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tazzygirl -> RE: Mass exodus of Physicians? (12/14/2010 4:42:39 AM)
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Their 2008 survey yielded
quote:
The last time the foundation asked doctors about their plans was in 2008. In that survey of 11,950 responding physicians, including family physicians, general internists, pediatricians and obstetrician-gynecologists, just over 51% planned to continue practicing as they had been and only 11% said they would retire. Slightly more than 7% talked about changing to concierge medicine, and nearly 8% planned to switch to locum tenens.
The 2010 survey...
The survey was completed by 2,379 family physicians, internists, pediatricians, obstetrician-gynecologists, cardiologists, orthopedic surgeons, radiologists, anesthesiologists, general surgeons and hospitalists in June, July and August. About 59% were part of physician-owned practices; 41% were employed by a hospital or other large entity -- below the overall 52% employed physician rate reported by the Medical Group Management Assn.
Only 26% of respondents planned to continue practicing as they have been for the next three years. A total of 14% planned to switch to locum tenens work, and 11% said they will take hospital jobs. About 16% intended to switch to concierge or cash practices, and 16% planned to retire.
Other notable changes between the two surveys done by the same group...
The question about hospital employment was not asked in the 2008 survey but was added in 2010. That's because of increased hospital interest in hiring physicians, particularly in the wake of the Patient Protection and Affordable Care Act.
The 2010 Physicians Foundation survey found significant dissatisfaction with the new health reform law. The major goal of the survey, "Health Reform and the Decline of the Private Practice," was to assess physicians' views of the legislation.
According to the survey, 67% felt "somewhat" or "very negative" about it when it was enacted in March. An additional 27% were "somewhat" or "very positive." After the initial reaction subsided, 10% felt more positive but 39% were more negative.
Of the respondents, 54% believe patient volume would increase because of reform, but 69% said they did not have the time or resources to treat additional patients while maintaining quality of care. A total of 68% believe that reform would diminish the financial viability of their practice.
"There's general anxiety about big government, and it is shared by physicians," said Tim Norbeck, the foundation's executive director.
This anxiety was compounded by numerous short-term Medicare pay patches in 2010.
According to the foundation's survey, physicians place reform of the sustainable growth rate formula (36%) above health reform (34%) as the policy that could have the greatest effect on their practices. An additional 30% said they were unsure which of the two would be the bigger issue.
Although the Physicians Foundation's survey documented a malaise among some physicians, experts cautioned about generalizing based on the results. Foundation representatives said the survey was mailed to 40,000 physicians and e-mailed to 60,000, with 2,379 completing them for a response rate of only 2.4%.
Even those conducting the surveys don't expect that every physician who says he or she will make a change will do so. However, "a certain percent are going to make a change, and this will have a significant impact on the delivery of health care," said Mark Smith, president of Merritt Hawkins & Associates, a physician placement firm in Irving, Texas, that conducted the survey for the foundation. "We are going to see a migration away from private practice to employment."
For example, the foundation noted that many of the options physicians might choose would involve treating fewer patients, which could exacerbate doctor shortages.
Dr. Lauer, who hopes to retire in five years, said he has no regrets about moving 2,000 miles from central New Jersey to southeastern New Mexico to leave private practice for hospital employment.
He said he still works hard, but it's eight to 10 hours a day rather than up to 14. He said he gets to spend more time with patients, because appointments are longer than they were at his medical group.
At first, Dr. Lauer said he wasn't sure whether his new job would be the right fit. "But I'm now quite happily employed at this small community hospital," he said. "The cardiology clinic keeps getting busier, and we're doing testing that they could never do before. To me, it's very satisfying."
http://www.ama-assn.org/amednews/2010/12/13/bisc1213.htm
16% who state they are considering retiring is a far cry from 1/3 as you stated. Now, if you believe 2.4% of those responding speak for the over 900,000 physicians practing (which is 2379 Physicians speaking for 900,000 or a percentage of 0.2643 %).. well... the math does not add up.
16% of 900000 = 144,000 Physicians who "may" retire. How many of them are baby boomer Physicians whose time have come to retire? Oh wait, your link provides that. Of those who said they planned to retire, 28% are 55 or younger and nearly half (49%) are 60 or younger. Meaning over half, or 51% are 60 and older. 8% = 72000.
One impetus for early physician retirement is the recent steep rise in malpractice insurance rates, which are literally driving physicians out of some states. Further, physicians site managed care, increasing government interference in healthcare and declining reimbursement as other reasons for early retirement. The nurse shortage also is contributing to low physician job satisfaction and the desire to leave medicine. Indeed, some experts believe attrition may cause a net decline in the number of practicing physicians in coming years. The MGT of America, a higher education consulting group, predicts that by 2020, more than 23,000 physicians will retire or die each year, while the number of physicians entering the workforce each year will remain constant at around 16,000 to 17,000, if the medical education system does not change. At present, there is no concerted effort to increase the number of medical graduates. In fact, recent Bush Administration proposals have called for a decrease in funding for medical residency programs.
http://www.newphysician.com/articles/needed_4.html
And that magical number of being 65 for retirement doesnt fit in medicine.
Things look grim for Gil Rodriguez, M.D., vice president of medical affairs at Southwest Washington Medical Center, Vancouver, BC. Already confronted by a doctor shortage, Rodriguez expects to be hit with dozens of physician retirements in the next five years, creating the need for a multimillion-dollar recruitment effort. A number of the retiring doctors will be in their 60s or beyond, an age when no one would begrudge them a gold watch. But others will be much younger, and they’ll shave off years of productive practice when they hang up their stethoscopes.
Early physician retirements constitute a new trend, one that’s being reported by doc recruiters and hospital executives around the country. A decade ago, doctors routinely worked well into their 60s. Not so anymore, at least not as much. Now, Rodriguez and many of his colleagues view any doctor 55 or older as “at risk.”
While the frustrations of managed care take a lot of blame, Michael Whitcomb, M.D., a senior vice president at the Association of American Medical Colleges, says that doctors have started paying attention to investment programs that would allow them to retire early.
(articles date, 2001... looooooooooooong before Obama)
http://www.nejmjobs.org/rpt/early-retirement-physicians.aspx
And, finally, to bring up the point of enrollment in schools... your article stated...
The doctors also told us — 67% to 22%, with 11% not responding — that they expected fewer students to apply for medical school in the future if the plan became law.
Btw, 97.6% of Physicians who were polled by this group never responded in any form.
Data released recently by the Association of American Medical Colleges, or AAMC, show that first-year enrollment at U.S. medical schools in 2008 totaled more than 18,000 students, the highest enrollment in history.
http://www.aafp.org/online/en/home/publications/news/news-now/resident-student-focus/20081119med-school-enroll.html
Despite the nation’s ongoing financial difficulties, early indicators such as the Medical College Admission Test (MCAT®), suggest that next year’s medical school applicant pool will continue to edge upward. From January to August of this year, more than 67,000 individuals took the MCAT exam, a nearly 3 percent increase over 2008.
http://www.physiciansnews.com/2009/10/20/medical-school-enrollment-continues-to-rise-to-meet-physician-need/
Again, your survey does not match reality. Enrollment is up, and schools would enroll more if it werent for that pesky Congressional act limiting the number of residency slots.
The numbers, according to the data, broke down as follows: Black student enrollment grew by 2.9%; American-Indian student enrollment increased nearly 25%; and Hispanic student enrollment was up by 9%. Women made up 47% and men 53% of the incoming 2010 medical class. Altogether, U.S. medical schools received 42,742 applications for the 2010 freshman class compared with 42,269 in 2009.
The total number of first-time applicants in 2010 increased by 2.5%—up to 31,834 applications—over 2009. “The growth in first-time applicants demonstrates that medicine is still a compelling career choice for many individuals,” said AAMC President and CEO Darrell Kirch.
http://www.ethnicmajority.com/wordpress/education/2010/10/medical-schools-make-gains-in-minority-enrollment
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