No clear trend in pathology industry as to the demand for services versus the supply of pathologists

Healthcare providers often describe themselves at being part of a family of caregivers, and right now, one member, the physician, is under extreme pressure. So much so, experts are calling on other members of the family, such as pathology groups and clinical laboratories, to seek ways to proactively ease the burdens on America’s doctors.

A survey by the Physicians Foundation reveals that 80% of physicians reported being overextended or at capacity, with no time to see additional patients. And the number of physicians considering an early exit from patient-centered roles is increasing. If allowed to continue, such a trend will negatively impact patients’ access to care.

Doctors Lack the Time Necessary to Provide Quality Care

The Physicians Foundation commissioned Merritt Hawkins, a physician search and consulting firm, to conduct the biennial survey. A total of 17,236 US physicians completed the online survey between April 2016 and mid-June 2016.

Here are key findings from the “2016 Survey of America’s Physicians: Practice Patterns and Perspectives:”

• Due to burnout and other factors, 48% of respondents plan to accelerate their retirement plans, move to non-clinical work, or switch to “concierge” medicine or other options—a slight uptick from the foundation’s 2014 survey.

• More than half (54%) of physicians surveyed rate their morale as somewhat or very negative and 49% said they often or always experience feelings of burnout. Physicians point to regulatory/paperwork burdens and loss of clinical autonomy as their primary pain points.

• Only 14% of physicians have the time they need to provide the highest standards of care.

• Only 37% describe their feelings about the future of the medical profession as positive, while more than one-quarter (28.3%) would not choose to be physicians if they had their careers to do over. Nearly half (49.2%) would not recommend medicine as a career to their children.

• Physicians spend 21% of their time on non-clinical paperwork, the equivalent of 168,000 physician FTEs not engaged in clinical activities.

• Only 33% of physicians identify as independent practice owners or partners, down from 48.5% in 2012.

“Many physicians are dissatisfied with the current state of medical practice and are starting to opt out of traditional patient care roles,” stated Walker Ray, MD, President of the Physicians Foundation and Chair of its Research Committee, in a news release. “By retiring, taking non-clinical roles, or cutting back in various other ways, physicians are essentially voting with their feet and leaving the clinical workforce. This trend is to the detriment of patient access. It is imperative that all healthcare stakeholders recognize and begin to address these issues more proactively, to support physicians and enhance the medical practice environment.”

Medical laboratories, for example, could provide enriched diagnostic testing and clinical consultation services to ease doctors’ burdens when selecting tests or when deciding on therapies. Labs also could offer patient monitoring services that would enable physicians to be more productive with less stress.

“It is striking that so many physicians across the US once again took time to respond to our survey, reinforcing key issues, but also bringing to light new challenges,” noted Timothy Norbeck, Chief Executive Officer of the Physicians Foundation. He was quoted in a news release. “Our goal is to educate stakeholders on the rising concerns related to medical practice in order to encourage change that will better the lives of both patients and physicians, ultimately improving the delivery of healthcare for all.”

Physician Martyrdom Contributes to Burnout

Rebekah Bernard, MD, a primary care physician in Fort Myers, Fla., describes what she calls the medical profession’s “martyrdom” problem, which ultimately can lead to burnout and disillusionment.

“Since physicians tend to be highly motivated, intelligent, and resilient, we get away with burning the candle at both ends for a very long time,” she said in a Medical Economics (MedEc) article  “Unfortunately, at some point, we burn so brightly that we burn ourselves out. And when doctors burn out, patients lose.”

Rebekah Bernard, MD, a primary care physician from Fort Myers, Fla., believes the medical profession’s “martyrdom” problem causes physicians to do a poor job caring for themselves. She argues physician self-care is important for patient care, not because burned out doctors do a worse job caring for patients, but because unsatisfied doctors are two to three times as likely to leave clinical practice. (Photo copyright: Medical Economics.)

Rebekah Bernard, MD, a primary care physician from Fort Myers, Fla., believes the medical profession’s “martyrdom” problem causes physicians to do a poor job caring for themselves. She argues physician self-care is important for patient care, not because burned out doctors do a worse job caring for patients, but because unsatisfied doctors are two to three times as likely to leave clinical practice. (Photo copyright: Medical Economics.)

While Bernard found no evidence in medical literature indicating burned out doctors do a poor job caring for patients, she says patients do suffer. She notes physician self-care is important for patient care because unsatisfied physicians are two to three times as likely to leave clinical practice.

“Patients suffer when doctors don’t care for themselves: Because burned-out doctors are doing something that hurts patients more than anything else,” she said in the MedEc article. “We are leaving the practice of medicine, either by leaving medicine entirely, or more heart-wrenchingly, by taking their own lives, with physician suicide claiming the lives of approximately 400 doctors—an entire medical school class—each year.”

This is not the first time physician burnout and dissatisfaction has made headlines. A 2016 study published in Mayo Clinic Proceedings found that high levels of burnout and low professional satisfactions scores led to a reduction in physician work hours. Each one-point increase on a seven-point emotional exhaustion scale correlated to a 43% higher likelihood a physician would reduce their working hours.

Because pathologists do not see patients, they experience a different range of pressures and challenges than most office-based physicians. It would be timely for one of the national pathology associations to conduct a well-designed study of how pathologists view their career prospects in medicine.

—Andrea Downing Peck

Related Information:

2016 Survey of America’s Physicians: Practice Patterns and Perspectives

The Physicians Foundation 2016 Physician Survey

The Problem of Martyrdom in Medicine

Longitudinal Study Evaluating the Association Between Physician Burnout and Changes in Professional Work Effort