every time he squirts freezing liquid on a skin spot.
True in this town. Sorry it bothers you.
Most dental care is not covered by insurance or medicare. Dentists do as they wish and they regulate the number of graduates so that the supply-demand balance favors them.
The medical system isn't working - not for liberals, not for conservatives, not for doctors, not for patients . If it weren't for insurance companies, no one would win in the medical system. ( And doctors and patients together can't stand the insurance companies... but at least they love themselves... which is really sick.)
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