Payers Can Help with the Joy of Medicine

Physician dissatisfaction is as problematic as escalating healthcare costs, and warrants an all-hands-on-deck approach. For payers, physicians very often are the face of healthcare for their members, meaning that they too have a compelling reason to join the efforts to restore the Joy of Medicine. This is even truer for payers with accountable care organizations (ACOs) and other risk-sharing arrangements that more closely align the goals and expectations of health plans and physicians.

In the nearly 18 months since Geneia released the Physician Misery Index, we have frequently written about the problem of physician dissatisfaction. Geneia surveyed more than 400 physicians who practice medicine full time, and found:

• 84 percent say the amount of quality time they can spend with patients has decreased in the past 10 years

• 67 percent know a physician who is likely to stop practicing medicine in the next five years as the result of physician burnout

• 87 percent say the “business and regulation of healthcare” has changed the practice of medicine for the worse

As physicians’ frustrations with the business of medicine have increased, many more have become hospital and health system employees. More than 200,000 physicians in the U.S. are now employees, and three in four medical residents will start their career as employees of a medical group, hospital or faculty plan.

The Government Accountability Office found the number of hospitals purchasing physician practices nearly doubled from 96,000 to 182,000 between 2007 and 2013, and the number of hospitals directly employing physicians grew from 1,400 to 1,700.

Accenture predicts two-thirds of physicians will be employees by the end of this year, up sharply from 43 percent in 2000. Accenture found the two factors that physicians cited most often as their biggest concern with remaining independent were reimbursement pressures and overhead costs.

The trend of physician employment is largely a reaction to reimbursement changes and the need for infrastructure investments in electronic health records (EHRs) and information technology. A recent Medical Group Management Association report showed that IT spending exceeded $32,000 per physician in 2015.

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