Physician Practice Satisfaction: Why We Should Care

Francis J. Crosson and Lawrence Casalino on Health Affairs Blog, May 9th, 2013

In less than nine months millions of Americans will receive new health care coverage through provisions of the Affordable Care Act. Most observers believe that strong physician leadership can help heath care reform succeed, through the optimization of care quality and cost management. But, at the same time, too many American physicians are dissatisfied with current medical practice and unsure of what to do about it. Many would not recommend a career as a physician to their own children.

There are multiple causes for this dissatisfaction where it exists, including unpredictable reimbursement for services, excessive work burden and long hours, and excessive time devoted to non-clinical activities, including “paperwork”.

One possible reaction to physician dissatisfaction is a shrug of one’s shoulders. Most physicians are well paid, compared to most Americans, and are highly respected. We suggest, however, that improving physician practice satisfaction should be important for both patients and policymakers.

The Impact of Physician Dissatisfaction

As the country adapts to the opportunities accelerated by the Affordable Care Act, physician dissatisfaction threatens the success of care delivery and payment reforms. The Commonwealth Fund Commission on a High Performance Health System recently listed ten strategies to improve health care services and save $2 trillion over the next decade. At least seven of these strategies will require the close involvement of practicing physicians in order to succeed.

In addition to the ultimate success of needed delivery system changes, such as major improvements in care coordination and affordability, there are other reasons to improve physician satisfaction with their work. There is very little research on the relationship between physician satisfaction, the quality and cost of care, and patient experience. The limited research that does exist suggests that physician satisfaction is important for patients, not just for physicians.

Patients whose physicians report greater practice satisfaction report significantly greater satisfaction with their care. The Rand Medical Outcomes Study demonstrated a significant positive correlation between physician satisfaction and patient adherence to physician care recommendations among patients with major chronic conditions. The Community Tracking Study survey of over 16,000 practicing U.S physicians found that dissatisfied physicians were 2-3 times more likely to leave medical practice than their more satisfied colleagues. This is not what we need in the face of newly insured patients seeking care services after January 1, 2014.

Increasing Physician Satisfaction

Improving physician satisfaction with medical practice will require efforts from government, payers, and hospitals, in addition to physicians and physician organizations. This work should focus on two specific goals: first, increasing physicians’ sense of influence over their practice environment, so that physicians feel that they are able to “do right” by each of their patients; second, establishing reasonable financial stability for medical practice, while aligning physicians’ financial incentives more closely with broader societal goals.

Read The Full Article for Impacts on Physicians and final conclusions.

CMJ- The burdens imposed on the modern physician by the traditional system of healthcare have many physicians in difficult times, both financially and emotionally. A growing number of physicians have adopted direct pay practice models under concierge medicine and direct primary care as a solution. These alternative models are not for every physician and carry their own set of obstacles, and it is clear change is needed. Dr. Albert Fuchs wrote the article “When it Catches on They Won’t Call it Concierge Medicine”, which is a good piece to review as it adds insight to this subject.

About Concierge Medicine Journal

Concierge Medicine Journal (CMJ) curates breaking concierge medicine news, and editorial opinion on a wide variety of topics relevant to the practice of Concierge Medicine.

One Response to “Physician Practice Satisfaction: Why We Should Care”

  1. Reblogged this on Towards Health Care Justice and commented:
    Very nice article. Concierge medicine can increase physician satisfaction because it eliminates dealing with insurance companies. Individuals who choose to become physicians do so to help sick people get healthier. However, these physicians find themselves swamped with paper work generated by the insurance industry. An average physician practice has to deal with ten of insurance companies. Each company has its own payment schedule, utilization review practices, and bureaucratic rules. The one thing all insurance companies have in common is their habitual delay and denial of physician reimbursement for services already rendered. The Affordable Care Act does nothing to address this problem.

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