The Physicians Foundation released part three of its 2022 Survey of America’s Physicians, which assessed the state of the physician practice and strategies to improve it.
“Before the pandemic and now, regulations and compliance have changed the landscape of physician practice—resulting in an environment that has negatively impacted physicians’ ability to deliver patient care and their overarching outlook on the profession,” said Gary Price, M.D., president of The Physicians Foundation. “Not only has our survey found that nearly half of physicians do not have high professional morale, but also that half would not recommend medicine as a career to young people. Many physicians feel overworked, underappreciated and unable to do their jobs to the best of their ability.”
Capacity Issues Impact Physicians’ Ability to Deliver Patient Care
Approximately one in three physicians has experienced a reduction in staff over the past year with the most shortages reported for registered nurses (90%), nursing assistants (86%), social workers (85%), physicians (84%) and licensed practice nurses (83%).
Among those who reported staff shortages, physicians stated that the most impactful contributing factors were:
- 85% reported administrative burdens
- 79% reported increased working hours without compensation
- 71% reported reduced salaries/benefits
Furthermore, almost one-quarter of physicians stated violence in the workplace as a contributing factor to staff shortages.
Additionally, one-third of physicians reported that their current practice is overextended and overworked, with nearly half of physicians also stating that they are at full capacity in their current practice.
“Staff shortages, combined with the negative outlook of physicians on their profession, reveals a physician practice environment that is unhealthy, unacceptable and detrimental to physicians and the future of medicine,” said Dr. Price. “We need to take action to help our physicians and, ultimately, the health of our patients.”
Mounting Challenges Are Affecting Primary Care
Primary care plays one of the most important roles in shifting our health care system to one that prevents disease rather than treats disease. Unfortunately, physicians are facing mounting challenges in primary care, most notably:
- 85% report administrative burdens, such as EHRs and prior approval
- 70% report lack of insurance for patients
- 64% report not prioritizing mental health integration
- 63% report pay-for-performance measurement
“Reductions in staff, administrative burdens, prior authorization and concerns with reimbursement have had devastating effects on primary care physicians and their practices,” said Robert Seligson, CEO of The Physicians Foundation. “We must acknowledge the critical role primary care plays in enhancing access to care and improving outcomes for patients and prioritize implementing solutions.”
Physicians identified which strategies would most improve the state of primary care, including reimbursement for responding to questions through emails, texts or telephone calls (86%), building partnerships to foster preventive health discussions, such as vaccinations, to reach critical populations, such as rural and low-income communities (84%) and evaluating reporting requirements to align with delivering quality care (76%).
Without action to address how we staff our care centers and how we deliver primary care, shortages will grow, and the resulting health of the country will worsen. The path towards this action is clear—physicians have identified what would most support them in ensuring access to high-quality, cost-efficient care for all patients. Approximately nine in 10 physicians identified simplifying/streamlining prior authorization for medical services and prescriptions; reimbursing physicians for providing telehealth services; simplifying access to integrated mental health services and advancing interoperability of EHRs as important.
Additionally, physicians identified the most important strategies to address staff shortages were:
- Removing low-value work
- Eliminating insurance approvals
- Offering customized retention strategies
- Addressing burnout among physicians/staff
“There is extensive action needed on the systemic, structural, organizational and policy level to improve the state of physician practice in 2023 and beyond,” said Seligson. “As much as we are at a worrisome inflection point, we now know where we stand and how we can spur action and drive change, so we can preserve our health for today and tomorrow.