3 major reasons American physicians abandon private practice
Updated: Feb 18
I would love to believe that most physicians became doctors because of their love for the practice of medicine and passion for patient care. Unfortunately for many, that love and passion are being challenged by the environment and conditions under which medicine is practiced in the United States.
An Association of American Medical Colleges research indicates there will be a shortage of possibly more than 100,000 Doctors by the year 2030. A number of reasons are advocated for this significant shortage, ranging from population growth, an increase in the number of aging Americans, as well as retirement of practicing doctors.
A fourth reason which I think is alarming is the noticeable impact of fatigue and the dwindling love and passion for the practice of medicine due to the numerous pressures and demands on physicians. Physicians no longer feel comfortable doing what's best for the patient. Fear of litigation is forcing physicians to practice defensive medicine often resulting in patients being exposed to unnecessary costly, invasive and sometimes risky procedures, ultimately hiking up healthcare costs.
Physicians no longer feel comfortable doing what's best for the patient. Fear of litigation is forcing physicians to practice defensive medicine often resulting in patients being exposed to unnecessary costly, invasive and sometimes risky procedures and ultimately hiking up healthcare costs.
Physicians are not trained to run businesses and are feeling mounting pressure to deal with the everyday worries of running a business (Yes, in case you forgot that medical practices are businesses), as well as other unique challenges that come with being a healthcare provider in the United States. As a result many physicians, especially those in private practice are rethinking their choice and some are ditching the practice of medicine, choosing instead to become consultants and hospital administrators.
Here are 3 major reasons I believe are driving American physicians to abandon private practice:
1. RISING COST OF RUNNING INDEPENDENT MEDICAL PRACTICES
This is considered to be among the most challenging problems physicians in private practice face. According to an article published by Medical economics in December 2018, titled "What's ruining medicine for physicians: Rising staff and overhead costs?", a 2018 Medical Group Management Association (MGMA) report found that since 2013, the median operating costs for primary care practices rose by 13 percent. Physicians are struggling to figure out how to deal with the rising cost of maintaining staff-Nurses, front desk, insurance verification, billing and coding as well as hiring consultants to help keep up with everchanging regulatory requirements and dwindling reimbursement rates.
High liability concerns and accompanying liability insurance rates also add to the costs, driving many physicians to abandon common sense evidence-based medicine.
2. INCREASING REQUIREMENTS TO USE EMR SYSTEMS FOR DOCUMENTATION
Electronic Medical Record (EMR) systems are becoming a requirement for "appropriate" documentation and maintenance of patient records. It's not a secret that using EMR's is very time-consuming and takes up too much of a physician's work day. It doesn't matter the brand of the EMR software, physicians just hate that they spend less time with their patients and more time consulting and documenting in electronic charts. Worst of all, they have a limited window to document in the EMR or they could be denied payment for services provided. EMR systems are not cheap either and for the most part are not user-friendly and require use of specific key words to receive optimal reimbursements.
3. PHYSICIAN BURNOUT
Physician burnout constitutes a strong reason physicians abandon the practice of medicine. Medscape National Physician burnout and depression report for 2018
found that among 15,000 respondents, 42% reported burnout while 15% admitted experiencing some form of depression. Rather than become a danger to themselves and their patients, some physicians opt to leave private practice for less-stressful jobs.
To encourage the transition to consulting and management positions, some business schools like IUPUI's Kelley Business School have created MBA degrees specifically for Physicians.
According to the American Association of Medical Colleges (AAMC), "the United States will see a shortage of up to nearly 122,000 physicians by 2032 as demand for physicians continues to grow faster than supply". I believe this is a conservative assessment as this does not factor in the number of physicians leaving the practice of medicine.
To remain in private practice, physicians must find ways to reduce operational cost and increase revenue. One of the best ways to increase revenue is to incorporate inhouse imaging services. Apart from increasing revenue, it also ensures continuity and timely life-saving care that ultimately improves quality of life and outcomes for patients. Vivid Diagnostic Imaging offers in-office Nuclear imaging services designed to empower physicians to focus on what they do best - patient care, while we provide them the critical information they need to take the guesswork out of diagnosis and treatment.
It is my hope that more organized effort will be made to address the issues highlighted in this article, as failure to do so will only exacerbate the already struggling and deteriorating American Healthcare delivery system.