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November 30, 2008

Paging Marcus Welby…

If you could get your doctor to change one thing, what would it be? A reasonable question given today’s healthcare environment. Apparently one that sparked quite a few postings in WSJ’s forum section. It appears some physicians feel more satisfied than others. Some see their profession as a privilege and honor…others are frustrated and disempowered by the corporate-driven machine of healthcare. They miss having the time to talk with their patients, and lament about the seven or eight minute visit managed care has allocated for a routine visit, to quote one anonymous reply, “To see twenty-three patients in a day, not spending enough time with any of them--that’s not why I went to medical school.”

The “Physicians’ Foundation” recently launched a press release regarding a physician career satisfaction survey, a poll that has inspired several national papers to comment. Plenty of figures seemed odd: 45% of respondents (which were mostly primary care physicians) stated they would leave medicine entirely if financially able, 60% said they would not recommend medicine as a career to a young person, and 78% believed there is a shortage of primary care docs, the same percentage indicated that medicine was “less rewarding” or “no longer rewarding”. Hmmm, what was the actual number of respondents? Who paid for this study? I for one could not believe my colleagues would have such a disparaging view.

These statistics generalized by the widespread media, (CNN, the Wall Street Journal, Boston Globe and others) look pretty demoralizing on the surface…but, lets look at the study methodology. First, the study was paid for by the Physicians’ Foundation (an organization founded with monies garnered after a class action lawsuit physicians won against third party payors). Second, the survey was performed by Merritt, Hawkins and Associates (a healthcare consulting and physician recruiting firm). Third, and most importantly, the survey was mailed to 320,000 physicians (only 11,950 responded). Now it stands to reason that the people most likely to post on physician discussion boards, or return surveys such as this are dissatisfied e.g.: an impetus for taking time out to respond (If knowledge serves this error is referred to as responder bias—a huge confounder in most survey-based research)

Wouldn’t it be in the interest of Merritt Hawkins to support the notion of a physician shortage? After all, they are in the business of prostituting physicians (oops I mean recruiting) for hospitals and other healthcare entities. Who is the true benefactor here? All of the percentages listed are extrapolated from 12,000 respondents (less than 3.8% of the total number surveyed…and an even smaller percentage of physicians nationwide) How is this representative of what doctors really think about their career decision, or job satisfaction?

To those who would complain about being a physician, get out…your bitching and moaning about the healthcare crisis is not part of the solution. If you don’t like working for the insurance company, or hospital administration, there are plenty of other opportunities to help patients in non-traditional practice models.

If you build it…they will come. www.insight-psychiatry.com

References:

CNN Video - Family doctor shortage
The Physicians' Foundation - Survey
Bostom.com - The crisis of primary care physicians
www.merritthawkins.com
WSJ - Doctors Feel Gloomy, Financially Strapped

Robin Stone, M.D.
Insight Psychiatry
13123 Rosedale Hill Ave.
Huntersville, NC 28078
704-948-3810

Posted by on November 30, 2008 3:28 PM | Permalink

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