"Tim Devitt, a family physician in rural Wisconsin, took calls on nights and weekends, delivered babies and visited his patients in the hospital," Roni Caryn Rabin writes for Kaiser Health News in The Washington Post. "The stress took a toll, though: He retired six years ago, at 62." There are thousands like him, and that is worsening America's shortage of primary-care physicians, which is particularly acute in some rural areas.
Though physician stress has always been a concern, recent reports and studies show an increase in discontent, particularly among primary-care doctors, Rabin writes: "Tired of working longer and harder because of discounted insurance payments and frustrated by stagnating pay and increasing oversight, many [doctors] are going to work for large groups or hospitals, curtailing their practices or in some cases, abandoning primary care or retiring early, experts say."
"The lack of an adequate primary-care infrastructure in the U.S. is a huge obstacle to creating a high-forming health-care system," said David Blumenthal, president of the Commonwealth Fund, a health-care research foundation. According to a 2012 Urban Institute study of 500 primary-care doctors, 30 percent of those 35 to 49 years old—and 52 percent of those over 50—planned to leave their practices in the next five years.
The doctors are stressed, and the patients are, too; some feel that their physicians don't have enough time to spend on each appointment and even worry about an increase in mistakes. In a 2012 Mayo Clinic survey of more than 7,200 doctors, almost half of those surveyed said they had at least one symptom of burnout. "What drives physician satisfaction is also what patients and payers want: delivering good care. And we're less and less able to do that," said Christine Sinsky, an internist in Dubuque, Iowa. "You spend less time listening to patients, getting to know them and thinking more deeply about their care."
American Board of Internal Medicine President Richard J. Baron wanted to record how much time a doctor spends caring for patients and found out "that on a typical day, he or she handles 18.5 phone calls, reads 16.8 emails, processes a dozen prescription refills (not counting those written during a visit), interprets 19.5 lab reports, reviews 11 imaging reports and reads and follows up on 13.9 reports from specialists," Rabin writes.
A related problem is the new policy about electronic medical records, which many greatly dislike, according to physician Mark Friedberg, a co-author of last year's RAND study. Instead of saving time, many doctors say the new system causes more problems and leaves "little room for the kind of personal, nuanced observation that was captured in an old-fashioned doctor's note," Rabin writes. "Many physicians said to us, 'I used to be a doctor; now I'm a clerk,'" said Jay Crosson, a pediatrician and vice president of professional satisfaction for the AMA. (Read more)
Though physician stress has always been a concern, recent reports and studies show an increase in discontent, particularly among primary-care doctors, Rabin writes: "Tired of working longer and harder because of discounted insurance payments and frustrated by stagnating pay and increasing oversight, many [doctors] are going to work for large groups or hospitals, curtailing their practices or in some cases, abandoning primary care or retiring early, experts say."
"The lack of an adequate primary-care infrastructure in the U.S. is a huge obstacle to creating a high-forming health-care system," said David Blumenthal, president of the Commonwealth Fund, a health-care research foundation. According to a 2012 Urban Institute study of 500 primary-care doctors, 30 percent of those 35 to 49 years old—and 52 percent of those over 50—planned to leave their practices in the next five years.
The doctors are stressed, and the patients are, too; some feel that their physicians don't have enough time to spend on each appointment and even worry about an increase in mistakes. In a 2012 Mayo Clinic survey of more than 7,200 doctors, almost half of those surveyed said they had at least one symptom of burnout. "What drives physician satisfaction is also what patients and payers want: delivering good care. And we're less and less able to do that," said Christine Sinsky, an internist in Dubuque, Iowa. "You spend less time listening to patients, getting to know them and thinking more deeply about their care."
American Board of Internal Medicine President Richard J. Baron wanted to record how much time a doctor spends caring for patients and found out "that on a typical day, he or she handles 18.5 phone calls, reads 16.8 emails, processes a dozen prescription refills (not counting those written during a visit), interprets 19.5 lab reports, reviews 11 imaging reports and reads and follows up on 13.9 reports from specialists," Rabin writes.
A related problem is the new policy about electronic medical records, which many greatly dislike, according to physician Mark Friedberg, a co-author of last year's RAND study. Instead of saving time, many doctors say the new system causes more problems and leaves "little room for the kind of personal, nuanced observation that was captured in an old-fashioned doctor's note," Rabin writes. "Many physicians said to us, 'I used to be a doctor; now I'm a clerk,'" said Jay Crosson, a pediatrician and vice president of professional satisfaction for the AMA. (Read more)
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