47% of Primary Care Doctors Think About Quitting

“Change is the price of survival.”

—Winston Churchill

My physician-dad took care of all sorts of ailments and, some of his patients tell me, was a real life saver. Just this summer one family friend and former patient of dad’s told me that my father not only saved the life of his mother, but his also. All on one day.

Although he carried board certification as an internist and a medical examiner, dad took care of families. He was a busy primary care doctor before the title was popularized. I trust that in today’s medical world the skill and caring of America’s doctors endures—if little else.

A new national survey of primary care providers (physicians, NPs, and PAs) from the Commonwealth Fund/Kaiser Family Foundation is out. More than 1,600 doctors were questioned about their “experiences with and reactions to recent changes in healthcare delivery and payment.”

Overall, the opinions of primary care physicians (PCPs) are mixed as to the current state of medical practice. Clearly, they understand that medicine is changing and will probably continue to. The successful physicians will adapt.

Surprisingly enough, with all the EHRs problems doctors cite, they generally like how information technology is helping with bettering healthcare. And in no surprise, nearly half of surveyed doctors said the recent trend in healthcare has them contemplating an early professional exit.

Here are few other PCP survey highlights:

• Regarding PCP pay, only about one-third are compensated exclusively on a fee-for-service basis. The vast majority (64%) say they are paid via capitation or salary. And most physicians (55%) said their “practice receives incentives or payments based on measures of quality of care, patients’ experiences, or efficiency of providing care.

• When it comes to hanging up the stethoscope early due to healthcare changes, nearly half (47%) of the PCPs said they have entertained the idea. This may not be all bad, though. “While physician dissatisfaction is associated with early retirement,” the survey concludes, “a look at historical trends shows that physician satisfaction levels have not changed dramatically over the past 20 years.”

• A clear majority of PCPs are skeptical about whether their performance assessments and financial penalties should be tied to patient outcomes. Half of all doctors “feel that the increased use of quality metrics to assess provider performance” is negatively impacting patient care.”

• When it comes to the increased use of non-physician clinicians, PCPs have very different views from their NPs and PA colleagues about their roles in primary care. Nearly 90% of NPs and PA see charges as positive; just 29% of doctors think that way. Still, regarding teamwork and collaboration among these three healthcare pros, more than 85% of doctors call it satisfying.

• Physicians were asked to “rate Medicaid, Medicare, and private insurers in terms of their reimbursement rates and administrative burden.” Most doctors rate these groups negatively when it comes to getting paid—although private insurance payers score better than public. About half of the PCPs admitted they don’t even know how they get paid by the federal government.

• Has primary care medical practice consolidation slowed? Perhaps. Among the surveyed doctors, just 17% “reported their practices were acquired by or consolidated with a group practice, hospital, or another type of organization within the past two years.”