A Review of the Studies and Surveys that Indicate Why Healthcare Practitioners are Leaving the System in America
I’m sure that you have heard the same rumors that I have heard about physicians leaving the healthcare industry. Some of these reports may be true, some may be exaggerated, and some may be scare tactics. But, what is the truth?
Since the healthcare reform debate began in earnest after Barrack Obama’s election in 2008, there have an increase in the number of news articles claiming that doctors would quit in droves if the Healthcare Reform Bill was passed. Now that the HCR Bill has passed, are doctors actually quitting, or planning to quit providing healthcare services? The real answer is not entirely clear at this time.
Three have been many articles written on the results of a survey conducted in 2008 by the Physicians’ Foundation. The Physicians’ Foundation mailed surveys to 270,000 primary care doctors and to 50,000 specialists. Of the 12,000 respondents to the survey, 49% said they would consider leaving the profession, IF they had a viable alternative.
There a couple of significant points within the responses to this survey that most of the headlines miss.
1) The response rate to the survey was extremely low. Less than 4% of the doctors who received the survey responded. It is fair to conclude that if a doctor took the time to respond to the survey, that he probably would agree with the question concerning early retirement or quitting the profession. It is human nature not to take the time to respond if your view is to keep the status quo; i.e. not quit the profession. I would ague that the respondents to the survey were a self selected group, who would be more apt to say that they would quit practicing medicine, and therefore heavily skewed toward those who say they would retire early.
2) Even these respondents qualify their response with the “if they had a viable alternative” phrase. That tells me that they would switch professions if they could make as much money. Like me, most doctors have become accustomed to a certain lifestyle, and it requires a continuing income to support that lifestyle. Since few alternative professions can offer the same income level without extensive retraining, most doctors will continue to practice medicine, though they may wish to change professions.
While the results of this survey are disturbing; in my humble opinion, very few doctors will actually walk away from the profession. Those who do quit the profession may be close to retirement age already, and they may just retire a few years earlier, rather than deal with the changes that are coming because of the Healthcare Reform Bill that was passed into law. A more likely scenario will be that doctors in private practice will combine practices or work for hospitals and leave the paperwork and hassles to others.
A secondary response item that I find more credible and potentially more damaging to the availability of future healthcare is that 60% of the survey respondents who said that they would discourage others from entering the medical profession. It is much easier to avoid the medical profession altogether, than it is to walk away from it when you have over $100,000 in student loans and 8-12 years invested in your education.
If you would like to read the entire survey, it is available in booklet form in a book entitled “In their Own Words”, published by Morgan James Publishing.
Two other significant surveys of doctors were released in September 2009 on the subject of Healthcare reform; with completely opposite results being reported by the media.
The first one was published in the New England Journal of Medicine, and funded by The Robert Wood Johnson Foundation, stated that 73% of the doctors who responded to the survey favored some type of ‘public option’ funding of a healthcare plan. When you look at the actual results of the survey you find that of the 73% who favor some kind of ‘public option’ 63% favored a combination of public and private plans, ( Isn’t this what we currently have?); while only 10% favored a ‘public only’ option, and 27% prefer the ‘private only’ option.
Of note, this survey had a reported response rate of 43.2%, which the much higher than the typical response to any mail survey. It should also be pointed out that the list of doctors surveyed was obtained from the AMA and the AMA publicly endorsed the Healthcare Reform Bill.
The second survey was conducted by Investor’s Business Daily, which found that 65% of those responding opposed any plan which included a ‘proposed government expansion plan.’ The response rate to the IBD survey was less than 6%, a more typical response rate to mail surveys.
While the media has reported that these two surveys show completely opposite results, upon closer investigation they actually report similar findings.
Note: While I was researching this posting, I came across a Fox News Health Blog where the Physicians’ Foundation survey was discussed. The Author then asked for responses to the blog. Most of the responses were from persons within the healthcare field, though some were from patients or suppliers to healthcare personnel. Of the 145 responses, I counted less than five that were favorable toward the healthcare reform that passed earlier this year. As the author pointed out, this is a far cry from the support for the bill from healthcare providers that the AMA and the White House have been trying to portray.
I have to wonder why the AMA has publicly supported the Healthcare reform, when so many doctors oppose it.
Submitted by Dr. DG Comfort, CO
This entry was posted on Thursday, July 1st, 2010 and is filed under Healthcare Reform. You can follow any responses to this entry through RSS 2.0. You can leave a response, or trackback from your own site.
- #1 by DR. MARK WINTERS on July 1st, 2010
THE AMA ‘ SUPPORTED ‘ IT BECAUSE THEY WERE THREATENED BY THE GOVERNMENT TO BE COMPLETELY LEFT OUT AND IF THEY WERE A MALE TURNED INTO A ‘ EUNICH ‘ AS A PROFESSIONAL GROUP WITH ANY POWER TO HAVE ANY INFLUENCE AT ALL IN THE NEW SYSTEM OR IT’S FORMATION – IN SHORT : THEY CAVED INTO A GOVERNMENT BRIBE!!! ANYTHING THAT THE PEOPLE IN GOVERNMENT IE: CONGRESS , THE PRESIDENT, ETC. DON’T WANT FOR THEMSELVES JUST CANNOT BE THAT GOOD.
- #2 by Dr. S. Haines on July 9th, 2010
While I agree with some of your thoughts regarding the ultimate outcome of certain physicians’ choices I am truly concerned you are presenting unsubstantiated opinion in the guise of data driven fact based on the results of these surveys.
It seems strange and confusing when you advise that the response rate to the Physicians’ Foundation survey was “extremely low” even though later you mention a response within a few percent to the IBD survey was “a more typical response rate to mail surveys”. Do you have some professional experience with mail surveys or a reference source for that assertion? Also your conclusions “It is fair to conclude that if a doctor took the time to respond to the survey, that he probably would agree with the question concerning early retirement or quitting the profession. “, and “It is human nature not to take the time to respond if your view is to keep the status quo…” have nothing to do with the survey design or results. I’d say they were arguable at best though I would stand corrected if you could point me to the psychology reference they were based on.
With all due respect when I read the title of your posting I expected more data driven facts and less opinion. It’s certainly your right to put it out there but I think your title is misleading. -SH
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